85134 — Drsg Vac Veraflo Cleanse Choice Lrg
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). DRSG VAC VERAFLO CLEANSE CHOICE LRG (CPT 85134) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/85134?code_type=CPT
MLA (9th ed.)
“DRSG VAC VERAFLO CLEANSE CHOICE LRG (CPT 85134) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/85134?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“DRSG VAC VERAFLO CLEANSE CHOICE LRG (CPT 85134) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/85134?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $284–$905 (25th–75th percentile) across 7 hospitals · 49 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT 85134 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Estimated complete episode
What this costs at this hospital
The hospital facility charge for this code — an actual negotiated rate from our data. A separate professional fee isn’t separately estimable for this code (see the note below).
What hospitals actually negotiate
Measured
$284
$500 typical
$905
The middle 50% of negotiated facility rates for this procedure, measured across 7 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $500 |
| Likely subtotal | $500 |
Facility charge (no separate professional fee)
$500
- Laboratory tests are priced under the Clinical Laboratory Fee Schedule (CLFS), not the PFS, so a separate professional fee is not estimable here — the figure above is the facility charge only.
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
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 |
|---|---|---|---|---|---|---|---|
| St Lawrence Rehabilitation Center Outpatient | Amerihealth | HMO | $59.00 | $74.00 | $74.00 | 2026-03-31 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Independence Keystone Health Plan | Commercial | $59.00 | $74.00 | $74.00 | 2026-03-31 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Aetna | Commercial | $74.00 | $74.00 | $74.00 | 2026-03-31 | MRF ↗ |
| COOSA VALLEY MEDICAL CENTER Outpatient | Health Spring | Commercial | $99.00 | $284.00 | $68.00 | 2026-01-28 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Medicaid Hmo Apr Drg | Medicaid Hmo Apr Drg | $129.72 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| COOSA VALLEY MEDICAL CENTER Outpatient | Aetna | Commercial | $131.00 | $284.00 | $68.00 | 2026-01-28 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Magellan Complete Care | Magellan Complete Care | $138.80 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Independence Keystone Health Plan | Commercial | $154.00 | $192.00 | $192.00 | 2026-03-31 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Amerihealth | HMO | $154.00 | $192.00 | $192.00 | 2026-03-31 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Chip | Upmc Chip | $154.35 | $441.00 | $132.30 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Chip | Upmc Chip | $154.35 | $441.00 | $132.30 | 2026-05-14 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Medicare Ppo | $172.02 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Health Options Inc | Bcbs Health Options Medicare | $172.02 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Independence Keystone Health Plan | Commercial | $180.00 | $225.00 | $225.00 | 2026-03-31 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Amerihealth | HMO | $180.00 | $225.00 | $225.00 | 2026-03-31 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Aetna | Commercial | $192.00 | $192.00 | $192.00 | 2026-03-31 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Careplus | Careplus | $217.29 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Carelon/Beacon Beahvioral Health | Carelon/Beacon Behavioral Health | $220.50 | $441.00 | $132.30 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Carelon/Beacon Beahvioral Health | Carelon/Beacon Behavioral Health | $220.50 | $441.00 | $132.30 | 2026-05-23 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Aetna | Commercial | $225.00 | $225.00 | $225.00 | 2026-03-31 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Cigna | Cigna | $238.14 | $441.00 | $132.30 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Cigna | Cigna | $238.14 | $441.00 | $132.30 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Geisinger Medicaid | Geisinger Medicaid | $242.55 | $441.00 | $132.30 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Geisinger Medicaid | Geisinger Medicaid | $242.55 | $441.00 | $132.30 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Unitedhealthcare Insurance Company | United | $255.78 | $441.00 | $132.30 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Unitedhealthcare Insurance Company | United | $255.78 | $441.00 | $132.30 | 2026-05-14 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Aetna Health | Aetna Medicare | $271.62 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| COOSA VALLEY MEDICAL CENTER Outpatient | Humana | Medicare Advantage | $284.00 | $284.00 | $68.00 | 2026-01-28 | MRF ↗ |
| COOSA VALLEY MEDICAL CENTER Outpatient | Blue Cross Blue Shield of Alabama | Medicare Advantage | $284.00 | $284.00 | $68.00 | 2026-01-28 | MRF ↗ |
| COOSA VALLEY MEDICAL CENTER Outpatient | Humana | PPO | $284.00 | $284.00 | $68.00 | 2026-01-28 | MRF ↗ |
| COOSA VALLEY MEDICAL CENTER Outpatient | Humana | HMO | $284.00 | $284.00 | $68.00 | 2026-01-28 | MRF ↗ |
| HANSFORD COUNTY HOSPITAL Outpatient | Blue Cross and Blue Shield | Medicare Advantage HMO | $358.00 | $511.00 | $383.00 | 2026-05-22 | MRF ↗ |
| HANSFORD COUNTY HOSPITAL Outpatient | Blue Cross and Blue Shield | Blue Advantage HMO | $368.00 | $511.00 | $383.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Msmc | Cigna | $380.26 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| HANSFORD COUNTY HOSPITAL Outpatient | Blue Cross and Blue Shield | HMO | $388.00 | $511.00 | $383.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Humana | Humana Humx | $389.32 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Multiplan | Multiplan | $396.90 | $441.00 | $132.30 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Inpatient | Multiplan | Multiplan | $396.90 | $441.00 | $132.30 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Health Plan | Upmc Medicaid | $400.87 | $441.00 | $132.30 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Upmc Health Plan | Upmc Medicaid | $400.87 | $441.00 | $132.30 | 2026-05-23 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Dimension Health | Dimension Plus | $407.43 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Oscar Health (Hie) | Oscar Health (Hie) | $407.43 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| HANSFORD COUNTY HOSPITAL Outpatient | Blue Cross and Blue Shield | Commercial | $409.00 | $511.00 | $383.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Aetna Health | Aetna Workers Comp | $425.53 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | United Healthcare | United Healthcare | $434.59 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Mcr Snf Episodic Bundle | $441.00 | $441.00 | $132.30 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Pa Workers' Compensation | Pa Workers Compensation | $441.00 | $441.00 | $132.30 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Highmark | Highmark Mcr Snf Episodic Bundle | $441.00 | $441.00 | $132.30 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Tricare | Tricare | $441.00 | $441.00 | $132.30 | 2026-05-23 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Tricare | Tricare | $441.00 | $441.00 | $132.30 | 2026-05-14 | MRF ↗ |
| ACMH HOSPITAL Outpatient | Pa Workers' Compensation | Pa Workers Compensation | $441.00 | $441.00 | $132.30 | 2026-05-14 | MRF ↗ |
| HANSFORD COUNTY HOSPITAL Outpatient | HealthSmart | Commercial | $460.00 | $511.00 | $383.00 | 2026-05-22 | MRF ↗ |
| HANSFORD COUNTY HOSPITAL Outpatient | Cigna | Commercial | $460.00 | $511.00 | $383.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Health Options Inc | Bcbs Health Options Hmo | $480.00 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| HANSFORD COUNTY HOSPITAL Outpatient | Alliance Regional | Commercial | $485.00 | $511.00 | $383.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Network Blue | $488.00 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| HANSFORD COUNTY HOSPITAL Outpatient | Blue Cross and Blue Shield | Medicare Advantage PPO | $511.00 | $511.00 | $383.00 | 2026-05-22 | MRF ↗ |
| HANSFORD COUNTY HOSPITAL Outpatient | Blue Cross and Blue Shield | Blue HMO | $511.00 | $511.00 | $383.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | United Healthcare | United Options Ppo | $534.18 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| HANSFORD COUNTY HOSPITAL Outpatient | 90 Degrees | Commercial | $537.00 | $511.00 | $383.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Dimension Health | Dimension International | $543.23 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| GORDON MEMORIAL HOSPITAL DISTRICT Outpatient | United Healthcare | Medicare Advantage | $545.00 | $1,159.00 | $1,159.00 | 2025-07-09 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Care Management Network | Care Management Network | $588.50 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Aetna Health | Aetna | $588.50 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Careworks Workers Comp | Careworks Workers Comp | $611.14 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Corvel Healthcare | Corvel Healthcare | $631.51 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Cigna Behavioral Health | Cigna Behavioral Health | $633.77 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Beech Street | Beech Street | $633.77 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Dimension Health | Dimension | $633.77 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Behavioral Services Network | Behavioral Services Network | $633.77 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Coventry | Coventry | $642.83 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Workers Compensation | $679.04 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Beech Street | Beech Street | $679.04 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Multiplan | Multiplan | $679.04 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Seasons Hospice | Seasons Hospice | $679.04 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Workmans Compensation | Workmans Compensation | $679.04 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| TYLER COUNTY HOSPITAL Outpatient | Blue Cross and Blue Shield | Blue Advantage HMO | $756.00 | $1,512.00 | $1,134.00 | 2025-04-15 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Wellcare | Wellcare | $769.58 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | First Health Network | First Health | $769.58 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Aetna International Ppo | Aetna International Ppo | $769.58 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Management Systems | Nch Humana Medicare | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Management Systems | Nch Simply Medicare | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Concordia Behavioral Health | Concordia Behavioral Health | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Humana Behavioral Health | Humana Behavioral Health Medicare | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Vitas Healthcare Of Fl | Vitas | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Devoted Medicare | Nch Devoted Medicare Rad Onc | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Devoted Medicare | Nch Devoted Medicare Med Onc | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Nch Devoted Medicare | Nch Devoted Medicare Rad Onc | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Miscellaneous Insurances | Miscellaneous Insurances | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Cenpatico Behavioral Health | Cenpatico Behavioral Health | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Mental Health Associates | Mental Health Associates | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Rehab Ppo | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | United Healthcare | United Behavioral Medicare | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Humana Behavioral Health | Humana Behavioral Health | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Magellan Behavioral Health | Magellan Behavioral Health | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Value Options | Value Options Behavioral Health | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Tricare | Tricare | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | United Healthcare | United Behavioral | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | United Healthcare | United Behavioral Medicaid | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | University Of Miami Behavioral Health | University Of Miami Behavioral Health | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | New Directions Behavioral Health | New Directions Behavioral Health | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Management Systems | Nch Careplus Medicare | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Management Systems | Nch Coventry Medicare | $905.39 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| GORDON MEMORIAL HOSPITAL DISTRICT Outpatient | Midlands Choice | Commercial | $927.00 | $1,159.00 | $1,159.00 | 2025-07-09 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Traditional | $996.00 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Ppo | $1,016.00 | $905.39 | $905.39 | 2026-05-22 | MRF ↗ |
| GORDON MEMORIAL HOSPITAL DISTRICT Outpatient | Medica | Commercial | $1,089.00 | $1,159.00 | $1,159.00 | 2025-07-09 | MRF ↗ |
| GORDON MEMORIAL HOSPITAL DISTRICT Outpatient | United Healthcare | Commercial | $1,089.00 | $1,159.00 | $1,159.00 | 2025-07-09 | MRF ↗ |
| GORDON MEMORIAL HOSPITAL DISTRICT Outpatient | Blue Cross Blue Shield | Commercial | $1,101.00 | $1,159.00 | $1,159.00 | 2025-07-09 | MRF ↗ |
| TYLER COUNTY HOSPITAL Outpatient | Blue Cross and Blue Shield | Blue Essentials | $1,210.00 | $1,512.00 | $1,134.00 | 2025-04-15 | MRF ↗ |
| TYLER COUNTY HOSPITAL Outpatient | Blue Cross and Blue Shield | PPO/POS Network Participation | $1,210.00 | $1,512.00 | $1,134.00 | 2025-04-15 | MRF ↗ |
| TYLER COUNTY HOSPITAL Outpatient | Blue Cross and Blue Shield | Traditional Indemnity | $1,285.00 | $1,512.00 | $1,134.00 | 2025-04-15 | MRF ↗ |