81696 — Eculizumab 300 Mg/30 Ml Soln 30 Ml Vial
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Eculizumab 300 mg/30 mL Soln 30 mL Vial (CDM 81696) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/81696?code_type=CDM
MLA (9th ed.)
“Eculizumab 300 mg/30 mL Soln 30 mL Vial (CDM 81696) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/81696?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“Eculizumab 300 mg/30 mL Soln 30 mL Vial (CDM 81696) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/81696?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $560–$61,058 (25th–75th percentile) across 19 hospitals · 153 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 81696 — 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 |
|---|---|---|---|---|---|---|---|
| BRIDGEPORT HOSPITAL Both | Harvard Pilgrim | All Plans | $3.30 | $32,614.95 | $16,633.62 | 2025-01-10 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior Health | STAR | $8.04 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior Health | CHIP | $8.04 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior Health | STARKids | $8.04 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior Health | CHPFC | $8.04 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior Health | STARPLUS | $8.04 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Amerigroup | CHIPBH | $18.76 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Community First | CHIP | $18.76 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Amerigroup | CHIP | $18.76 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Community First | MCDSTAR | $18.76 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Amerigroup | MCD | $18.76 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Amerigroup | MCDBH | $18.76 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Imperial Insurance | MCRPFFS | $25.46 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Imperial Insurance | DualEligible | $25.46 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Imperial Insurance | MCRPPO | $25.46 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Imperial Insurance | MCRPOS | $25.46 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Imperial Insurance | MCRHMO | $25.46 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Imperial Insurance | MCRSNP | $25.46 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Oscar | POS | $26.80 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Oscar | PPO | $26.80 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Oscar | BroadNetworkHIX | $26.80 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Oscar | EPO | $26.80 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Molina | QHP | $33.50 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | United | OptionsPPO | $34.57 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Aetna | QHPHIX | $35.78 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Cigna | NBN | $39.80 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Cigna Lifesource | COMM | $41.54 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Community First Health Plans | COMM | $41.54 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | MBH | $41.67 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Healthcare Highways | NarrowNetwork | $42.08 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | TRAD | $42.75 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Focus Health Solutions | COMM | $42.88 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Cigna | OpenAccessPlus | $44.62 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Humana | PPO | $45.05 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Humana | HMO | $45.05 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Valenz | COMM | $46.90 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior | AmbetterValueHMO | $46.90 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Aetna | NarrowNetwork | $48.78 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | HPN | $50.38 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | EPO | $50.38 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | BAV | $50.52 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Evry Health | Broad | $50.65 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior | AmbetterHMO | $50.92 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior | AmbetterEPO | $50.92 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Aetna | NewBusinessRates | $52.39 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Cigna | PPO | $54.00 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Aetna | CommercialBaseNetwork | $54.00 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | First Health | COMM | $59.50 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Fidelis SecureCare | MGMCR | $60.30 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | HMO | $61.24 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Aetna | OON | $63.38 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | EPOSOA | $64.05 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Emerging Therapy Solutions | MCR | $64.32 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | BCBS | PPO | $66.73 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Texas Healthcare Foundation HEB | HEBEmployee | $67.00 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | TX Healthcare Foundation | PPO | $67.00 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | National ChoiceCare | WORKERSCOMP | $67.00 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Aetna | ASA | $68.61 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Independent Medical Systems | PPO | $73.70 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Physician Cooperative of Texas | WORKERSCOMP | $73.70 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | HealthSmart Preferred Care | Accel | $73.70 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | HAA Preferred Partners | LOGOV | $80.40 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | San Antonio Employers Health Alliance | PPO | $80.40 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Coastal Comp Health Networks | WORKERSCOMP | $87.10 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | National Healthcare Solutions | PPO | $87.10 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | PHCS | PrimaryPPO | $89.78 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | MultiPlan, Inc. | PRIMARYPPO | $89.78 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | TML Intergovernmental EBP | PPO | $93.80 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Emerging Therapy Solutions | COMM | $96.48 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | TriWest Health Alliance | TRICARE | $100.50 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | MultiPlan, Inc. | COMPLEMENTARYPPO | $100.50 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | PHCS | Complimentary | $100.50 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | TriWest VA PCCC | FEDERAL | $100.50 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Admar Corporation | EPO | $107.20 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Admar Corporation | PPO | $107.20 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Blue Bell | PPO | $107.20 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | DirectCare America | PPO | $107.20 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | United Payors United Providers | PPO | $107.20 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | USA Managed Care | PPO | $107.20 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Managed Healthcare | PPO | $113.90 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | MedicalControl | PPO | $113.90 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Galaxy Health Network | COMM | $113.90 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Optum | MCD | $134.00 | $134.00 | $134.00 | 2025-01-01 | MRF ↗ |
| SHERMAN OAKS HOSPITAL Outpatient | Keenan | Keenan | $178.80 | $596.00 | — | 2024-12-19 | MRF ↗ |
| PORTSMOUTH REGIONAL HOSPITAL Outpatient | AmeriHealth Caritas | MCD | $199.70 | $4,847.00 | $4,847.00 | 2026-03-01 | MRF ↗ |
| PORTSMOUTH REGIONAL HOSPITAL Outpatient | AmeriHealth Caritas | MCD | $199.70 | $4,847.00 | $4,847.00 | 2026-03-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | Anthem BCBS | MGMCD | $214.69 | $3,067.00 | $3,067.00 | 2024-10-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | Molina | MCD | $214.69 | $3,067.00 | $3,067.00 | 2024-10-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | United | MGMCD | $214.69 | $3,067.00 | $3,067.00 | 2024-10-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | Humana CareSource | MGMCD | $216.84 | $3,067.00 | $3,067.00 | 2024-10-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | Anthem BCBS | MGMCD | $225.12 | $3,216.00 | $3,216.00 | 2026-03-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | Molina | MCD | $225.12 | $3,216.00 | $3,216.00 | 2026-03-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | United | MGMCD | $225.12 | $3,216.00 | $3,216.00 | 2026-03-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | Humana CareSource | MGMCD | $227.37 | $3,216.00 | $3,216.00 | 2026-03-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | SMARTHEALTH | 1129_SMARTHEALTH EMPLOYEES 20221001 | $266.27 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | ANTHEM PATHWAYS | 1121_ANTHEM PATHWAYS 20221001 | $279.92 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| SHERMAN OAKS HOSPITAL Outpatient | Health Net Of CA | Health Net Of CA Commercial | $303.96 | $596.00 | — | 2024-12-19 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | UNITED HEALTH CARE | 1282_UNITED HEALTH CARE 20250701 | $319.81 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | SEHN | 1171_SEHN 20241001 | $319.81 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | WEA TRUST SELECT POS | 431_WEA TRUST SELECT POS MIL 20180201 | $339.00 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | WEA TRUST PPO | 1164_WEA TRUST PPO MIL 20241001 | $339.00 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | SEHN | 1171_SEHN 20241001 | $341.37 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Both | NETWORK HEALTH PLAN | 1136_NETWORK HEALTH PLAN 20221001 | $341.37 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | UNITED HEALTH CARE | 1282_UNITED HEALTH CARE 20250701 | $341.37 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | HUMANA WVN | 1135_HUMANA WVN 20221001 | $355.02 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | ANTHEM BLUE CONNECTION | 1117_ANTHEM BLUE CONNECTION 20221001 | $355.02 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | WEA TRUST SELECT POS | 431_WEA TRUST SELECT POS MIL 20180201 | $361.85 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | SEHN C89 | 1128_SEHN 20221001 | $361.85 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | WEA TRUST PPO | 1164_WEA TRUST PPO MIL 20241001 | $361.85 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | MOLINA MARKETPLACE | 1162_MOLINA MARKETPLACE MIL 20241001 | $377.38 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | ANTHEM HMO POS | 1120_ANTHEM HMO POS 20221001 | $395.99 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| PORTSMOUTH REGIONAL HOSPITAL Outpatient | Well Sense Health Plan | MCD | $396.48 | $4,847.00 | $4,847.00 | 2026-03-01 | MRF ↗ |
| PORTSMOUTH REGIONAL HOSPITAL Outpatient | Well Sense Health Plan | MCD | $396.48 | $4,847.00 | $4,847.00 | 2026-03-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | WEA PPP | 204_WEA PPP 20160101 | $402.82 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | MOLINA MARKETPLACE | 1162_MOLINA MARKETPLACE MIL 20241001 | $402.82 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | Coventry Cares | MCD | $429.38 | $3,067.00 | $3,067.00 | 2024-10-01 | MRF ↗ |
| HENRICO DOCTORS' HOSPITAL Outpatient | Cigna | IFP | $439.30 | $3,072.00 | $3,072.00 | 2026-03-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | TRILOGY | 1271_TRILOGY 20250701 | $441.34 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | NEHA ASCENSION ONLY | 820_NEHA ASCENSION ONLY 20220101 | $447.73 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | NEHA LIMITED | 821_NEHA LIMITED 20220101 | $447.73 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | Coventry Cares | MCD | $450.24 | $3,216.00 | $3,216.00 | 2026-03-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | CENTIVO | 1125_CENTIVO 20221001 | $457.44 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| HENRICO DOCTORS' HOSPITAL Outpatient | Aetna | MGMCR | $460.80 | $3,072.00 | $3,072.00 | 2026-03-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | TRILOGY | 1271_TRILOGY 20250701 | $471.09 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | WPS | 1132_WISCONSIN PHYSICIAN SERVICES MCWI OCWI 20221001 | $471.09 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | Prime Health | WORKERSCOMP | $473.54 | $3,067.00 | $3,067.00 | 2024-10-01 | MRF ↗ |
| SHERMAN OAKS HOSPITAL Outpatient | Anthem Blue cross | Anthem Blue Cross Exchange - Non-Contracted | $476.80 | $596.00 | — | 2024-12-19 | MRF ↗ |
| SHERMAN OAKS HOSPITAL Outpatient | Aetna | Aetna Commercial - Non-Contracted | $476.80 | $596.00 | — | 2024-12-19 | MRF ↗ |
| SHERMAN OAKS HOSPITAL Outpatient | Anthem Blue cross | Anthem Blue Cross Commercial - Non-Contracted | $476.80 | $596.00 | — | 2024-12-19 | MRF ↗ |
| SHERMAN OAKS HOSPITAL Outpatient | Non-Contracted Commercials - 80% of BC | Non-Contracted Commercials - 80% of BC | $476.80 | $596.00 | — | 2024-12-19 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | AETNA | 567_AETNA 20190701 | $477.92 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | ARISE | 1123_ARISE PREMIER MCWI OCWI 20221001 | $477.92 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | NEHA LIMITED | 821_NEHA LIMITED 20220101 | $477.92 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | NEHA ASCENSION ONLY | 820_NEHA ASCENSION ONLY 20220101 | $477.92 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | FIRST HEALTH NETWORK | 1290_FIRST HEALTH 20240101 SJWI FNWI MWWI | $479.71 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | AETNA | 1279_AETNA MIL 20250701 | $492.51 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | TRILOGY | 1070_TRILOGY 20220101 | $498.40 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | FIRST HEALTH NETWORK | 1290_FIRST HEALTH 20240101 SJWI FNWI MWWI | $512.05 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | Prime Health | WORKERSCOMP | $516.17 | $3,216.00 | $3,216.00 | 2026-03-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | HEALTH PAYMENT SYSTEMS | 1126_HEALTH PAYMENT SYSTEMS 20221001 | $518.88 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | FIRST HEALTH NETWORK | 1291_FIRST HEALTH 20240101 EMWI | $524.49 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | WEA PROVIDER AND POS | 434_WEA PROVIDER AND POS MIL 20180201 | $524.49 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | AETNA | 1279_AETNA MIL 20250701 | $525.71 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | ELAP | COMM | $549.83 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | ANTHEM PPO | 1122_ANTHEM PPO 20221001 | $553.02 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | HEALTH EOS/MULTIPLAN | 1015_HEALTH EOS/MULTIPLAN 20230701 | $556.47 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | PARADIGM NETWORK | 580_PARADIGM NETWORK 20161001 | $559.85 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | FIRST HEALTH NETWORK | 1292_FIRST HEALTH 20240101 SFWI | $559.85 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | WEA PROVIDER AND POS | 434_WEA PROVIDER AND POS MIL 20180201 | $559.85 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| CATHOLIC MEDICAL CENTER Outpatient | AmeriHealth Caritas | MCD | $568.88 | $5,021.00 | $5,021.00 | 2026-03-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | NEHA PPO ON/NEAR SITE | 390_NEHA PPO ON/NEAR SITE 20180701 | $569.26 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | NEHA PPO BROAD | 388_NEHA PPO BROAD 20180701 | $569.26 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | NEHA PPO | 989_NEHA PPO BROAD MCWI 20210101 | $573.50 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| HENRICO DOCTORS' HOSPITAL Outpatient | Lifeworks | MCR | $583.68 | $3,072.00 | $3,072.00 | 2026-03-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | WEA POS | 539_WEA POS 20090101 | $587.16 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | HEALTH EOS/MULTIPLAN | 1015_HEALTH EOS/MULTIPLAN 20230701 | $593.98 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Outpatient | HEALTH EOS/MULTIPLAN WC | 1016_HEALTH EOS/MULTIPLAN (WORKERS COMP) 20230701 | $601.24 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Outpatient | WEA | 419_WEA 20090116 | $607.64 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | NEHA PPO ON/NEAR SITE | 390_NEHA PPO ON/NEAR SITE 20180701 | $607.64 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | NEHA PPO BROAD | 388_NEHA PPO BROAD 20180701 | $607.64 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| HENRICO DOCTORS' HOSPITAL Outpatient | United | OptionsPPO | $638.98 | $3,072.00 | $3,072.00 | 2026-03-01 | MRF ↗ |
| Ascension SE Wisconsin Hospital - Elmbrook Campus Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $639.62 | $639.62 | $339.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Outpatient | HEALTH EOS/MULTIPLAN WC | 1016_HEALTH EOS/MULTIPLAN (WORKERS COMP) 20230701 | $641.78 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| HENRICO DOCTORS' HOSPITAL Outpatient | Cigna | PPO | $645.12 | $3,072.00 | $3,072.00 | 2026-03-01 | MRF ↗ |
| HENRICO DOCTORS' HOSPITAL Outpatient | Cigna | HMO | $645.12 | $3,072.00 | $3,072.00 | 2026-03-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | Sterling Life Insurance | MCR | $649.00 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | Cigna | IFPLP | $661.98 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| HENRICO DOCTORS' HOSPITAL Outpatient | Universal Healthcare Group | MCR | $675.84 | $3,072.00 | $3,072.00 | 2026-03-01 | MRF ↗ |
| ASCENSION COLUMBIA ST MARYS HOSPITAL MILWAUKEE Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $682.74 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| ASCENSION ST FRANCIS HOSPITAL Both | CDM DEFAULT - NON-NEGOTIATED RATE | CDM DEFAULT - NON-NEGOTIATED RATE | $682.74 | $682.74 | $361.85 | 2026-01-01 | MRF ↗ |
| CATHOLIC MEDICAL CENTER Outpatient | Well Sense Health Plan | MCD | $702.94 | $5,021.00 | $5,021.00 | 2026-03-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | PEHP | Exclusive | $716.50 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| FRISBIE MEMORIAL HOSPITAL Outpatient | AmeriHealth Caritas | MCD | $721.99 | $8,762.00 | $8,762.00 | 2026-03-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | Bright Health | HIX | $726.88 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | Cigna | OAPNBN | $747.65 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | Aetna | PeakPreference | $804.76 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | University of Utah | HIXIndividual | $825.53 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | Cigna | Exclusive | $859.28 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | Molina | HIX | $867.06 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | PEHP | Summit | $921.58 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | University of Utah | HealthyPreferred | $950.14 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | University of Utah | HealthyPremierSSG | $950.14 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | DMBA (Deseret Mutual Benefit Admin) | PPO | $978.95 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | University of Utah | HealthyPremier | $1,035.80 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | Universal Healthcare | MCR | $1,038.40 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | Cigna UT Overstock | COMM | $1,038.40 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | Aetna | StandardNetwork | $1,038.40 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | United | OptionsPPO | $1,041.98 | $3,216.00 | $3,216.00 | 2026-03-01 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Medicaid Managed UHC | All Plans | $1,047.21 | $32,614.95 | $16,633.62 | 2025-01-10 | MRF ↗ |
| TRISTAR GREENVIEW REGIONAL HOSPITAL Outpatient | United | OptionsPPO | $1,061.18 | $3,067.00 | $3,067.00 | 2024-10-01 | MRF ↗ |
| FRISBIE MEMORIAL HOSPITAL Outpatient | Well Sense Health Plan | MCD | $1,069.84 | $8,762.00 | $8,762.00 | 2026-03-01 | MRF ↗ |
| HENRICO DOCTORS' HOSPITAL Outpatient | Virginia Health Network | ULTRA | $1,075.20 | $3,072.00 | $3,072.00 | 2026-03-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | Cigna | NBNPPO | $1,142.24 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | Humana ChoiceCare | PPO | $1,161.19 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | Imagine Health Wise | PPO | $1,206.36 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| RESTON HOSPITAL CENTER Outpatient | Aetna | MGMCR | $1,221.96 | $8,146.43 | $8,146.43 | 2024-10-01 | MRF ↗ |
| PORTSMOUTH REGIONAL HOSPITAL Outpatient | United | FreedomBenefitPlans | $1,245.68 | $4,847.00 | $4,847.00 | 2026-03-01 | MRF ↗ |
| PORTSMOUTH REGIONAL HOSPITAL Outpatient | United | FreedomBenefitPlans | $1,245.68 | $4,847.00 | $4,847.00 | 2026-03-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | MotivHealth | TPARental | $1,246.08 | $2,596.00 | $2,596.00 | 2024-10-01 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | MotivHealth | COMM | $1,246.08 | $2,596.00 | $2,596.00 | 2024-10-01 | 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.