891590 — Drsg Wnd Hdrcl Adh 4x4in
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). DRSG WND HDRCL ADH 4X4IN (CDM 891590) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/891590?code_type=CDM
MLA (9th ed.)
“DRSG WND HDRCL ADH 4X4IN (CDM 891590) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/891590?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“DRSG WND HDRCL ADH 4X4IN (CDM 891590) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/891590?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $26–$169 (25th–75th percentile) across 4 hospitals · 51 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 891590 — 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 |
|---|---|---|---|---|---|---|---|
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Amerigroup | MCD | $2.16 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Peach State (Ambetter) | HIX | $2.53 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Aetna | MCR | $2.55 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Friday Health | HIX | $2.55 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Pruitt Health | MCR | $3.23 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Peach State | MGMCD | $3.40 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | United | OptionsPPO | $4.62 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Humana | COMM | $5.61 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Cigna | OAP | $6.46 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Cigna | PPO | $6.46 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Cigna | HMO | $6.46 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | United | GlobalBenefitPlan | $7.65 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Memorial Health Plan-Core Community Care | COMM | $7.82 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Health One Alliance | COMMHIX | $7.82 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Industry Buying Group | COMM | $8.50 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Aetna | PPO | $12.56 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | MultiPlan | Primary | $15.30 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | MultiPlan | Complementary | $15.30 | $17.00 | $17.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Aetna | MCRPOS | $16.95 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | MedCare Partners | MGMCR | $16.95 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Imperial Insurance | MCR | $16.95 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Aetna | MCRHMO | $16.95 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Aetna | MCRPPO | $16.95 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Santa Clara Family Health Plan | Medicaid | $21.47 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Bright Health | COMM | $22.71 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Aetna | AWH | $24.30 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Aetna | PPO | $24.86 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Aetna | HMO | $24.86 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Cigna | LocalPlus | $26.07 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Health Net | COMM | $26.67 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Amerigroup | MCD | $26.69 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Peach State (Ambetter) | HIX | $29.08 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | CIGNA | POS | $29.29 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | CIGNA | HMO | $29.29 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Cigna | PPO | $29.29 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Friday Health | HIX | $29.88 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Aetna | MCR | $29.88 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | United | OptionsPPO | $31.64 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Canopy | COMM | $33.90 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Blue Shield | COMM | $34.39 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Blue Shield | EPN | $34.39 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | NHC Advantage | MGMCR | $37.85 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Pruitt Health | MCR | $37.85 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Peach State | MGMCD | $39.84 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Wellcare | MCD | $39.84 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Memorial Health Plan | EMPLOYEEPLAN | $43.82 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | United | OptionsPPO | $49.20 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Aetna | QualifiedHealthPlan | $51.51 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Cigna | LocalPlus | $54.18 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Centurion | PRISN | $55.16 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Americas 1st Choice | MCR | $55.78 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Santa Clara IPA MCR | MCR | $56.50 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Santa Clara IPA COMM | COMM | $56.50 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Leavitt Risk Partners | COMM | $59.76 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Palo Alto Medical | COMM | $62.15 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Memorial Health Plan | HEALTHGRAM | $67.73 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | NX Health Network | COMM | $67.80 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Sutter Select | COMM | $67.80 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Aetna | OpenAccess | $68.52 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Aetna | PPO | $68.52 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Aetna | POS | $68.52 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Aetna | HMO | $68.52 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Cigna | HMO | $72.31 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Cigna | PPO | $72.31 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Cigna | OAP | $72.31 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | MultiPlan | Primary | $73.45 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Memorial Health Plan | COMM | $73.70 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Networks by Design | COMM | $76.84 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Humana Choicecare | COMM | $79.10 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | First Health | COMM | $85.88 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Memorial Health Plan | CORECOMMUNITYCARE | $87.65 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | United | GlobalBenefitPlan | $89.64 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Memorial Health Plan | COASTALHEALTHPLAN | $89.64 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | HealthSmart | WCOMP | $90.40 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | PHA Pacific Health Alliance | COMM | $90.40 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Intercontinental Corporation | COMM | $90.40 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | PPO Next | COMM | $90.40 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | PPO Next | PPO | $90.40 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Cigna BH | COMMBH | $90.40 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Health One Alliance | COMMHIX | $91.63 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | HealthSmart | COMM | $96.05 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Dodge County Hospital | COMM | $99.60 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Aetna | NAP | $109.82 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | First Health | WCOMP | $113.00 | $113.00 | $113.00 | 2024-10-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Graham Brothers Construction | COMM | $169.32 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | City of Eastman | COMM | $169.32 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | American Steel Products | COMM | $169.32 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | Dodge Co Board of Commissioners | COMM | $169.32 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | MultiPlan | Complementary | $179.28 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | NovaNet | COMM | $179.28 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| FAIRVIEW PARK HOSPITAL Outpatient | MultiPlan | Primary | $179.28 | $199.20 | $199.20 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Vail Health | COMM | $74,988.74 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | United | OptionsPPO | $102,122.83 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Aetna | MCRADVHMO | $148,004.10 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Bright Health | OON | $148,004.10 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Aetna | MCRADVPPO | $148,004.10 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Colorado Program for Children with Special Needs | HCP | $217,072.68 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | United | GlobalBenefit | $222,006.15 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Cigna | Connect-SBPLeanBenefitPlans | $315,742.08 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Cigna | BroadLeanBenefitPlans | $315,742.08 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Cigna | SureFitLeanBenefitPlans | $315,742.08 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Cigna | Connect-NSBPLeanBenefitPlans | $315,742.08 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Western Plains Community Health | COMM | $320,675.55 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Physician Health Partners | MCR | $345,342.90 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Multiplan | COMMPPOPRIMARYNETWORK | $345,342.90 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | NorthCare | COMM | $345,342.90 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Anthem | PAR | $365,076.78 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Pinnacol Workers Comp | WORKERSCOMP | $370,010.25 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Medical Development International | COMM | $394,677.60 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | TriWest Health Alliance | FED | $394,677.60 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Multiplan | COMMPPOCOMPLEMENTARYNETWORK | $419,344.95 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Prime Health | WORKERSCOMP | $444,012.30 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |
| HCA-HEALTHONE DBA SWEDISH MEDICAL CENTER Outpatient | Multiplan | BeechStreetCOMMPPO | $444,012.30 | $493,347.00 | $493,347.00 | 2026-03-01 | MRF ↗ |