A9584 — Iodine I-123 Ioflupane
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Iodine i-123 ioflupane (HCPCS A9584) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/A9584?code_type=HCPCS
MLA (9th ed.)
“Iodine i-123 ioflupane (HCPCS A9584) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/A9584?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Iodine i-123 ioflupane (HCPCS A9584) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/A9584?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,527–$5,995 (25th–75th percentile) across 1,468 hospitals · 3,610 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS A9584 — 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 |
|---|---|---|---|---|---|---|---|
| ST FRANCIS HOSPITAL & MEDICAL CENTER OutpatientFacility | CTCare | Medicare Advantage | — | $7,404.00 | $4,072.20 | 2025-01-01 | MRF ↗ |
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | None | — | — | $56,161.00 | $28,080.50 | 2024-12-15 | MRF ↗ |
| SAINT AGNES MEDICAL CENTER OutpatientFacility | UHC | All products | — | $19,744.00 | $13,820.80 | 2025-01-01 | MRF ↗ |
| SAINT AGNES MEDICAL CENTER OutpatientFacility | Correct Care Integrated Health | Medicaid | — | $19,744.00 | $13,820.80 | 2025-01-01 | MRF ↗ |
| ST FRANCIS HOSPITAL & MEDICAL CENTER OutpatientFacility | CTCare | Medicare Advantage | — | $7,404.00 | $4,072.20 | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | VNA Homecare Options | Medicaid | — | $7,404.00 | $6,293.40 | 2025-01-01 | MRF ↗ |
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | None | — | — | $56,161.00 | $28,080.50 | 2024-12-15 | MRF ↗ |
| SAINT MARY'S HOSPITAL OutpatientFacility | CTCare | Medicare Advantage | — | $7,404.00 | $4,072.20 | 2025-01-01 | MRF ↗ |
| JOHNSON MEMORIAL HOSPITAL OutpatientFacility | CTCare | Medicare Advantage | — | $12,340.00 | $6,787.00 | 2025-01-01 | MRF ↗ |
| JOHNSON MEMORIAL HOSPITAL OutpatientFacility | CTCare | Medicare Advantage | — | $12,340.00 | $6,787.00 | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | VNA Homecare Options | Medicaid | — | $7,404.00 | $6,293.40 | 2025-01-01 | MRF ↗ |
| SUNNYVIEW HOSPITAL AND REHABILITATION CENTER OutpatientFacility | VNA Homecare Options | Medicaid | — | $7,404.00 | $6,293.40 | 2025-01-01 | MRF ↗ |
| ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL OutpatientFacility | Wellpoint | NJ Family Care | $0.33 | — | — | 2026-03-04 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | HMO | — | $7,413.31 | $6,078.91 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | EPO | — | $7,413.31 | $6,078.91 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | CORVEL HEALTHCARE CORPORATION | Worker's Compensation | — | $1.01 | $0.65 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | HMO | — | $7,413.31 | $6,078.91 | 2025-11-26 | MRF ↗ |
| ESSENTIA HEALTH DULUTH OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $7,413.31 | $6,078.91 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $1.01 | $0.65 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | Covered | — | $7,413.31 | $6,078.91 | 2025-11-26 | MRF ↗ |
| ESSENTIA HEALTH OutpatientFacility | BCBS PLUS PMAP PCC PRIME | Medicaid | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $7,413.31 | $6,078.91 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | Health Net of California, Inc. | HMO | — | $7,413.31 | $6,078.91 | 2025-11-26 | MRF ↗ |
| ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| ESSENTIA HEALTH OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $7,413.31 | $6,078.91 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $7,413.31 | $6,078.91 | 2025-11-26 | MRF ↗ |
| ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER OutpatientFacility | BLUE PLUS PMAP PCC PRIME | Medicaid | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $7,413.31 | $6,078.91 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | SCAN Health Plan | Medicare Advantage | — | $1.01 | $0.65 | 2025-11-26 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | Self Insured | $2.10 | $5,400.00 | — | 2025-06-28 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Prospect Health Plan, Inc. | Medi-Cal | — | $1.01 | $0.65 | 2025-11-26 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $11.33 | $6,296.00 | — | 2024-12-31 | MRF ↗ |
| ST JOE MERCY HOSPITAL SYSTEM LIVONIA OutpatientFacility | VACCN United | Veterans Affairs | $20.50 | $12,340.00 | $8,021.00 | 2025-01-01 | MRF ↗ |
| ST JOE MERCY HOSPITAL SYSTEM LIVONIA OutpatientFacility | VACCN United | Veterans Affairs | $20.50 | $12,340.00 | $8,021.00 | 2025-01-01 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $23.09 | $6,240.00 | $5,928.00 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $23.09 | $6,240.00 | $5,928.00 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $23.09 | $6,240.00 | $5,928.00 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $23.71 | $6,240.00 | $5,928.00 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $24.34 | $6,240.00 | $5,928.00 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $24.96 | $6,240.00 | $5,928.00 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $25.40 | $5,292.00 | $5,027.40 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $25.40 | $5,292.00 | $5,027.40 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $25.93 | $5,292.00 | $5,027.40 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $25.93 | $5,292.00 | $5,027.40 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $25.93 | $5,292.00 | $5,027.40 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $25.93 | $5,292.00 | $5,027.40 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $26.46 | $5,292.00 | $5,027.40 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $26.99 | $5,292.00 | $5,027.40 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $27.52 | $5,292.00 | $5,027.40 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $28.58 | $5,292.00 | $5,027.40 | 2026-02-20 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| ST CATHERINE OF SIENA HOSPITAL OutpatientFacility | Beacon Health Options | Medicare | $32.39 | $17,885.00 | — | 2026-02-19 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Cigna HealthCare of California, Inc. (CHC) and Cigna Health and Life Insurance Company (CHLIC) | POS | — | $7,413.31 | $6,078.91 | 2025-11-26 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $43.07 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $43.07 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $43.07 | — | — | 2026-03-18 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Cigna HealthCare of California, Inc. (CHC) and Cigna Health and Life Insurance Company (CHLIC) | PPO | — | $7,413.31 | $6,078.91 | 2025-11-26 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $49.36 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $49.36 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $49.36 | — | — | 2026-03-18 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $53.75 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $53.75 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $53.75 | — | — | 2026-03-18 | MRF ↗ |
| SAINT MARY'S HOSPITAL OutpatientFacility | UHC | All Products | $62.00 | $7,404.00 | $4,072.20 | 2025-01-01 | MRF ↗ |
| MEDICAL CITY DENTON Outpatient | Imaging Providers of Texas | HMOBlue | $70.00 | — | — | 2026-03-01 | MRF ↗ |
| MEDICAL CITY PLANO Outpatient | Imaging Providers of Texas | HMOBlue | $70.00 | $8,018.59 | $8,018.59 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY SPINE HOSPITAL Outpatient | Imaging Providers of Texas | HMOBlue | $70.00 | $17,933.34 | $17,933.34 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY HEART HOSPITAL Outpatient | Imaging Providers of Texas | HMOBlue | $70.00 | $17,933.34 | $17,933.34 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY ARGYLE HOSPITAL Outpatient | Imaging Providers of Texas | HMOBlue | $70.00 | — | — | 2026-03-01 | MRF ↗ |
| MEDICAL CITY ARLINGTON Outpatient | Imaging Providers of Texas | HMOBlue | $70.00 | — | — | 2026-03-01 | MRF ↗ |
| MEDICAL CENTER OF MCKINNEY Outpatient | Imaging Providers of Texas | HMOBlue | $70.00 | — | — | 2026-03-01 | MRF ↗ |
| MEDICAL CITY DALLAS HOSPITAL Outpatient | Imaging Providers of Texas | HMOBlue | $70.00 | $17,933.34 | $17,933.34 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Imaging Providers of Texas | HMOBlue | $70.00 | $180,804.82 | $180,804.82 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY LEWISVILLE Outpatient | Imaging Providers of Texas | HMOBlue | $70.00 | $12,505.31 | $12,505.31 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY NORTH HILLS Outpatient | Imaging Providers of Texas | HMOBlue | $70.00 | $16,095.98 | $16,095.98 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY LAS COLINAS Outpatient | Imaging Providers of Texas | HMOBlue | $70.00 | — | — | 2026-03-01 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Oxford | Value Based/Exchange - All Payor | — | $6,296.00 | — | 2024-12-31 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | United | HMO | — | $6,296.00 | — | 2024-12-31 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Brighton Health Plan | All Products | $82.15 | $6,296.00 | — | 2024-12-31 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | MVP | Individual Plan | $89.00 | $7,404.00 | $6,293.40 | 2025-01-01 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | $5,586.00 | $4,189.50 | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $98.80 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $98.80 | — | — | 2025-01-01 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $98.92 | — | — | 2025-06-28 | MRF ↗ |
| CHI ST LUKES LAKESIDE HOSPITAL Outpatient | Cigna | Commercial|HMO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| CHI ST LUKES LAKESIDE HOSPITAL Outpatient | Cigna | Commercial|PPO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| CHI ST LUKES LAKESIDE HOSPITAL Outpatient | Cigna | Commercial|Surefit | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| CHANDLER REGIONAL MEDICAL CENTER Outpatient | Aetna | Commercial|PPO | $100.00 | $11,285.00 | $3,024.38 | 2026-02-28 | MRF ↗ |
| ST LUKE'S THE WOODLANDS HOSPITAL Outpatient | Cigna | Commercial|PPO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| ST LUKE'S THE WOODLANDS HOSPITAL Outpatient | Cigna | Commercial|Surefit | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| ST LUKE'S THE WOODLANDS HOSPITAL Outpatient | Cigna | Commercial|Surefit | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| ST LUKE'S HOSPITAL AT THE VINTAGE Outpatient | Cigna | Commercial|PPO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| Baylor St Lukes Medical Center Outpatient | Cigna | Commercial|Surefit | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| CHANDLER REGIONAL MEDICAL CENTER Outpatient | Aetna | Commercial|All Other Plans | $100.00 | $11,285.00 | $3,024.38 | 2026-02-28 | MRF ↗ |
| ST LUKE'S THE WOODLANDS HOSPITAL Outpatient | Cigna | Commercial|HMO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| MERCY GILBERT MEDICAL CENTER Outpatient | Aetna | Commercial|All Other Plans | $100.00 | $11,285.00 | $2,776.11 | 2026-02-28 | MRF ↗ |
| SAINT ROSE DOMINICAN HOSPITALS - ROSE DE LIMA Outpatient | Aetna | Commercial|All Other Plans | $100.00 | $7,120.00 | $2,036.32 | 2026-02-28 | MRF ↗ |
| ST LUKE'S THE WOODLANDS HOSPITAL Outpatient | Cigna | Commercial|HMO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| ST LUKE'S HOSPITAL AT THE VINTAGE Outpatient | Cigna | Commercial|Surefit | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| MERCY GILBERT MEDICAL CENTER Outpatient | Aetna | Commercial|HMO | $100.00 | $11,285.00 | $2,776.11 | 2026-02-28 | MRF ↗ |
| St. Luke's Health - Springwoods Village Hospital Outpatient | Cigna | Commercial|PPO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| CHANDLER REGIONAL MEDICAL CENTER Outpatient | Aetna | Commercial|HMO | $100.00 | $11,285.00 | $3,024.38 | 2026-02-28 | MRF ↗ |
| St Rose Dominican Hospital Siena Campus Outpatient | Aetna | Commercial|PPO | $100.00 | $7,120.00 | $1,616.24 | 2026-02-28 | MRF ↗ |
| CHANDLER REGIONAL MEDICAL CENTER Outpatient | Aetna | Commercial|PPO | $100.00 | $11,285.00 | $3,024.38 | 2026-02-28 | MRF ↗ |
| ST LUKE'S HOSPITAL AT THE VINTAGE Outpatient | Cigna | Commercial|HMO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| MERCY GILBERT MEDICAL CENTER Outpatient | Aetna | Commercial|PPO | $100.00 | $11,285.00 | $2,776.11 | 2026-02-28 | MRF ↗ |
| MERCY GILBERT MEDICAL CENTER Outpatient | Aetna | Commercial|All Other Plans | $100.00 | $11,285.00 | $2,776.11 | 2026-02-28 | MRF ↗ |
| ST JOSEPHS HOSPITAL AND MEDICAL CENTER Outpatient | Aetna | Commercial|All Plans | $100.00 | $5,894.00 | $2,251.51 | 2026-02-28 | MRF ↗ |
| St. Luke's Health - Springwoods Village Hospital Outpatient | Cigna | Commercial|HMO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| ST LUKE'S SUGAR LAND HOSPITAL Outpatient | Cigna | Commercial|HMO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| CHANDLER REGIONAL MEDICAL CENTER Outpatient | Aetna | Commercial|All Other Plans | $100.00 | $11,285.00 | $3,024.38 | 2026-02-28 | MRF ↗ |
| SAINT ROSE DOMINICAN HOSPITALS - ROSE DE LIMA Outpatient | Aetna | Commercial|PPO | $100.00 | $7,120.00 | $2,036.32 | 2026-02-28 | MRF ↗ |
| SAINT ROSE DOMINICAN HOSPITALS - SAN MARTIN CAMPUS Outpatient | Aetna | Commercial|PPO | $100.00 | $7,120.00 | $1,459.60 | 2026-02-28 | MRF ↗ |
| ST LUKE'S THE WOODLANDS HOSPITAL Outpatient | Cigna | Commercial|PPO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| SAINT ROSE DOMINICAN HOSPITALS - SAN MARTIN CAMPUS Outpatient | Aetna | Commercial|All Other Plans | $100.00 | $7,120.00 | $1,459.60 | 2026-02-28 | MRF ↗ |
| St Rose Dominican Hospital Siena Campus Outpatient | Aetna | Commercial|All Other Plans | $100.00 | $7,120.00 | $1,616.24 | 2026-02-28 | MRF ↗ |
| ST LUKE'S SUGAR LAND HOSPITAL Outpatient | Cigna | Commercial|Surefit | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| MERCY GILBERT MEDICAL CENTER Outpatient | Aetna | Commercial|HMO | $100.00 | $11,285.00 | $2,776.11 | 2026-02-28 | MRF ↗ |
| CHI ST LUKES LAKESIDE HOSPITAL Outpatient | Cigna | Commercial|Surefit | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| ST LUKE'S SUGAR LAND HOSPITAL Outpatient | Cigna | Commercial|PPO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| MERCY GILBERT MEDICAL CENTER Outpatient | Aetna | Commercial|PPO | $100.00 | $11,285.00 | $2,776.11 | 2026-02-28 | MRF ↗ |
| CHI ST LUKES LAKESIDE HOSPITAL Outpatient | Cigna | Commercial|PPO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| Baylor St Lukes Medical Center Outpatient | Cigna | Commercial|PPO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| St. Luke's Health - Springwoods Village Hospital Outpatient | Cigna | Commercial|Surefit | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| CHANDLER REGIONAL MEDICAL CENTER Outpatient | Aetna | Commercial|HMO | $100.00 | $11,285.00 | $3,024.38 | 2026-02-28 | MRF ↗ |
| CHI ST LUKES LAKESIDE HOSPITAL Outpatient | Cigna | Commercial|HMO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| Baylor St Lukes Medical Center Outpatient | Cigna | Commercial|HMO | $100.00 | $11,649.00 | $4,077.15 | 2026-02-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $100.19 | — | — | 2025-06-28 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Kaiser Foundation Hospitals | Medicare Advantage | — | $1.01 | $0.65 | 2025-11-26 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | UHC | Medicaid | $102.75 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | UHC | Medicaid | $102.75 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Molina | Medicaid | $103.74 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Molina | Medicaid | $103.74 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Anthem | Medicaid | $103.74 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Anthem | Medicaid | $103.74 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Humana | Medicaid | $104.73 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Humana | Medicaid | $104.73 | — | — | 2025-01-01 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $104.73 | — | — | 2025-06-28 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | Summacare | MEDICARE ADVANTAGE | $104.73 | — | — | 2025-06-28 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Kaiser Foundation Hospitals | HMO | — | $1.01 | $0.65 | 2025-11-26 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Caresource | Medicaid | $105.72 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Caresource | Medicaid | $105.72 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye Community Health | Medicaid | $105.72 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye (Centene) | Medicaid | $105.72 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | AmeriHealth Caritas | Medicaid | $105.72 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye (Centene) | Medicaid | $105.72 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | AmeriHealth Caritas | Medicaid | $105.72 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye Community Health | Medicaid | $105.72 | — | — | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL BothFacility | Empire | Medicare Advantage | $107.00 | $7,404.00 | $6,293.40 | 2025-01-01 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | Paramount | Managed Medicaid | $107.25 | — | — | 2025-06-28 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Safe Program | Medicaid | $107.69 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | PARAMOUNT | Medicaid | $107.69 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | PARAMOUNT | Medicaid | $107.69 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Safe Program | Medicaid | $107.69 | — | — | 2025-01-01 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | Buckeye | Managed Medicaid | $107.87 | — | — | 2025-06-28 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | CARESOURCE | Managed Medicaid | $107.87 | — | — | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | Paramount | Managed Medicaid | $108.62 | — | — | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $109.34 | — | — | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $109.34 | — | — | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $109.34 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $109.65 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $109.65 | — | — | 2025-06-28 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | MOLINA | Managed Medicaid | $109.97 | — | — | 2025-06-28 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | ANTHEM | Managed Medicaid | $109.97 | — | — | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | United BH | Managed Medicaid | $110.38 | — | — | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $110.73 | — | — | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $110.73 | — | — | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $110.73 | — | — | 2025-06-28 | MRF ↗ |
| ADVENTHEALTH HENDERSONVILLE Outpatient | Wellcare_of_NC | Medicare_HMO | $111.00 | $56,701.00 | $28,350.50 | 2024-12-15 | MRF ↗ |
| ADVENTHEALTH HENDERSONVILLE Outpatient | Blue_Cross_Blue_Shield_of_North_Carolina | Medicare | $111.00 | $56,701.00 | $28,350.50 | 2024-12-15 | MRF ↗ |
| ADVENTHEALTH HENDERSONVILLE Outpatient | Humana_Health | PFFS_Medicare | $111.00 | $56,701.00 | $28,350.50 | 2024-12-15 | MRF ↗ |
| ADVENTHEALTH HENDERSONVILLE Outpatient | Aetna | Medicare | $111.00 | $56,701.00 | $28,350.50 | 2024-12-15 | MRF ↗ |
| AdventHealthManchester Outpatient | Anthem_BCBS | HMO_PPO_Medicare | $111.00 | $56,701.00 | $28,350.50 | 2024-12-15 | MRF ↗ |
| AdventHealthManchester Outpatient | Humana_Health_Plan | HMO_PPO_Medicare | $111.00 | $56,701.00 | $28,350.50 | 2024-12-15 | MRF ↗ |
| ADVENTHEALTH HENDERSONVILLE Outpatient | United_HealthCare | Medicare_HMO_PPO | $111.00 | $56,701.00 | $28,350.50 | 2024-12-15 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $111.42 | — | — | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $111.42 | — | — | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | United BH | Managed Medicaid | $111.79 | — | — | 2025-06-28 | MRF ↗ |
| ADVENTHEALTH HENDERSONVILLE Outpatient | Humana_Health | Medicare_HMO_PPO | $112.00 | $56,701.00 | $28,350.50 | 2024-12-15 | MRF ↗ |
| ADVENTHEALTH REDMOND Outpatient | Anthem_BCBS_of_GA | _Medicare_HMO | $112.00 | $57,241.00 | $28,620.50 | 2024-12-15 | MRF ↗ |
| ADVENTHEALTH GORDON Outpatient | Cigna_Healthcare_of_Georgia | _Medicare_HMO | $112.00 | $57,241.00 | $28,620.50 | 2024-12-15 | MRF ↗ |
| ADVENTHEALTH REDMOND Outpatient | Aetna_of_GA | Medicare_HMO | $112.00 | $57,241.00 | $28,620.50 | 2024-12-15 | MRF ↗ |
| ADVENTHEALTH REDMOND Outpatient | Humana | HMO_Medicare | $112.00 | $57,241.00 | $28,620.50 | 2024-12-15 | MRF ↗ |
| AdventHealthManchester Outpatient | Molina_Healthcare_of_KY | HMO_Medicare | $112.00 | $56,701.00 | $28,350.50 | 2024-12-15 | MRF ↗ |
| ADVENTHEALTH GORDON Outpatient | Humana | Medicare_PFFS | $112.00 | $57,241.00 | $28,620.50 | 2024-12-15 | MRF ↗ |
| ADVENTHEALTH REDMOND Outpatient | Cigna | _Medicare_HMO | $112.00 | $57,241.00 | $28,620.50 | 2024-12-15 | MRF ↗ |
| ADVENTHEALTH MURRAY Outpatient | Humana_Health_Plan | HMO_PPO_Medicare | $112.00 | $57,241.00 | $28,620.50 | 2024-12-15 | MRF ↗ |
| EUCLID HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $112.02 | — | — | 2025-06-28 | 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.