C8921 — Tte W Or Without Fol W/cont, Com
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Tte w or w/o fol w/cont, com (HCPCS C8921) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/C8921?code_type=HCPCS
MLA (9th ed.)
“Tte w or w/o fol w/cont, com (HCPCS C8921) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/C8921?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Tte w or w/o fol w/cont, com (HCPCS C8921) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/C8921?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $801–$1,766 (25th–75th percentile) across 1,283 hospitals · 3,243 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS C8921 — 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 MEDICAL CENTER OutpatientFacility | Self Pay | All Plans | $0.03 | $5,199.00 | — | 2026-02-19 | MRF ↗ |
| CHSLI ST JOSEPH HOSPITAL OutpatientFacility | United Healthcare | BH Empire MPN | $0.03 | $5,199.00 | — | 2026-02-19 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | United Healthcare | BH Empire MPN | $0.03 | $5,199.00 | — | 2026-02-19 | MRF ↗ |
| CHSLI ST JOSEPH HOSPITAL OutpatientFacility | Self Pay | All Plans | $0.03 | $5,199.00 | — | 2026-02-19 | MRF ↗ |
| GARNET HEALTH MEDICAL CENTER CATSKILLS OutpatientFacility | Blue Cross | All Commercial Plans | $0.06 | — | — | 2026-04-01 | MRF ↗ |
| SAN ANTONIO REGIONAL HOSPITAL Outpatient | ANTHEM BLUE CROSS EXCHG | ANTHEM BLUE CROSS EXCHG | $5.89 | $2,695.00 | $1,263.00 | 2026-04-02 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $14.08 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $14.17 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $14.17 | — | — | 2026-03-18 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - Molina | Medicaid - Molina | $16.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $16.13 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $16.23 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $16.23 | — | — | 2026-03-18 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $17.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Medicaid - United | Medicaid - United | $17.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $17.56 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $17.67 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $17.67 | — | — | 2026-03-18 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - United | Medicaid - United | $18.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $19.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - Meridian | Medicaid - Meridian | $19.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $19.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - Meridian | Medicaid - Meridian | $19.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - United | Medicaid - United | $20.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| ST JOE MERCY HOSPITAL SYSTEM LIVONIA OutpatientFacility | VACCN United | Veterans Affairs | $20.50 | $2,400.00 | $1,560.00 | 2025-01-01 | MRF ↗ |
| ST JOE MERCY HOSPITAL SYSTEM LIVONIA OutpatientFacility | VACCN United | Veterans Affairs | $20.50 | $2,400.00 | $1,560.00 | 2025-01-01 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $21.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - Meridian | Medicaid - Meridian | $22.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $23.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - United | Medicaid - United | $23.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Tricare | Tricare | $24.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Medicaid - Molina | Medicaid - Molina | $24.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - Molina | Medicaid - Molina | $25.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - Molina | Medicaid - Molina | $26.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | WC - Workers Compensation | WC - Workers Compensation | $26.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicare - United | Medicare - United | $26.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | HAP - HMO | HAP - HMO | $27.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Tricare | Tricare | $27.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicare - Molina | Medicare - Molina | $27.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Traditional Medicare HMO PPO | Traditional Medicare HMO PPO | $27.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Medicaid - Meridian | Medicaid - Meridian | $27.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicare - Priority Health | Medicare - Priority Health | $28.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicare - Humana | Medicare - Humana | $28.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicare - United | Medicare - United | $29.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | United Healthcare | United Healthcare | $30.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Tricare | Tricare | $31.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Tricare | Tricare | $31.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicare - Humana | Medicare - Humana | $32.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | United Healthcare | United Healthcare | $32.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicare - United | Medicare - United | $32.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Aetna | Aetna | $33.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicare - Humana | Medicare - Humana | $33.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | United Healthcare | United Healthcare | $33.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Traditional Medicare HMO PPO | Traditional Medicare HMO PPO | $33.00 | $137.00 | $68.00 | 2025-02-03 | 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 ↗ |
| MCLAREN BAY REGION Outpatient | Medicare - United | Medicare - United | $34.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Aetna | Aetna | $34.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | HAP - HMO | HAP - HMO | $34.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | HAP | HAP | $34.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | United Healthcare | United Healthcare | $34.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Traditional Medicare HMO PPO | Traditional Medicare HMO PPO | $34.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Priority Health | Priority Health | $34.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicare - Priority Health | Medicare - Priority Health | $34.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Priority Health | Priority Health | $34.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Priority Health | Priority Health | $34.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Medicare - Priority Health | Medicare - Priority Health | $34.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicare - Molina | Medicare - Molina | $34.00 | $137.00 | $68.00 | 2025-02-03 | 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 ↗ |
| MCLAREN MACOMB Outpatient | Tricare | Tricare | $35.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | HAP - HMO | HAP - HMO | $35.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | HAP - HMO | HAP - HMO | $35.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | WC - Workers Compensation | WC - Workers Compensation | $35.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicare - United | Medicare - United | $35.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Priority Health | Priority Health | $35.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | HAP | HAP | $36.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | WC - Workers Compensation | WC - Workers Compensation | $36.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Aetna | Aetna | $36.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Medicare - Humana | Medicare - Humana | $36.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Traditional Medicare HMO PPO | Traditional Medicare HMO PPO | $36.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicare - Priority Health | Medicare - Priority Health | $37.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Traditional Medicare HMO PPO | Traditional Medicare HMO PPO | $37.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicare - Humana | Medicare - Humana | $37.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | HAP | HAP | $38.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Priority Health | Priority Health | $38.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | HAP | HAP | $38.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Medicare - Molina | Medicare - Molina | $38.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | United Healthcare | United Healthcare | $39.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $41.74 | — | — | 2026-03-18 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicare - Priority Health | Medicare - Priority Health | $42.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Aetna | Aetna | $42.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicare - Molina | Medicare - Molina | $43.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | WC - Workers Compensation | WC - Workers Compensation | $45.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Aetna | Aetna | $45.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | WC - Workers Compensation | WC - Workers Compensation | $49.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | 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 ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | HAP - HMO | HAP - HMO | $51.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| EDGERTON HOSPITAL AND HEALTH SERVICES Both | Aetna | Default | $55.00 | $3,142.00 | $2,293.66 | 2026-05-09 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | HAP | HAP | $62.00 | $137.00 | $68.00 | 2025-02-03 | MRF ↗ |
| EDGERTON HOSPITAL AND HEALTH SERVICES Both | Blue Cross Blue Shield Of Wi Anthem | Default | $74.00 | $3,142.00 | $2,293.66 | 2026-05-09 | MRF ↗ |
| LIBERTY REGIONAL MEDICAL CENTER Both | Medicaid Georgia | Default | $79.99 | $495.00 | $371.25 | 2026-04-01 | MRF ↗ |
| LIBERTY REGIONAL MEDICAL CENTER Both | Amerigroup NM, GA, DC | Default | $80.19 | $495.00 | $371.25 | 2026-04-01 | MRF ↗ |
| LIBERTY REGIONAL MEDICAL CENTER Both | WellCare of Georgia | Default | $81.79 | $495.00 | $371.25 | 2026-04-01 | MRF ↗ |
| LIBERTY REGIONAL MEDICAL CENTER Both | CareSource GA | Default | $83.99 | $495.00 | $371.25 | 2026-04-01 | MRF ↗ |
| EDGERTON HOSPITAL AND HEALTH SERVICES Both | Quartz | Default | $88.00 | $3,142.00 | $2,293.66 | 2026-05-09 | MRF ↗ |
| EDGERTON HOSPITAL AND HEALTH SERVICES Both | Alliance Healthplans Of Wi | Default | $88.01 | $3,142.00 | $2,293.66 | 2026-05-09 | MRF ↗ |
| LIBERTY REGIONAL MEDICAL CENTER Both | United Healthcare | Default | $89.10 | $495.00 | $371.25 | 2026-04-01 | MRF ↗ |
| CHRISTUS ST FRANCES CABRINI HOSPITAL OutpatientFacility | Healthy Blue Louisiana | KM | $89.52 | $746.00 | $193.96 | 2026-01-13 | MRF ↗ |
| CHRISTUS ST FRANCES CABRINI HOSPITAL OutpatientFacility | Healthy Blue Louisiana | KM | $89.52 | $746.00 | $193.96 | 2026-01-13 | MRF ↗ |
| CHRISTUS ST FRANCES CABRINI HOSPITAL OutpatientFacility | Louisiana Healthcare Connections | KM | $89.52 | $746.00 | $193.96 | 2026-01-13 | MRF ↗ |
| CHRISTUS ST FRANCES CABRINI HOSPITAL OutpatientFacility | United Healthcare | KM | $89.52 | $746.00 | $193.96 | 2026-01-13 | MRF ↗ |
| CHRISTUS ST FRANCES CABRINI HOSPITAL OutpatientFacility | Humana | Healthy Horizons KM | $89.52 | $746.00 | $193.96 | 2026-01-13 | MRF ↗ |
| CHRISTUS ST FRANCES CABRINI HOSPITAL OutpatientFacility | Amerihealth Caritas Louisiana | KM | $89.52 | $746.00 | $193.96 | 2026-01-13 | MRF ↗ |
| CHRISTUS ST FRANCES CABRINI HOSPITAL OutpatientFacility | Humana | Healthy Horizons KM | $89.52 | $746.00 | $193.96 | 2026-01-13 | MRF ↗ |
| CHRISTUS ST FRANCES CABRINI HOSPITAL OutpatientFacility | United Healthcare | KM | $89.52 | $746.00 | $193.96 | 2026-01-13 | MRF ↗ |
| CHRISTUS ST FRANCES CABRINI HOSPITAL OutpatientFacility | Louisiana Healthcare Connections | KM | $89.52 | $746.00 | $193.96 | 2026-01-13 | MRF ↗ |
| CHRISTUS ST FRANCES CABRINI HOSPITAL OutpatientFacility | Amerihealth Caritas Louisiana | KM | $89.52 | $746.00 | $193.96 | 2026-01-13 | MRF ↗ |
| CHRISTUS ST FRANCES CABRINI HOSPITAL OutpatientFacility | Aetna | KM | $96.98 | $746.00 | $193.96 | 2026-01-13 | MRF ↗ |
| CHRISTUS ST FRANCES CABRINI HOSPITAL OutpatientFacility | Aetna | KM | $96.98 | $746.00 | $193.96 | 2026-01-13 | MRF ↗ |
| EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER Outpatient | Cigna | PPO | $100.00 | $1,752.50 | — | 2026-02-24 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Humana National | Transplant (All Contracted Plans) | — | $1,089.00 | $707.85 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Blue Cross Blue Shield Association BDCT | Transplant (All Contracted Plans) | — | $1,089.00 | $707.85 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Optum Health | Transplant Commercial (All Contracted Plans) | — | $1,089.00 | $707.85 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Interlink National | Transplant Commercial (All Contracted Plans) | — | $1,089.00 | $707.85 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Kaiser National | Transplant (All Contracted Plans) | — | $1,089.00 | $707.85 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | CCHA Behavioral Health | Medicaid (All Contracted Plans) | $108.90 | $1,089.00 | $707.85 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Life Trac National | Transplant (All Contracted Plans) | — | $1,089.00 | $707.85 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Optum Health | Transplant Government (All Contracted Plans) | — | $1,089.00 | $707.85 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Interlink National | Transplant Medicaid (All Contracted Plans) | — | $1,089.00 | $707.85 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Anthem Centers for Medical Excellence | Transplant (All Contracted Plans) | — | $1,089.00 | $707.85 | 2026-04-17 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | University of Utah | HIX | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | University of Utah | HMP | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | University of Utah | PPO | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Molina | HIX | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Cigna | PPO | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | United | OptionsPPO | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Multiplan | PRIMARY | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Prime Health | GROUPHEALTH | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | PacificSource Health | CCNNetworks | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health Idaho (EIRMC only) | PPO | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | PacificSource Health | PPO | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health Idaho (EIRMC only) | HIX | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | First Choice Health Of Washington | WCOMP | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | First Choice of the Midwest | COMM | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Interwest Health | PPO | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Select Health Idaho (EIRMC only) | SelectMed | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Mountain Health Co-Op | Individual | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Mountain Health Co-Op | Group | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | DMBA | PPO | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | EverNorth BH | COMM | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Intermountain Healthcare | HIX | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | DMBA | HMO | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Doug Andrus Distributing | COMM | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Shashone-Bannock Tribal Health | MCR | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Aetna | PEAKPERFERENCE | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Coventry First Health | WCOMP | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Aetna | IdahoEnvironmentalCoalition | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Coventry First Health | COMM | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Prime Health | WCOMP | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Prime Health | INDIGENTCARE | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Aetna | CWI | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | GEHA PPO USA | COMM | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Intermountain Healthcare | PPO | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Shashone-Bannock Tribal Health | FED | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | St. John's Health Network | COMM | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Multiplan | COMPLEMENTARY | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | QEP | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | TRAD | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | QHP | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | ConnectedCare | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | POS | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient | Blue Cross | PPO | — | $4,546.75 | $4,546.75 | 2024-10-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $118.28 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $118.28 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $118.28 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $118.28 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $118.28 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $118.28 | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $118.28 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $118.28 | — | — | 2026-04-01 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $118.28 | — | — | 2026-04-01 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Blue Cross Blue Shield | HMO | — | $1,264.00 | $1,264.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Community Partners Health Plan (CPHP) | PPO | — | $1,264.00 | $1,264.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Multiplan/PHCS | PPO | — | $1,264.00 | $1,264.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Blue Cross Blue Shield | Managed Medicaid | — | $1,264.00 | $1,264.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | United Healthcare (UHC) | PPO | — | $1,264.00 | $1,264.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | United Healthcare (UHC) | Medicare Advantage | — | $1,264.00 | $1,264.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Blue Cross Blue Shield | Medicare Advantage | — | $1,264.00 | $1,264.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Meridian | Managed Medicaid | — | $1,264.00 | $1,264.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Meridian | Medicare-Medicaid (D-SNP) | $126.40 | $1,264.00 | $1,264.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Humana | Medicare Advantage | — | $1,264.00 | $1,264.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Cigna | PPO | — | $1,264.00 | $1,264.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Blue Cross Blue Shield | Blue Choice/Options/PPO | — | $1,264.00 | $1,264.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Aetna | Medicare Advantage | — | $1,264.00 | $1,264.00 | 2026-04-15 | 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.