91495 — Certolizumab Pegol 400 Mg (200 Mg X 2 Vials) Subcutaneous Kit
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT (CDM 91495) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/91495?code_type=CDM
MLA (9th ed.)
“CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT (CDM 91495) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/91495?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT (CDM 91495) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/91495?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $25–$5,338 (25th–75th percentile) across 6 hospitals · 54 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 91495 — 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 | $6.25 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | UNITED HEALTH CARE | 1282_UNITED HEALTH CARE 20250701 | $14.33 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | SEHN | 1171_SEHN 20241001 | $14.33 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | SEHN | 1171_SEHN 20241001 | $14.33 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | UNITED HEALTH CARE | 1282_UNITED HEALTH CARE 20250701 | $14.33 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA TRUST SELECT POS | 431_WEA TRUST SELECT POS MIL 20180201 | $15.19 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA TRUST SELECT POS | 431_WEA TRUST SELECT POS MIL 20180201 | $15.19 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA TRUST PPO | 1164_WEA TRUST PPO MIL 20241001 | $15.19 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA TRUST PPO | 1164_WEA TRUST PPO MIL 20241001 | $15.19 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | MOLINA MARKETPLACE | 1161_MOLINA MARKETPLACE ASWI 20241001 | $16.91 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | MOLINA MARKETPLACE | 1162_MOLINA MARKETPLACE MIL 20241001 | $16.91 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | MOLINA MARKETPLACE | 1162_MOLINA MARKETPLACE MIL 20241001 | $16.91 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | MOLINA MARKETPLACE | 1161_MOLINA MARKETPLACE ASWI 20241001 | $16.91 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | TRILOGY | 1271_TRILOGY 20250701 | $19.78 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | TRILOGY | 1271_TRILOGY 20250701 | $19.78 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | NEHA LIMITED | 821_NEHA LIMITED 20220101 | $20.06 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | NEHA LIMITED | 821_NEHA LIMITED 20220101 | $20.06 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | NEHA ASCENSION ONLY | 820_NEHA ASCENSION ONLY 20220101 | $20.06 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | NEHA ASCENSION ONLY | 820_NEHA ASCENSION ONLY 20220101 | $20.06 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA TRUST SELECT POS | 432_WEA TRUST SELECT POS ASWI 20180201 | $21.50 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA TRUST PPO | 1163_WEA TRUST PPO ASWI 20241001 | $21.50 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | FIRST HEALTH NETWORK | 1290_FIRST HEALTH 20240101 SJWI FNWI MWWI | $21.50 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA TRUST SELECT POS | 432_WEA TRUST SELECT POS ASWI 20180201 | $21.50 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | FIRST HEALTH NETWORK | 1290_FIRST HEALTH 20240101 SJWI FNWI MWWI | $21.50 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA TRUST PPO | 1163_WEA TRUST PPO ASWI 20241001 | $21.50 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | AETNA | 1279_AETNA MIL 20250701 | $22.07 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | AETNA | 1279_AETNA MIL 20250701 | $22.07 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA PROVIDER AND POS | 434_WEA PROVIDER AND POS MIL 20180201 | $23.50 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA PROVIDER AND POS | 434_WEA PROVIDER AND POS MIL 20180201 | $23.50 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA PROVIDER AND POS | 433_WEA PROVIDER AND POS ASWI 20180201 | $24.36 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | WEA PROVIDER AND POS | 433_WEA PROVIDER AND POS ASWI 20180201 | $24.36 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | AETNA | 1278_AETNA ASWI 20250701 | $24.65 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | AETNA | 1278_AETNA ASWI 20250701 | $24.65 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | FIRST HEALTH NETWORK | 1281_FIRST HEALTH 20240101 ASWI | $24.65 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | FIRST HEALTH NETWORK | 1281_FIRST HEALTH 20240101 ASWI | $24.65 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | HEALTH EOS/MULTIPLAN | 1015_HEALTH EOS/MULTIPLAN 20230701 | $24.93 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | HEALTH EOS/MULTIPLAN | 1015_HEALTH EOS/MULTIPLAN 20230701 | $24.93 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | NEHA PPO BROAD | 388_NEHA PPO BROAD 20180701 | $25.51 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | NEHA PPO BROAD | 388_NEHA PPO BROAD 20180701 | $25.51 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | NEHA PPO ON/NEAR SITE | 390_NEHA PPO ON/NEAR SITE 20180701 | $25.51 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | NEHA PPO ON/NEAR SITE | 390_NEHA PPO ON/NEAR SITE 20180701 | $25.51 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | HEALTH EOS/MULTIPLAN WC | 1016_HEALTH EOS/MULTIPLAN (WORKERS COMP) 20230701 | $26.94 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| ASCENSION ALL SAINTS HOSPITAL Outpatient | HEALTH EOS/MULTIPLAN WC | 1016_HEALTH EOS/MULTIPLAN (WORKERS COMP) 20230701 | $26.94 | $28.66 | $15.19 | 2026-01-01 | MRF ↗ |
| FREDERICK HEALTH HOSPITAL Both | All Payers | All Plans | — | $30.66 | $30.05 | 2025-03-17 | MRF ↗ |
| FREDERICK HEALTH HOSPITAL Both | All Payers | All Plans | — | $32.85 | $32.19 | 2025-08-04 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | ELAP | COMM | $66.08 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Sterling Life Insurance | MCR | $78.00 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Cigna | IFPLP | $79.56 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | PEHP | Exclusive | $86.11 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Bright Health | HIX | $87.36 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Cigna | OAPNBN | $89.86 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | University of Utah | HIXIndividual | $99.22 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Cigna | Exclusive | $103.27 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Molina | HIX | $104.21 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | PEHP | Summit | $110.76 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Aetna | PeakPreference | $112.32 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | University of Utah | HealthyPremierSSG | $114.19 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | University of Utah | HealthyPreferred | $114.19 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | DMBA (Deseret Mutual Benefit Admin) | PPO | $117.66 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | University of Utah | HealthyPremier | $124.49 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Cigna UT Overstock | COMM | $124.80 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Cigna | NBNPPO | $137.28 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Humana ChoiceCare | PPO | $139.56 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Imagine Health Wise | PPO | $144.99 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Aetna | StandardNetwork | $146.64 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | MotivHealth | TPARental | $149.76 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | MotivHealth | COMM | $149.76 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Angle Insurance | COMM | $149.76 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Cigna | Non-ExclusivePPO | $173.47 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Select Health ER | COMM | $180.34 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Aetna | AetnaSignatureAdministrators | $180.96 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Aetna | UtahConnectedNetwork | $187.20 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Multiplan | Primary | $196.56 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Aetna | FirstHealth | $227.76 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | Injury Care of Utah | WCOMP | $243.36 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| LONE PEAK HOSPITAL Outpatient | TriWest Healthcare Alliance | Veterans | $249.60 | $312.00 | $312.00 | 2024-10-01 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Medicaid Managed UHC | All Plans | $453.34 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Medicare Adv Aetna | All Plans | $1,362.51 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | TRPN | All Plans | $1,411.93 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | Medicare Adv Aetna | All Plans | $1,510.42 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Medicare Adv Anthem | All Plans | $1,875.72 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Medicare Adv UHC | All Plans | $1,890.96 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Medicare Adv CtCare | All Plans | $2,040.78 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Medicare Adv Wellcare | All Plans | $2,042.00 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | Medicare Adv UHC | All Plans | $2,107.86 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | Medicare Adv Anthem | All Plans | $2,116.36 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | First Health | All Plans | $2,117.89 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | Medicare Adv Wellcare | All Plans | $2,137.99 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | Medicare Adv CTCare | All Plans | $2,287.54 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | Champus | All Plans | $3,242.56 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Tricare | Commercial | $3,386.00 | $12,734.00 | $12,734.00 | 2025-11-07 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Oscar | All Plans | $3,842.02 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | Optum | All Plans | $4,094.58 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Tufts | All Plans | $4,618.91 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Oxford | All Plans | $5,008.85 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | Magnacare | All Plans | $5,048.84 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Champus | All Plans | $5,183.62 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | Magellan | All Plans | $5,224.12 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | UHC | All Plans | $5,329.51 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Anthem | All Plans | $5,365.32 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Create Alliance | All Plans | $5,365.32 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | CtCare | All Plans | $5,505.06 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Aetna | All Plans | $5,640.72 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Cigna | All Plans | $5,753.92 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Multiplan | All Plans | $6,325.42 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | Harvard Pilgrim | All Plans | $6,386.02 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | Oxford | All Plans | $6,750.83 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | Cigna | All Plans | $6,820.81 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | UHC | All Plans | $7,091.49 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Claimdoc | All Plans | $7,384.37 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | AMPS | All Plans | $7,384.37 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | Multiplan | All Plans | $7,765.59 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | Create | All Plans | $7,765.59 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | MagnaCare | All Plans | $8,073.63 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Great West | All Plans | $8,132.69 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | First Choice | All Plans | $8,330.36 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | ClaimDoc | All Plans | $9,459.90 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | AMPS | All Plans | $9,459.90 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | HIP | All Plans | $10,307.05 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | Great West | All Plans | $10,448.25 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Optum | All Plans | $11,125.97 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| BRIDGEPORT HOSPITAL Both | Magellan | All Plans | $11,408.35 | $14,119.25 | $7,200.82 | 2025-01-10 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Ambetter | Commercial | $11,970.00 | $12,734.00 | $12,734.00 | 2025-11-07 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Midlands Choice | Commercial | $11,970.00 | $12,734.00 | $12,734.00 | 2025-11-07 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Cigna | Commercial | $11,970.00 | $12,734.00 | $12,734.00 | 2025-11-07 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | First Health | All Plans | $12,001.36 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Medica | Commercial | $12,097.00 | $12,734.00 | $12,734.00 | 2025-11-07 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Blue Cross Blue Shield | Commercial | $12,097.00 | $12,734.00 | $12,734.00 | 2025-11-07 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Meritain | Commercial | $12,225.00 | $12,734.00 | $12,734.00 | 2025-11-07 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Coventry | Commercial | $12,225.00 | $12,734.00 | $12,734.00 | 2025-11-07 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Both | Aetna | Commercial | $12,225.00 | $12,734.00 | $12,734.00 | 2025-11-07 | MRF ↗ |
| YALE-NEW HAVEN HOSPITAL Both | TRPN | All Plans | $12,707.33 | $14,119.25 | $8,330.36 | 2025-01-10 | MRF ↗ |