76499 — Unlisted Diagnostic Radiographic Procedure
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Unlisted diagnostic radiographic procedure (OTHER 76499) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/76499?code_type=OTHER
MLA (9th ed.)
“Unlisted diagnostic radiographic procedure (OTHER 76499) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/76499?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“Unlisted diagnostic radiographic procedure (OTHER 76499) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/76499?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $83–$237 (25th–75th percentile) across 48 hospitals · 188 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 76499 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| CLARION HOSPITAL Outpatient | Upmc | Chip | $11.56 | — | — | 2026-05-23 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Upmc | Chip | $11.56 | — | — | 2026-05-13 | MRF ↗ |
| PROVIDENT HOSPITAL OF CHICAGO Both | Aetna | Hmo | $13.80 | $199.99 | $139.99 | 2026-05-22 | MRF ↗ |
| JOHN H STROGER JR HOSPITAL Both | Aetna | Hmo | $13.80 | $199.99 | $139.99 | 2026-05-14 | MRF ↗ |
| JOHN H STROGER JR HOSPITAL Both | Aetna | Ppo | $13.80 | $199.99 | $139.99 | 2026-05-14 | MRF ↗ |
| PROVIDENT HOSPITAL OF CHICAGO Both | Aetna | Ppo | $13.80 | $199.99 | $139.99 | 2026-05-22 | MRF ↗ |
| NEW LONDON HOSPITAL Outpatient | Granite State Health Plan | New Hampshire Healthy Families - Nh Managed Medicaid | — | — | — | 2026-05-23 | MRF ↗ |
| NEW LONDON HOSPITAL Outpatient | Wellsense Health Plan | Wellsense - Nh Managed Medicaid | — | — | — | 2026-05-23 | MRF ↗ |
| NEW LONDON HOSPITAL Outpatient | Amerihealth Caritas Nh | Amerihealth Caritas - Nh Managed Medicaid | — | — | — | 2026-05-23 | MRF ↗ |
| Wayne Medical Center Outpatient | Unitedhealthcare | Medicaid | $22.94 | — | — | 2026-05-13 | MRF ↗ |
| Wayne Medical Center Outpatient | Unitedhealthcare | Medicaid | $22.94 | — | — | 2026-05-23 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | United Healthcare | Uhc Community Tenncare | $25.96 | — | — | 2026-05-13 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | Aetna | Commercial | — | — | — | 2026-05-24 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | Aetna | Commercial | — | — | — | 2026-05-13 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | Coventry | Hmo/Pos/Ppo | — | — | — | 2026-05-13 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | Coventry | Hmo/Pos/Ppo | — | — | — | 2026-05-24 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | United Healthcare | Uhc Community Tenncare | $25.96 | — | — | 2026-05-24 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Centercare Aetna | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Oh Network | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Plan Vista | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Centercare | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Anthem | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Comm Care | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Multiplan-Phcs | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Uhc Plan 2 | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Anthem Pathways Hmo | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Passport Molina Mco | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Humana Mco | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Centercare Cigna | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Uhc Options Ppo | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | United Mco | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Coventry 1St Health | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Aetna Better Health Mco | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Encore | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Sagamore | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Wellcare Mco | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Anthem Pathways Hpn | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Beech Street | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Great West | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Ccn 1Source | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| OWENSBORO HEALTH REGIONAL HOSPITAL Both | Uhc Plan 1 | All Plans | — | $131.04 | $85.18 | 2026-05-08 | MRF ↗ |
| MARSHALL MEDICAL CENTER Outpatient | Unitedhealthcare | Medicaid | $28.68 | — | — | 2026-05-08 | MRF ↗ |
| MARSHALL MEDICAL CENTER Outpatient | Humana | Commercial | — | — | — | 2026-05-08 | MRF ↗ |
| MARSHALL MEDICAL CENTER Outpatient | Aetna | Whole Health & Vhan | — | — | — | 2026-05-08 | MRF ↗ |
| ST CLAIR HOSPITAL Both | Upmc | Upmc Advantage � Premium Network (Bronze/Silver/Gold/Platinum) | $38.95 | $220.00 | $53.15 | 2026-05-23 | MRF ↗ |
| ST CLAIR HOSPITAL Both | Upmc | Upmc First Care | $38.95 | $220.00 | $53.15 | 2026-05-13 | MRF ↗ |
| ST CLAIR HOSPITAL Both | Upmc | Upmc My Care Advantage | $38.95 | $220.00 | $53.15 | 2026-05-13 | MRF ↗ |
| ST CLAIR HOSPITAL Both | Upmc | Upmc My Care Advantage | $38.95 | $220.00 | $53.15 | 2026-05-23 | MRF ↗ |
| ST CLAIR HOSPITAL Both | Upmc | Upmc Total Advantage | $38.95 | $220.00 | $53.15 | 2026-05-23 | MRF ↗ |
| ST CLAIR HOSPITAL Both | Upmc | Upmc First Care | $38.95 | $220.00 | $53.15 | 2026-05-23 | MRF ↗ |
| ST CLAIR HOSPITAL Both | Upmc | Upmc Health Plan (Individual/Employer Provided) | $38.95 | $220.00 | $53.15 | 2026-05-13 | MRF ↗ |
| ST CLAIR HOSPITAL Both | Upmc | Upmc Advantage � Premium Network (Bronze/Silver/Gold/Platinum) | $38.95 | $220.00 | $53.15 | 2026-05-13 | MRF ↗ |
| ST CLAIR HOSPITAL Both | Upmc | Upmc Health Plan (Individual/Employer Provided) | $38.95 | $220.00 | $53.15 | 2026-05-23 | MRF ↗ |
| ST CLAIR HOSPITAL Both | Upmc | Upmc Total Advantage | $38.95 | $220.00 | $53.15 | 2026-05-13 | MRF ↗ |
| ST. GEORGE REGIONAL HOSPITAL | Medicaid Az Blue Cross Blue Shield Ahcccs - Inpatient/Outpatient | — | $41.85 | $113.12 | $84.84 | 2026-07-17 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $45.14 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $45.14 | — | — | 2026-05-23 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | Priority Health | Mi Medicaid | $49.44 | — | — | 2026-05-13 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | Uhc | Mi Medicaid | $49.44 | — | — | 2026-05-13 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | Mclaren | Mi Medicaid | $49.44 | — | — | 2026-05-13 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | Aetna | Mi Medicaid | $49.44 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mclaren (Mi | Mi Medicaid | $49.44 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hhw | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hcc | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hhw Bh | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hip | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hcc Bh | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hip Bh | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mdwise | In Medicaid Hhw | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mdwise | In Medicaid Hip | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Caresource | In Medicaid Hip | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Caresource | In Medicaid Hhw | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hhw | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | Pathways For Aging | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hip | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hcc | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Humana | Pathways For Aging | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Uhc | Mi Medicaid | $49.44 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Uhc | Pathways For Aging | — | — | — | 2026-05-13 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | Molina | Mi Medicaid | $49.44 | — | — | 2026-05-13 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Upmc | Commercial | $50.86 | — | — | 2026-05-23 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Upmc | Commercial | $50.86 | — | — | 2026-05-13 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | Wellpoint | Wellpoint Tenncare | $53.66 | — | — | 2026-05-24 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | Wellpoint | Wellpoint Tenncare | $53.66 | — | — | 2026-05-13 | MRF ↗ |
| NORTHWEST TEXAS HOSPITAL Both | United Healthcare | Managed Care | $58.87 | $305.00 | $122.00 | 2026-05-08 | MRF ↗ |
| ST LUKE'S HOSPITAL AT THE VINTAGE | Medicaid|Texas Childrens (Tch)|Starkids | — | $60.80 | $207.00 | $72.45 | 2026-07-30 | MRF ↗ |
| ST LUKE'S SUGAR LAND HOSPITAL | Medicaid|Texas Childrens (Tch)|Starkids | — | $60.80 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| Baylor St Lukes Medical Center | Medicaid|United|Chip | — | $60.80 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| CHI ST LUKES LAKESIDE HOSPITAL | Medicaid|Texas Childrens (Tch)|Starkids | — | $60.80 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| Baylor St Lukes Medical Center | Medicaid|Texas Childrens (Tch)|Starkids | — | $60.80 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| ST LUKE'S THE WOODLANDS HOSPITAL | Medicaid|Texas Childrens (Tch)|Starkids | — | $60.80 | $207.00 | $72.45 | 2026-07-30 | MRF ↗ |
| NORTHWEST TEXAS HOSPITAL Both | First Care Star | Medicaid | $60.80 | $305.00 | $122.00 | 2026-05-08 | MRF ↗ |
| METHODIST JENNIE EDMUNDSON | Clover Health Medicare Advantage | — | $61.64 | $134.00 | $40.20 | 2026-07-30 | MRF ↗ |
| CHI ST LUKES LAKESIDE HOSPITAL | Medicaid|United|Starplus | — | $62.62 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| ST LUKE'S THE WOODLANDS HOSPITAL | Medicaid|United|Starkids | — | $62.62 | $207.00 | $72.45 | 2026-07-30 | MRF ↗ |
| CHI ST LUKES LAKESIDE HOSPITAL | Medicaid|Amerigroup|Chip | — | $62.62 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| ST LUKE'S SUGAR LAND HOSPITAL | Medicaid|United|Chip | — | $62.62 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| ST LUKE'S HOSPITAL AT THE VINTAGE | Medicaid|United|Chip | — | $62.62 | $207.00 | $72.45 | 2026-07-30 | MRF ↗ |
| ST LUKE'S HOSPITAL AT THE VINTAGE | Medicaid|United|Starkids | — | $62.62 | $207.00 | $72.45 | 2026-07-30 | MRF ↗ |
| Baylor St Lukes Medical Center | Medicaid|Amerigroup|Starkids | — | $62.62 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| ST LUKE'S SUGAR LAND HOSPITAL | Medicaid|Amerigroup|Chip | — | $62.62 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| Baylor St Lukes Medical Center | Medicaid|United|Starkids | — | $62.62 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| Baylor St Lukes Medical Center | Medicaid|Amerigroup|Chip | — | $62.62 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| ST LUKE'S SUGAR LAND HOSPITAL | Medicaid|United|Starkids | — | $62.62 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| ST LUKE'S HOSPITAL AT THE VINTAGE | Medicaid|Amerigroup|Starkids | — | $62.62 | $207.00 | $72.45 | 2026-07-30 | MRF ↗ |
| ST LUKE'S THE WOODLANDS HOSPITAL | Medicaid|United|Chip | — | $62.62 | $207.00 | $72.45 | 2026-07-30 | MRF ↗ |
| ST LUKE'S THE WOODLANDS HOSPITAL | Medicaid|Amerigroup|Chip | — | $62.62 | $207.00 | $72.45 | 2026-07-30 | MRF ↗ |
| CHI ST LUKES LAKESIDE HOSPITAL | Medicaid|Amerigroup|Starkids | — | $62.62 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| ST LUKE'S SUGAR LAND HOSPITAL | Medicaid|Amerigroup|Starkids | — | $62.62 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| ST LUKE'S THE WOODLANDS HOSPITAL | Medicaid|Amerigroup|Starkids | — | $62.62 | $207.00 | $72.45 | 2026-07-30 | MRF ↗ |
| ST LUKE'S HOSPITAL AT THE VINTAGE | Medicaid|Amerigroup|Chip | — | $62.62 | $207.00 | $72.45 | 2026-07-30 | MRF ↗ |
| CHI ST LUKES LAKESIDE HOSPITAL | Medicaid|United|Starkids | — | $62.62 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| CHI ST LUKES LAKESIDE HOSPITAL | Medicaid|United|Chip | — | $62.62 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| METHODIST JENNIE EDMUNDSON | Bcbs Select Blue Choice | — | $63.78 | $134.00 | $40.20 | 2026-07-30 | MRF ↗ |
| ST LUKE'S THE WOODLANDS HOSPITAL | Medicaid|Bcbs - Tx|All Plans | — | $63.84 | $207.00 | $72.45 | 2026-07-30 | MRF ↗ |
| ST LUKE'S HOSPITAL AT THE VINTAGE | Medicaid|Bcbs - Tx|All Plans | — | $63.84 | $207.00 | $72.45 | 2026-07-30 | MRF ↗ |
| Baylor St Lukes Medical Center | Medicaid|Bcbs - Tx|All Plans | — | $63.84 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| CHI ST LUKES LAKESIDE HOSPITAL | Medicaid|Bcbs - Tx|All Plans | — | $63.84 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| ST LUKE'S SUGAR LAND HOSPITAL | Medicaid|Bcbs - Tx|All Plans | — | $63.84 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| NORTHWEST TEXAS HOSPITAL Both | Molina | Medicaid | $65.88 | $305.00 | $122.00 | 2026-05-08 | MRF ↗ |
| METHODIST JENNIE EDMUNDSON | Aetna - Nhn Narrow Network | — | $67.00 | $134.00 | $40.20 | 2026-07-30 | MRF ↗ |
| METHODIST JENNIE EDMUNDSON | Oscar Health | — | $67.00 | $134.00 | $40.20 | 2026-07-30 | MRF ↗ |
| NORTHWEST TEXAS HOSPITAL Both | Aetna | Managed Care | $67.10 | $305.00 | $122.00 | 2026-05-08 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | Optum/Uhc Kidney Transplant | Tenncare | $67.20 | — | — | 2026-05-13 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | Optum/Uhc Kidney Transplant | Tenncare | $67.20 | — | — | 2026-05-24 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Selecthealth Med Network - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Cigna Healthcare Oap - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Student Resources - Uhc - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Cigna - Apwu Oap - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Selecthealth Chip - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Sierra Health And Life - Uhc - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Selecthealth Value Network - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Cigna - Apwu Ppo - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Healthscope Benefits - Uhc - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Golden Rule - Uhc One - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Cbsa Aetna Standard Network - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Chip Molina Healthy Kids - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Aetna Utah Connected Care Network - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Ushealth Group Freedom Life Uhc - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | United Healthcare - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Cigna Healthcare Localplus - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Selecthealth St. Luke'S Ppo - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Selecthealth Share Network - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Selecthealth Value Network Individual - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Selecthealth Med Network Individual - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Selecthealth Med Network Federal Employee - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Uhc Medica Choice Plus - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Umr United Healthcare Choice Network - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Selecthealth Care Network - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Cigna Healthcare Ppo - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Humana - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Meritain Health - Aetna Ut Connected Care Ntwk - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Aetna Signature Administrators Standard Network - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Umr United Healthcare Options Ppo - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Humana One Ppo - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Molina Marketplace - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Great West Cigna - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Uhc All Savers - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Cigna Healthcare Utah Connect - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Aetna Standard Network - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Aetna Global Benefits Standard Network - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Surest - Uhc Choice Plus - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Cigna Healthcare Hmo - Inpatient | — | $67.79 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| Baylor St Lukes Medical Center | Commercial|Bcbs - Tx|Myblue Health Exchange | — | $68.87 | $207.00 | $72.45 | 2026-07-31 | MRF ↗ |
| METHODIST FREMONT HEALTH | Oscar Health | — | $69.01 | $138.02 | $51.07 | 2026-07-30 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Regence Group Administrators - Inpatient | — | $69.70 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Regence Blue Cross Out Of State - Inpatient | — | $69.70 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Regence Blue Cross Out Of State Ppo - Inpatient | — | $69.70 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Regence Blue Cross Valuecare Ppo - Inpatient | — | $69.70 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Regence Blue Cross Traditional - Inpatient | — | $69.70 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Regence Blue Cross Federal - Inpatient | — | $69.70 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Regence Blue Shield Idaho - Ut Services - Inpatient | — | $69.70 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| PRIMARY CHILDREN'S HOSPITAL | Regence Preferred Blue Option - Inpatient | — | $69.70 | $95.48 | $71.61 | 2026-07-17 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Aetna Better Health | Medicaid Aetna Better Health | $70.48 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Youth Care | Medicaid Youth Care | $70.48 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Illinois | Medicaid Illinois | $70.48 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Countycare Claims | Medicaid Countycare Claims | $70.48 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Health Alliance | Medicaid Health Alliance | $70.48 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Blue Cross Community Family Health Plan Xxl / Xog | Medicaid Blue Cross Community Family Health Plan Xxl / Xog | $70.48 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Humana Health Plan | Medicaid Humana Health Plan | $70.48 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Molina | Medicaid Molina | $70.48 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Illinois | Medicaid Illinois | $70.48 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Meridian | Medicaid Meridian | $70.48 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Wellcare | Medicaid Wellcare | $70.48 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Countycare Claims | Medicaid Countycare Claims | $70.48 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Youth Care | Medicaid Youth Care | $70.48 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Wellcare | Medicaid Wellcare | $70.48 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Blue Cross Community Family Health Plan Xxl / Xog | Medicaid Blue Cross Community Family Health Plan Xxl / Xog | $70.48 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Meridian | Medicaid Meridian | $70.48 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Aetna Better Health | Medicaid Aetna Better Health | $70.48 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Molina | Medicaid Molina | $70.48 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Health Alliance | Medicaid Health Alliance | $70.48 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid Humana Health Plan | Medicaid Humana Health Plan | $70.48 | — | — | 2026-05-24 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | United Healthcare | Nexus Aco Oap | $71.68 | — | — | 2026-05-24 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | United Healthcare | Tn Individual Exchange Benefit | $71.68 | — | — | 2026-05-24 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | United Healthcare | Tn Individual Exchange Benefit | $71.68 | — | — | 2026-05-13 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | United Healthcare | Core | $71.68 | — | — | 2026-05-13 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | United Healthcare | Nexus Aco Oap | $71.68 | — | — | 2026-05-13 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | United Healthcare | Heritage Select | $71.68 | — | — | 2026-05-13 | MRF ↗ |
| UNIVERSITY HEALTH SYSTEM, INC Outpatient | United Healthcare | Commercial | $71.68 | — | — | 2026-05-13 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.