92930 — Pr Perq Tcat Plmt Ntrac St 2+les 2+st 2+c Segments
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PR PERQ TCAT PLMT NTRAC ST 2+LES 2+ST 2+C SEGMENTS (CPT 92930) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/92930?code_type=CPT
MLA (9th ed.)
“PR PERQ TCAT PLMT NTRAC ST 2+LES 2+ST 2+C SEGMENTS (CPT 92930) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/92930?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“PR PERQ TCAT PLMT NTRAC ST 2+LES 2+ST 2+C SEGMENTS (CPT 92930) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/92930?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $18,115–$38,862 (25th–75th percentile) across 670 hospitals · 2,098 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 92930 — 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 |
|---|---|---|---|---|---|---|---|
| MERCY HOSPITAL SOUTH OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $293.80 | $4,520.00 | $2,938.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MULTIPLAN CONTRACTED [320270] | HB SAMC PHCS PRIMARY | — | $4,520.00 | $2,938.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MERCY MGD BEHAVIORAL HEALTH CONTRACTED [320259] | HB SAMC PHCS PRIMARY | — | $4,520.00 | $2,938.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | FIRST HEALTH CONTRACTED [320128] | HB SAMC PHCS PRIMARY | — | $4,520.00 | $2,938.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | PRIVATE HEALTH CARE SYSTEMS CONTRACTED [320320] | HB SAMC PHCS PRIMARY | — | $4,520.00 | $2,938.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $293.80 | $4,520.00 | $2,938.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $293.80 | $4,520.00 | $2,938.00 | 2026-03-12 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE GEORGIA [3050605] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER SOUTHERN CA [4000602] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER COLORADO [4000605] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER HAWAII [4000607] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER OUT OF AREA [4000603] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE SOUTHERN CA [3050602] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE NORTHERN CA [3050601] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER GEORGIA [4000611] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER EPO [4000604] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE COLORADO [3050604] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER OUT OF AREA MEDICARE ADVANTAGE [3050603] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER NORTHERN CA [4000601] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER NORTHWEST [4000609] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE HAWAII [3050606] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADV MID-ATLANTIC STATES [3050607] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE NORTHWEST [3050608] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER WASHINGTON [4000610] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDI-CAL- AFTER 10/01/21 [30505] | KAISER MEDI-CAL HMO [3050501] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE WASHINGTON [3050609] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER MID ATLANTIC STATES [4000608] | $386.73 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| Ira Davenport Memorial Hospital OutpatientFacility | Empire | All Products Non MD | $394.42 | $73,523.37 | $14,704.67 | 2026-03-27 | MRF ↗ |
| ARNOT OGDEN MEDICAL CENTER OutpatientFacility | Empire | All Products Non MD | $419.08 | $73,523.37 | $14,704.67 | 2026-03-27 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MERCY MGD BEHAVIORAL HEALTH CONTRACTED [320259] | HB STLO WASH JEFN PHCS PRIMARY | — | $6,780.00 | $4,407.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | FIRST HEALTH CONTRACTED [320128] | HB STLO WASH JEFN PHCS PRIMARY | — | $6,780.00 | $4,407.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MULTIPLAN CONTRACTED [320270] | HB STLO WASH JEFN PHCS PRIMARY | — | $6,780.00 | $4,407.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | PRIVATE HEALTH CARE SYSTEMS CONTRACTED [320320] | HB STLO WASH JEFN PHCS PRIMARY | — | $6,780.00 | $4,407.00 | 2026-03-12 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | TUFTS CONNCARE/QHP [8020] | BMC HB TUFTS SUBSIDIZED PLANS | $431.24 | $27,462.00 | $12,357.90 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MULTIPLAN CONTRACTED [320270] | HB STLO WASH JEFN PHCS PRIMARY | — | $6,780.00 | $4,407.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $440.70 | $6,780.00 | $4,407.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MERCY MGD BEHAVIORAL HEALTH CONTRACTED [320259] | HB STLO WASH JEFN PHCS PRIMARY | — | $6,780.00 | $4,407.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | FIRST HEALTH CONTRACTED [320128] | HB STLO WASH JEFN PHCS PRIMARY | — | $6,780.00 | $4,407.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTHEAST OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $440.70 | $6,780.00 | $4,407.00 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $440.70 | $6,780.00 | $4,407.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTHEAST OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $440.70 | $6,780.00 | $4,407.00 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL SOUTHEAST OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $440.70 | $6,780.00 | $4,407.00 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $440.70 | $6,780.00 | $4,407.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $440.70 | $6,780.00 | $4,407.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $440.70 | $6,780.00 | $4,407.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | PRIVATE HEALTH CARE SYSTEMS CONTRACTED [320320] | HB STLO WASH JEFN PHCS PRIMARY | — | $6,780.00 | $4,407.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTHEAST OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $440.70 | $6,780.00 | $4,407.00 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $440.70 | $6,780.00 | $4,407.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $440.70 | $6,780.00 | $4,407.00 | 2026-03-12 | MRF ↗ |
| OKLAHOMA HEART HOSPITAL SOUTH, LLC Both | HUMANA HEALTHY HORIZONS IN OK | HUMANA MEDICAID | $445.86 | $52,892.43 | $18,512.35 | 2026-03-27 | MRF ↗ |
| OKLAHOMA HEART HOSPITAL SOUTH, LLC Both | AETNA BETTER HEALTH OF OK | AETNA MEDICAID | $445.86 | $52,892.43 | $18,512.35 | 2026-03-27 | MRF ↗ |
| OKLAHOMA HEART HOSPITAL, LLC Both | AETNA BETTER HEALTH OF OK | AETNA MEDICAID | $445.86 | $52,892.43 | $18,512.35 | 2026-03-27 | MRF ↗ |
| OKLAHOMA HEART HOSPITAL, LLC Both | HUMANA HEALTHY HORIZONS IN OK | HUMANA MEDICAID | $445.86 | $52,892.43 | $18,512.35 | 2026-03-27 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Health | Open Choice Ppo | $448.00 | $56,187.00 | $5,618.70 | 2026-05-14 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Health | Open Choice Ppo | $448.00 | $56,187.00 | $5,618.70 | 2026-05-22 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Aetna Health | Open Choice Ppo | $448.00 | $56,187.00 | $5,618.70 | 2026-05-06 | MRF ↗ |
| Ira Davenport Memorial Hospital OutpatientFacility | Empire | All Products MD | $468.38 | $73,523.37 | $14,704.67 | 2026-03-27 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MDWISE ST MARG BHS [224] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MANAGED HEALTH [210] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID HIP [230] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MDWISE STC BHS [222] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID ADVANTAGED HEALTH [201] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MD WISE HIP STC BHS [231] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MDWISE [220] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | FRANCISCAN ACO [236] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID PATHWAYS [270] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID PRESUMPTIVE [250] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID ANTHEM MAGELLAN HLT [212] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | CARESOURCE HOOSIER HEALTHWISE [233] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MDWISE CARE SELECT [221] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | CARETAKER HIP [232] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID CENPATICO BHS [211] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MDWISE HOOSIER BHS [223] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID [200] | Indiana Medicaid | $475.51 | $38,775.00 | $23,265.00 | 2026-04-01 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM CHIPPEWA VALLEY BothFacility | ACUTE REHABILITATION [1140122] | CHIPPEWA MEDICARE CAH ACUTE REHAB [1337] | $482.29 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM OAKRIDGE BothFacility | ACUTE REHABILITATION [1140122] | MEDICARE CAH ACUTE REHAB [1339] | $482.29 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM-NORTHLAND BothFacility | ACUTE REHABILITATION [1140122] | MEDICARE CAH ACUTE REHAB [1336] | $482.29 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| VOLUNTEER COMMUNITY HOSPITAL OutpatientFacility | Cigna | HMO/Network/Open Access Plus | $485.16 | $40,387.00 | $28,270.90 | 2026-02-05 | MRF ↗ |
| DYERSBURG REGIONAL MEDICAL CENTER OutpatientFacility | Cigna | IFP/LocalPlus | $485.16 | $40,387.00 | $28,270.90 | 2026-02-06 | MRF ↗ |
| VOLUNTEER COMMUNITY HOSPITAL OutpatientFacility | Cigna | IFP/LocalPlus | $485.16 | $40,387.00 | $28,270.90 | 2026-02-05 | MRF ↗ |
| DYERSBURG REGIONAL MEDICAL CENTER OutpatientFacility | Cigna | HMO/Network/Open Access Plus | $485.16 | $40,387.00 | $28,270.90 | 2026-02-06 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM ST. JAMES BothFacility | ACUTE REHABILITATION [1140122] | MEDICARE CRITICAL ACCESS HOSPITAL ACUTE REHAB [1334] | $487.33 | $42,521.00 | $37,418.48 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - WASECA BothFacility | ACUTE REHABILITATION [1140122] | MEDICARE CAH ACUTE REHAB [1335] | $487.33 | $42,521.00 | $37,418.48 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - LAKE CITY BothFacility | ACUTE REHABILITATION [1140122] | MEDICARE CAH ACUTE REHAB [1332] | $487.33 | $42,521.00 | $37,418.48 | 2026-03-31 | MRF ↗ |
| ARNOT OGDEN MEDICAL CENTER OutpatientFacility | Empire | All Products MD | $493.03 | $73,523.37 | $14,704.67 | 2026-03-27 | MRF ↗ |
| USA HEALTH UNIVERSITY HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Alabama | Medicare Advantage | $495.25 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH CHILDREN'S & WOMEN'S HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Alabama | Medicare Advantage | $495.25 | — | — | 2026-04-30 | MRF ↗ |
| PRISMA HEALTH LAURENS COUNTY HOSPITAL Both | ALTERNATE MEDICARE RAILROAD [41801] | PHU HB 100% OF MEDICARE - LMH | $495.28 | $46,822.00 | $30,434.30 | 2026-03-01 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | HEALTH CHOICE GENERATIONS | HEALTH CHOICE GENERATIONS | $498.87 | $1,497.00 | $523.95 | 2026-02-25 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | APIPA - MEDICARE | APIPA - MEDICARE | $498.87 | $1,497.00 | $523.95 | 2026-02-25 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | HPN SIERRA NEVADA MCR ADV | HPN SIERRA NEVADA MCR ADV | $498.87 | $1,497.00 | $523.95 | 2026-02-25 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | TRIWEST - ALL PLANS | TRIWEST - ALL PLANS | $498.87 | $1,497.00 | $523.95 | 2026-02-25 | MRF ↗ |
| USA HEALTH CHILDREN'S & WOMEN'S HOSPITAL OutpatientFacility | VIVA Health | Medicare Advantage | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH CHILDREN'S & WOMEN'S HOSPITAL OutpatientFacility | Humana | Medicare Advantage/PPO | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH CHILDREN'S & WOMEN'S HOSPITAL OutpatientFacility | Humana | Medicare Advantage/HMO | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH CHILDREN'S & WOMEN'S HOSPITAL OutpatientFacility | Devoted Health | Medicare Advantage | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH CHILDREN'S & WOMEN'S HOSPITAL OutpatientFacility | United Healthcare | Medicare Advantage | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH UNIVERSITY HOSPITAL OutpatientFacility | United Healthcare | Medicare Advantage | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH UNIVERSITY HOSPITAL OutpatientFacility | Cigna Healthspring | Medicare Advantage | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH UNIVERSITY HOSPITAL OutpatientFacility | WellCare | Medicare Advantage | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH UNIVERSITY HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH UNIVERSITY HOSPITAL OutpatientFacility | Devoted Health | Medicare Advantage | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH UNIVERSITY HOSPITAL OutpatientFacility | Humana | Medicare Advantage/PPO | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH UNIVERSITY HOSPITAL OutpatientFacility | United Healthcare | VACCN | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH CHILDREN'S & WOMEN'S HOSPITAL OutpatientFacility | United Healthcare | VACCN | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH CHILDREN'S & WOMEN'S HOSPITAL OutpatientFacility | WellCare | Medicare Advantage | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH UNIVERSITY HOSPITAL OutpatientFacility | VIVA Health | Medicare Advantage | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH UNIVERSITY HOSPITAL OutpatientFacility | Humana | Medicare Advantage/HMO | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH CHILDREN'S & WOMEN'S HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | $505.36 | — | — | 2026-04-30 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER INC BothFacility | MEDICA [91180027] | LACROSSE MEDICA MEDICARE ADVANTAGE PLAN MINNESOTA SENIOR HEALTH OPTIONS MSC+ [672] | $506.40 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER INC BothFacility | MEDICA [91200026] | LACROSSE MEDICA MEDICARE ADVANTAGE PLAN MINNESOTA SENIOR HEALTH OPTIONS MSC+ [672] | $506.40 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Dignity/Chw | Ucd Hb Dignity Health Hmo | $521.40 | — | — | 2026-04-01 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | CARE 1ST MCR ADV-ALL OTHER PLANS | CARE 1ST MCR ADV-ALL OTHER PLANS | $523.81 | $1,497.00 | $523.95 | 2026-02-25 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | MERCY CARE ADV SNP-ALL OTHER PLANS | MERCY CARE ADV SNP-ALL OTHER PLANS | $548.76 | $1,497.00 | $523.95 | 2026-02-25 | MRF ↗ |
| ANTELOPE VALLEY HOSPITAL Outpatient | Blue Shield Of California | Promise | $550.00 | $32,162.00 | $32,162.00 | 2026-05-24 | MRF ↗ |
| MAYO CLINIC HLTH SYSTM FRANCISCAN HLTHCARE SPARTA BothFacility | MEDICA [1110027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [599] | $554.63 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM CHIPPEWA VALLEY BothFacility | MEDICA [91180027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [599] | $554.63 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER INC BothFacility | MEDICA [91180027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [599] | $554.63 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM-RED CEDAR INC BothFacility | MEDICA [1110027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [599] | $554.63 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM OAKRIDGE BothFacility | MEDICA [1110027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [599] | $554.63 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM-RED CEDAR INC BothFacility | MEDICA [91180027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [599] | $554.63 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER INC BothFacility | MEDICA [1110027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [599] | $554.63 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM EAU CLAIRE HOSPITAL BothFacility | MEDICA [91180027] | MEDICA PRIME SOLUTIONS PART B MAP [599] | $554.63 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM EAU CLAIRE HOSPITAL BothFacility | MEDICA [1110027] | MEDICA PRIME SOLUTIONS PART B MAP [599] | $554.63 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM OAKRIDGE BothFacility | MEDICA [91180027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [599] | $554.63 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM CHIPPEWA VALLEY BothFacility | MEDICA [1110027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [599] | $554.63 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM-NORTHLAND BothFacility | MEDICA [1110027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [599] | $554.63 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HLTH SYSTM FRANCISCAN HLTHCARE SPARTA BothFacility | MEDICA [91180027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [599] | $554.63 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM-NORTHLAND BothFacility | MEDICA [91180027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [599] | $554.63 | $37,959.00 | $34,163.10 | 2026-03-31 | MRF ↗ |
| USA HEALTH CHILDREN'S & WOMEN'S HOSPITAL OutpatientFacility | Molina Marketplace | Medicare Advantage | $555.89 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH UNIVERSITY HOSPITAL OutpatientFacility | Molina Marketplace | Medicare Advantage | $555.89 | — | — | 2026-04-30 | MRF ↗ |
| MERCY HOSPITAL ARDMORE, INC OutpatientFacility | HEALTHCARE HIGHWAYS PLUS CONTRACTED [320175] | HB ADA, ARDM, OKLC HEALTHCARE HWY CHICKSAW NATION | — | $5,563.00 | $3,615.95 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ADA OutpatientFacility | GLOBALHEALTH CONTRACTED [320144] | HB ADA GLOBALHEALTH | — | $5,563.00 | $3,615.95 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL OKLAHOMA CITY, INC OutpatientFacility | HEALTHCARE HIGHWAYS PLUS CONTRACTED [320175] | HB ADA, ARDM, OKLC HEALTHCARE HWY CHICKSAW NATION | — | $5,563.00 | $3,615.95 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ADA OutpatientFacility | HEALTH CHOICE CONTRACTED [320166] | HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOICE (OSEEGIB) | $556.30 | $5,563.00 | $3,615.95 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ADA OutpatientFacility | HEALTHCARE HIGHWAYS PLUS CONTRACTED [320175] | HB ADA, ARDM, OKLC HEALTHCARE HWY CHICKSAW NATION | — | $5,563.00 | $3,615.95 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ARDMORE, INC OutpatientFacility | HEALTH CHOICE CONTRACTED [320166] | HB ADA, ARDM, HMH, KGFER, LGNOK, LHCP, TISH, WTGA HEALTHCHOICE (OSEEGIB) | $556.30 | $5,563.00 | $3,615.95 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL OKLAHOMA CITY, INC OutpatientFacility | HEALTH CHOICE CONTRACTED [320166] | HB OKLC HEALTHCHOICE/OSEEGIB TIER 1 | $556.30 | $5,563.00 | $3,615.95 | 2026-03-12 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | HUMANA VA | HUMANA VA | $558.73 | $1,497.00 | $523.95 | 2026-02-25 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MULTIPLAN CONTRACTED [320270] | HB STLO WASH JEFN PHCS PRIMARY | — | $8,652.00 | $5,623.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | FIRST HEALTH CONTRACTED [320128] | HB STLO WASH JEFN PHCS PRIMARY | — | $8,652.00 | $5,623.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MERCY MGD BEHAVIORAL HEALTH CONTRACTED [320259] | HB STLO WASH JEFN PHCS PRIMARY | — | $8,652.00 | $5,623.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $562.38 | $8,652.00 | $5,623.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | PRIVATE HEALTH CARE SYSTEMS CONTRACTED [320320] | HB STLO WASH JEFN PHCS PRIMARY | — | $8,652.00 | $5,623.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $562.38 | $8,652.00 | $5,623.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $562.38 | $8,652.00 | $5,623.80 | 2026-03-12 | MRF ↗ |
| MOUNT CARMEL DUBLIN BothFacility | BLUE CROSS - OH (ANTHEM) | ANTHEM BCBS PATHWAY GRP HMO | $563.86 | $26,921.00 | $17,498.65 | 2026-03-31 | MRF ↗ |
| AVOYELLES HOSPITAL Both | FIRST CHOICE HEALTH | FIRST HEALTH IP | $594.52 | $99,000.00 | $29,700.00 | 2026-04-29 | MRF ↗ |
| AVOYELLES HOSPITAL Both | AETNA | AETNA IP | $594.52 | $99,000.00 | $29,700.00 | 2026-04-29 | MRF ↗ |
| AVOYELLES HOSPITAL Both | AETNA | AETNA OP | $594.52 | $99,000.00 | $29,700.00 | 2026-04-29 | MRF ↗ |
| AVOYELLES HOSPITAL Both | FIRST CHOICE HEALTH | FIRST HEALTH OP | $594.52 | $99,000.00 | $29,700.00 | 2026-04-29 | MRF ↗ |
| AVOYELLES HOSPITAL Both | AMER CONTL INS | AMERICAN CONTINENTAL | $594.52 | $99,000.00 | $29,700.00 | 2026-04-29 | MRF ↗ |
| AVOYELLES HOSPITAL Both | FIRST CHOICE HEALTH | FIRST HEALTH PSYCH | $594.52 | $99,000.00 | $29,700.00 | 2026-04-29 | MRF ↗ |
| AVOYELLES HOSPITAL Both | COVENTRY | COVENTRY PSYCH | $594.52 | $99,000.00 | $29,700.00 | 2026-04-29 | MRF ↗ |
| AVOYELLES HOSPITAL Both | MERITAN HEALTH | MERITAIN OP | $594.52 | $99,000.00 | $29,700.00 | 2026-04-29 | MRF ↗ |
| AVOYELLES HOSPITAL Both | COVENTRY | COVENTRY IP | $594.52 | $99,000.00 | $29,700.00 | 2026-04-29 | MRF ↗ |
| AVOYELLES HOSPITAL Both | COVENTRY | COVENTRY OP | $594.52 | $99,000.00 | $29,700.00 | 2026-04-29 | MRF ↗ |
| USA HEALTH CHILDREN'S & WOMEN'S HOSPITAL OutpatientFacility | Ambetter | Commercial/Exchange | $606.43 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH UNIVERSITY HOSPITAL OutpatientFacility | Ambetter | Commercial/Exchange | $606.43 | — | — | 2026-04-30 | MRF ↗ |
| HILO BENIOFF MEDICAL CENTER OutpatientFacility | UnitedHealthcare | Medicaid | $644.55 | $63,116.00 | $37,869.60 | 2026-06-15 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MEDICAID [20240] | HB WASH JEFN LINC SAMC PCMH STOD IL MEDICAID | $678.00 | $4,520.00 | $2,938.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | AETNA MEDICAID [20009] | HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $678.00 | $4,520.00 | $2,938.00 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $678.00 | $4,520.00 | $2,938.00 | 2026-03-12 | MRF ↗ |
| USA HEALTH CHILDREN'S & WOMEN'S HOSPITAL OutpatientFacility | Mississippi Physicians Care Network (MPCN) | Commercial | $682.23 | — | — | 2026-04-30 | MRF ↗ |
| USA HEALTH UNIVERSITY HOSPITAL OutpatientFacility | Mississippi Physicians Care Network (MPCN) | Commercial | $682.23 | — | — | 2026-04-30 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | WellCare of Florida | Medicare Advantage | $697.79 | $67,002.00 | $36,851.10 | 2026-03-31 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | $697.79 | $67,002.00 | $36,851.10 | 2026-03-31 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | BLUE SHIELD [30102] | BLUE SHIELD COVERED CALIFORNIA [3010202] | $727.04 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - CANNON FALLS BothFacility | HEALTHPARTNERS [91180021] | HEALTHPARTNERS MEDICARE ADVANTAGE PLAN PART B [610] | $731.00 | $42,521.00 | $37,418.48 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM ST. JAMES BothFacility | HEALTHPARTNERS [91180021] | HEALTHPARTNERS MEDICARE ADVANTAGE PLAN PART B [610] | $731.00 | $42,521.00 | $37,418.48 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - FAIRMONT BothFacility | HEALTHPARTNERS [91180021] | HEALTHPARTNERS MEDICARE ADVANTAGE PLAN PART B [610] | $731.00 | $42,521.00 | $37,418.48 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - LAKE CITY BothFacility | HEALTHPARTNERS [91180021] | HEALTHPARTNERS MEDICARE ADVANTAGE PLAN PART B [610] | $731.00 | $42,521.00 | $37,418.48 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM NEW PRAGUE BothFacility | HEALTHPARTNERS [91180021] | HEALTHPARTNERS MEDICARE ADVANTAGE PLAN PART B [610] | $731.00 | $42,521.00 | $31,890.75 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN BothFacility | HEALTHPARTNERS [91180021] | HEALTHPARTNERS MEDICARE ADVANTAGE PLAN PART B [610] | $731.00 | $42,521.00 | $37,418.48 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - MANKATO BothFacility | HEALTHPARTNERS [91180021] | HEALTHPARTNERS MEDICARE ADVANTAGE PLAN PART B [610] | $731.00 | $42,521.00 | $37,418.48 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - WASECA BothFacility | HEALTHPARTNERS [91180021] | HEALTHPARTNERS MEDICARE ADVANTAGE PLAN PART B [610] | $731.00 | $42,521.00 | $37,418.48 | 2026-03-31 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | GEO GROUP CHC AZ STATE PRISON-ALL PLANS | GEO GROUP CHC AZ STATE PRISON-ALL PLANS | $748.31 | $1,497.00 | $523.95 | 2026-02-25 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | CIGNA-ALL PLANS | CIGNA-ALL PLANS | $748.50 | $1,497.00 | $523.95 | 2026-02-25 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | AETNA-ALL PLANS | AETNA-ALL PLANS | $773.25 | $1,497.00 | $523.95 | 2026-02-25 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | HEALTH PLAN OF NEVADA-ALL OTHER PLANS | HEALTH PLAN OF NEVADA-ALL OTHER PLANS | $773.25 | $1,497.00 | $523.95 | 2026-02-25 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | MEDICARE PART A & B [1000102] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | DESERT OASIS HEALTH CARE [30001] | HEALTHNET POS DOHC [3000109] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | HEALTH NET [30004] | HEALTHNET AMBETTER COVERED CALIF PPO [3000401] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | MEDICARE PART B [1000103] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | ASCEND HOSPICE [32000] | ASCEND HOSPICE [3200001] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP [20502] | INLAND EMPIRE HEALTH PLAN [2050201] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | RAILROAD MEDICARE [1000104] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MOLINA MCAL HMO [20503] | MOLINA MCAL HMO [2050301] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | MEDICARE PART A [1000101] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | VETERANS ADMINISTRATION [80002] | VETERANS ADMINISTRATION [8000201] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP [20502] | IEHP LASALLE MEDICAL ASSOCIATES [2050204] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | CHAMPVA [80001] | VHA OFFICE OF COMMUNITY CARE [8000101] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP [20502] | IEHP INLAND VALLEY IPA [2050203] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | AETNA [30003] | AETNA TRAVEL [3000304] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | AETNA [30003] | AETNA PPO [3000302] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP COVERED CA [20523] | IEHP COVERED CA [2052301] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP CAL MEDI-CONNECT MEDICARE ADVANTAGE [10512] | IEHP LASALLE MED ASSOC MEDICARE ADV [1051204] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP CAL MEDI-CONNECT MEDICARE ADVANTAGE [10512] | IEHP INLAND VALLEY IPA MEDICARE ADV [1051203] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | AETNA [30003] | AETNA HMO/POS/EPO [3000301] | $773.45 | $1,546.89 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | HEALTH NET [30004] | HEALTHNET AMBETTER COVERED CALIF HMO [3000405] | $773.45 | $1,546.89 | — | 2026-04-02 | 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.