A9504 — Tc99m Apcitide
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Tc99m apcitide (OTHER A9504) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/A9504?code_type=OTHER
MLA (9th ed.)
“Tc99m apcitide (OTHER A9504) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/A9504?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“Tc99m apcitide (OTHER A9504) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/A9504?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $452–$787 (25th–75th percentile) across 103 hospitals · 93 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER A9504 — 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 |
|---|---|---|---|---|---|---|---|
| VALLEY HOSPITAL MEDICAL CENTER Both | Anthem Blue Cross Blue Shield | Medicaid | $24.55 | $773.00 | $309.20 | 2026-05-06 | MRF ↗ |
| VALLEY HOSPITAL MEDICAL CENTER Both | Smart Choice | Medicaid | $24.55 | $773.00 | $309.20 | 2026-05-06 | MRF ↗ |
| VALLEY HOSPITAL MEDICAL CENTER Both | Silver Summit | Medicaid | $25.04 | $773.00 | $309.20 | 2026-05-06 | MRF ↗ |
| VALLEY HOSPITAL MEDICAL CENTER Both | Molina | Medicaid | $25.29 | $773.00 | $309.20 | 2026-05-06 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Upmc | Chip | $37.18 | — | — | 2026-05-23 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Upmc | Chip | $37.18 | — | — | 2026-05-13 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Aetna | Commercial | — | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Upmc | Mcd Advantage | $40.90 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $46.48 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Upmc | Commercial | $46.48 | — | — | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $46.48 | — | — | 2026-05-23 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Surest | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Healthscope | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-05-17 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Medica | — | — | — | 2026-05-18 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-05-17 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | Geha | Geha | — | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-05-17 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-05-18 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-05-22 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-05-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-05-18 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-05-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Medica | — | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-05-17 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Surest | — | — | — | 2026-05-22 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Surest | — | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | Geha | Geha | — | — | — | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Medica | — | — | — | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Medica | — | — | — | 2026-05-17 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Surest | — | — | — | 2026-05-18 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-05-17 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-05-22 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Surest | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Healthscope | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-05-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-05-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-05-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Medica | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Medica | — | — | — | 2026-05-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-05-22 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Healthscope | — | — | — | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Healthscope | — | — | — | 2026-05-18 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-05-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Surest | — | — | — | 2026-05-22 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | Geha | Geha | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-05-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | Geha | Geha | — | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-05-22 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-05-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-05-18 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-05-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-05-22 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-05-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | Geha | Geha | — | — | — | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | Geha | Geha | — | — | — | 2026-05-17 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Healthscope | — | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-05-17 | MRF ↗ |
| TWIN COUNTY REGIONAL HOSPITAL Outpatient | Vaughan-Bassett Furniture Co. | Vaughan-Bassett | — | $635.00 | $254.00 | 2026-05-23 | MRF ↗ |
| TWIN COUNTY REGIONAL HOSPITAL Outpatient | Medcost | Medcost | — | $635.00 | $254.00 | 2026-05-23 | MRF ↗ |
| TWIN COUNTY REGIONAL HOSPITAL Outpatient | Bcbs Of Va | Anthem Blue Cross Hmo | — | $635.00 | $254.00 | 2026-05-23 | MRF ↗ |
| TWIN COUNTY REGIONAL HOSPITAL Outpatient | Uhc | Uhc | — | $635.00 | $254.00 | 2026-05-23 | MRF ↗ |
| TWIN COUNTY REGIONAL HOSPITAL Outpatient | Bcbs Of Va | Anthem Blue Cross Ppo | — | $635.00 | $254.00 | 2026-05-23 | MRF ↗ |
| TWIN COUNTY REGIONAL HOSPITAL Outpatient | Cigna | Cigna | — | $635.00 | $254.00 | 2026-05-23 | MRF ↗ |
| TWIN COUNTY REGIONAL HOSPITAL Outpatient | Bcbs Of Va | Anthem Hix | — | $635.00 | $254.00 | 2026-05-23 | MRF ↗ |
| TWIN COUNTY REGIONAL HOSPITAL Outpatient | Gateway | Gateway | — | $635.00 | $254.00 | 2026-05-23 | MRF ↗ |
| TWIN COUNTY REGIONAL HOSPITAL Outpatient | Optima Health Plan | Sentara (Optima) | — | $635.00 | $254.00 | 2026-05-23 | MRF ↗ |
| TWIN COUNTY REGIONAL HOSPITAL Outpatient | Aetna | Aetna | — | $635.00 | $254.00 | 2026-05-23 | MRF ↗ |
| TWIN COUNTY REGIONAL HOSPITAL Outpatient | Optima Health Plan | Optima | — | $635.00 | $254.00 | 2026-05-23 | MRF ↗ |
| CHESHIRE MEDICAL CENTER Outpatient | Aetna | Aetna Hmo/Pos/Ppo | — | — | — | 2026-05-08 | MRF ↗ |
| CHESHIRE MEDICAL CENTER Outpatient | Aetna | Aetna Hmo/Pos/Ppo | — | — | — | 2026-05-23 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Caresource | Caresourcemedicaid | $79.78 | — | — | 2026-05-27 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Anthem | Anthemmedicaid | $79.78 | — | — | 2026-05-27 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Molina | Molinamedicaid | $82.17 | — | — | 2026-05-27 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Amerihealth | Amerihealthmedicaid | $82.17 | — | — | 2026-05-27 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Buckeye | Buckeyemedicaid | $82.17 | — | — | 2026-05-27 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | United Healthcare | Unitedmedicaid | $82.17 | — | — | 2026-05-27 | MRF ↗ |
| UNIVERSITY OF LOUISVILLE HOSPITAL Outpatient | Anthem | In Medicaid | — | — | — | 2026-05-22 | MRF ↗ |
| UNIVERSITY OF LOUISVILLE HOSPITAL Outpatient | Anthem | In Medicaid | — | — | — | 2026-05-14 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hip | — | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | Pathways For Aging | — | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hhw | — | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hip | — | — | — | 2026-05-09 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hcc Bh | — | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hip | — | — | — | 2026-05-09 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mdwise | In Medicaid Hip | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hcc | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mdwise | In Medicaid Hhw | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hhw | — | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hcc | — | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hip | — | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hhw | — | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Caresource | In Medicaid Hhw | — | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Caresource | In Medicaid Hip | — | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Humana | Pathways For Aging | — | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Uhc | Pathways For Aging | — | — | — | 2026-05-09 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hhw Bh | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hcc | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Caresource | In Medicaid Hhw | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hip Bh | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Caresource | In Medicaid Hip | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | Pathways For Aging | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hip | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hhw | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Humana | Pathways For Aging | — | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Uhc | Pathways For Aging | — | — | — | 2026-05-13 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Caresource | Wv Marketplace | — | — | — | 2026-05-14 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Caresource | Wv Marketplace | — | — | — | 2026-05-24 | MRF ↗ |
| FORT DUNCAN MEDICAL CENTER Both | Driscoll | Medicaid | $96.10 | $622.00 | $248.80 | 2026-05-23 | MRF ↗ |
| FORT DUNCAN MEDICAL CENTER Both | Driscoll | Medicaid | $96.10 | $622.00 | $248.80 | 2026-05-14 | MRF ↗ |
| FORT DUNCAN MEDICAL CENTER Both | United Healthcare | Medicaid | $97.97 | $622.00 | $248.80 | 2026-05-14 | MRF ↗ |
| FORT DUNCAN MEDICAL CENTER Both | Molina | Medicaid | $97.97 | $622.00 | $248.80 | 2026-05-14 | MRF ↗ |
| FORT DUNCAN MEDICAL CENTER Both | United Healthcare | Medicaid | $97.97 | $622.00 | $248.80 | 2026-05-23 | MRF ↗ |
| FORT DUNCAN MEDICAL CENTER Both | Molina | Medicaid | $97.97 | $622.00 | $248.80 | 2026-05-23 | MRF ↗ |
| VALLEY HOSPITAL MEDICAL CENTER Both | Prominence | Hmo | $110.08 | $773.00 | $309.20 | 2026-05-06 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Blue Cross | Blue Access & Small Group | $120.00 | — | — | 2026-05-14 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Blue Cross | Blue Access & Small Group | $120.00 | — | — | 2026-05-23 | MRF ↗ |
| VALLEY HOSPITAL MEDICAL CENTER Both | Prominence | Ppo | $125.84 | $773.00 | $309.20 | 2026-05-06 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Upmc | Commercial | $126.88 | — | — | 2026-05-09 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Blue Cross | Epo/Ppo/Hmo/Indemnity | $128.00 | — | — | 2026-05-14 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Blue Cross | Epo/Ppo/Hmo/Indemnity | $128.00 | — | — | 2026-05-23 | MRF ↗ |
| VALLEY HOSPITAL MEDICAL CENTER Both | Sierra Health Options | Managed Care | $149.19 | $773.00 | $309.20 | 2026-05-06 | MRF ↗ |
| SAN JUAN REGIONAL MEDICAL CENTER INC Both | Standard_Charge|Rocky_Mountain_Health_Plans_Medicaid|Negotiated_Charge | — | $150.75 | $201.00 | $100.50 | 2026-05-22 | MRF ↗ |
| SAN JUAN REGIONAL MEDICAL CENTER INC Both | Standard_Charge|Humana_Choicecare_Commercial|Negotiated_Charge | — | $160.80 | $201.00 | $100.50 | 2026-05-22 | MRF ↗ |
| SAN JUAN REGIONAL MEDICAL CENTER INC Both | Standard_Charge|Cigna|Negotiated_Charge | — | $169.04 | $201.00 | $100.50 | 2026-05-22 | MRF ↗ |
| SAN JUAN REGIONAL MEDICAL CENTER INC Both | Standard_Charge|Uhc_Commercial|Negotiated_Charge | — | $170.85 | $201.00 | $100.50 | 2026-05-22 | MRF ↗ |
| SAN JUAN REGIONAL MEDICAL CENTER INC Both | Standard_Charge|Aetna|Negotiated_Charge | — | $180.90 | $201.00 | $100.50 | 2026-05-22 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Commercial | — | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $181.51 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Commercial | — | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $181.51 | — | — | 2026-05-23 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Upmc | Commercial | $204.47 | — | — | 2026-05-23 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Upmc | Commercial | $204.47 | — | — | 2026-05-13 | MRF ↗ |
| FORT DUNCAN MEDICAL CENTER Both | Superior | Medicaid | $211.48 | $622.00 | $248.80 | 2026-05-14 | MRF ↗ |
| FORT DUNCAN MEDICAL CENTER Both | Superior | Medicaid | $211.48 | $622.00 | $248.80 | 2026-05-23 | MRF ↗ |
| VALLEY HOSPITAL MEDICAL CENTER Both | Aetna | Managed Care | $243.50 | $773.00 | $309.20 | 2026-05-06 | MRF ↗ |
| VALLEY HOSPITAL MEDICAL CENTER Both | Sierra Health Plan Of Nevada | Managed Care | $248.13 | $773.00 | $309.20 | 2026-05-06 | MRF ↗ |
| FORT DUNCAN MEDICAL CENTER Both | United Healthcare | Managed Care | $255.02 | $622.00 | $248.80 | 2026-05-23 | MRF ↗ |
| FORT DUNCAN MEDICAL CENTER Both | United Healthcare | Managed Care | $255.02 | $622.00 | $248.80 | 2026-05-14 | MRF ↗ |
| FORT DUNCAN MEDICAL CENTER Both | Eagle Pass Isd | Managed Care | $267.46 | $622.00 | $248.80 | 2026-05-23 | MRF ↗ |
| FORT DUNCAN MEDICAL CENTER Both | Eagle Pass Isd | Managed Care | $267.46 | $622.00 | $248.80 | 2026-05-14 | MRF ↗ |
| COLUMBIA MEMORIAL HOSPITAL Both | Blue Cross | Blue Access Small Group | $306.00 | — | — | 2026-05-08 | MRF ↗ |
| FORT DUNCAN MEDICAL CENTER Both | Blue Cross Blue Shield Of Tx | Hmo | $311.00 | $622.00 | $248.80 | 2026-05-23 | MRF ↗ |
| FORT DUNCAN MEDICAL CENTER Both | Blue Cross Blue Shield Of Tx | Hmo | $311.00 | $622.00 | $248.80 | 2026-05-14 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Wellsense Health Plan | Wellsense - Nh Managed Medicaid | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Wellsense Health Plan | Wellsense - Nh Managed Medicaid - Dhp | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Granite State Health Plan | New Hampshire Healthy Families - Nh Managed Medicaid - Dhp | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Granite State Health Plan | New Hampshire Healthy Families - Nh Managed Medicaid Beh Health - Dhp | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Granite State Health Plan | New Hampshire Healthy Families - Nh Managed Medicaid Beh Health | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Granite State Health Plan | New Hampshire Healthy Families - Nh Managed Medicaid | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Beacon Health Strategies/Carelon | Wellsense - Nh Managed Medicaid Beh Health | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Beacon Health Strategies/Carelon | Wellsense - Nh Managed Medicaid Beh Health - Dhp | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Amerihealth Caritas Nh | Amerihealth Caritas - Nh Managed Medicaid - Dhp | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Amerihealth Caritas Nh | Amerihealth Caritas - Nh Managed Medicaid | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Maine Community Health Options | Mcho Indiv - Exchange | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | First Health/Hcvm | First Health/Hcvm | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | First Health/Hcvm | First Health/Hcvm - Dhp | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Ccmsi | Ccmsi - Workers Comp | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Corvel | Corvel - Workers Comp | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Cigna | Cigna Hmo-Pos | $312.31 | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Cigna | Cigna Ppo | $312.31 | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Phcs | Phcs - Ppo | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Unitedhealthcare | Uhc - Indemnity | — | — | — | 2026-05-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Coventry | Coventry- Workers Comp | — | — | — | 2026-05-08 | MRF ↗ |
| GLENS FALLS HOSPITAL Both | Blue Cross | Epo Hmo | $316.80 | — | — | 2026-05-08 | MRF ↗ |
| COLUMBIA MEMORIAL HOSPITAL Both | Blue Cross | Hmo | $324.00 | — | — | 2026-05-08 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Uhc | Pathways For Aging | — | — | — | 2026-05-14 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hip | — | — | — | 2026-05-14 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hhw | — | — | — | 2026-05-14 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | — | — | — | 2026-05-22 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hip | — | — | — | 2026-05-14 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | — | — | — | 2026-05-14 | 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.