PX-36001148 — Hc Or Acuity Lvl 2 Ea Addl 30 Min
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). HC or Acuity Lvl 2 Ea Addl 30 Min (CDM PX-36001148) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/PX-36001148?code_type=CDM
MLA (9th ed.)
“HC or Acuity Lvl 2 Ea Addl 30 Min (CDM PX-36001148) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/PX-36001148?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“HC or Acuity Lvl 2 Ea Addl 30 Min (CDM PX-36001148) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/PX-36001148?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,203–$6,725 (25th–75th percentile) across 11 hospitals · 129 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM PX-36001148 — 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 |
|---|---|---|---|---|---|---|---|
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | BLUE CROSS [1014] | ANTHEM FRANCISCAN ALLIANCE EMPLOYEES-CID | $428.34 | $1,298.00 | $341.37 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | BLUE CROSS [1014] | ANTHEM HEALTHSYNC HMO-CID-CARMEL ORTHO | $533.09 | $1,298.00 | $341.37 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | COMMERCIAL [2001] | ADVANTUS-CIR | $534.80 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | ADVANTUS-CIR | $534.80 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | ADVANTUS-CIR | $534.80 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | COMMERCIAL [2001] | ADVANTUS-CIR | $534.80 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | MERITAIN HEALTH [312084] | $548.17 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | AETNA [1005] | AETNA [100507] | $548.17 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | AETNA [1005] | AETNA-NID-DYER-MUNSTER-CRN POINT | $548.17 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | AETNA-NID-DYER-MUNSTER-CRN POINT | $548.17 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | AETNA [1005] | AETNA-NID-DYER-MUNSTER-CRN POINT | $548.17 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | AETNA [1005] | AETNA OAP/POS STATE OF ILLINOIS [317013] | $548.17 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | AETNA-NID-DYER-MUNSTER-CRN POINT | $548.17 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | AETNA [1005] | AETNA QCHP STATE OF ILLINOIS [317014] | $548.17 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | AETNA [1005] | AETNA HMO/POS [300598] | $548.17 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | AETNA [1005] | AETNA CHOICE PPO [100503] | $548.17 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | BLUE CROSS [1014] | ANTHEM HEALTHSYNC POS-CID- CARMEL ORTHO | $603.96 | $1,298.00 | $341.37 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | FRANCISCAN HEALTH PLAN CAP-CIR | $621.71 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | FRANCISCAN HEALTH PLAN CAP-CIR | $621.71 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | UNICARE [1150] | ANTHEM BLUE ACCESS PPO-CID-CARMEL ORTHO | $674.83 | $1,298.00 | $341.37 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | BLUE CROSS [1014] | ANTHEM BLUE PREFERRED HMO-CID-CARMEL ORTHO | $674.83 | $1,298.00 | $341.37 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | BLUE CROSS ILLINOIS [1210] | ANTHEM BLUE ACCESS PPO-CID-CARMEL ORTHO | $674.83 | $1,298.00 | $341.37 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | BLUE CROSS [1014] | ANTHEM BLUE ACCESS PPO-CID-CARMEL ORTHO | $674.83 | $1,298.00 | $341.37 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | BLUE CROSS BLUE SHIELD IL [1030] | ANTHEM BLUE ACCESS PPO-CID-CARMEL ORTHO | $674.83 | $1,298.00 | $341.37 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | SIHO - CID & NID & WID LOCATIONS | $735.35 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | SIHO - CID & NID & WID LOCATIONS | $735.35 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | PEACHSTATE [43] | PEACH STATE: SCOTTISH RITE MCAID | $745.82 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | PEACHSTATE [43] | PEACH STATE: SCOTTISH RITE PEACHCARE | $745.82 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | PEACHSTATE [43] | PEACH STATE: AMBH MCAID | $762.39 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | PEACHSTATE [43] | PEACH STATE: AMBH PEACHCARE | $762.39 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | CARESOURCE [61] | CARESOURCE: SCOTTISH RITE PEACHCARE | $766.04 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | CARESOURCE [61] | CARESOURCE: SCOTTISH RITE MCAID | $766.04 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | AMERIGROUP [102] | AMERIGROUP: SCOTTISH RITE MCAID | $773.83 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | AMERIGROUP [102] | AMERIGROUP: SCOTTISH RITE PEACHCARE | $773.83 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | CARESOURCE [61] | CARESOURCE: AMBH MCAID | $783.81 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | CARESOURCE [61] | CARESOURCE: AMBH PEACHCARE | $783.81 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | LUTHERAN PREFERRED-NID & WID & CID-CARME | $802.20 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | AMERIGROUP [102] | AMERIGROUP: AMBH PEACHCARE | $821.13 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | AMERIGROUP [102] | AMERIGROUP: AMBH MCAID | $821.13 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | MANAGED CARE [2000] | CIGNA-CID | $826.83 | $1,298.00 | $341.37 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | COMMERCIAL [2001] | CIGNA-CID | $826.83 | $1,298.00 | $341.37 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | CIGNA [1037] | CIGNA-CID | $826.83 | $1,298.00 | $341.37 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | MANAGED CARE [2000] | SIHO - CID & NID & WID LOCATIONS | $843.70 | $1,298.00 | $341.37 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | CIGNA [1037] | CIGNA-CID | $851.67 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Both | MANAGED CARE [2000] | CIGNA-CID | $851.67 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | CIGNA [1037] | CIGNA OA PLUS [312118] | $851.67 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | CIGNA [1037] | CIGNA PPO [103703] | $851.67 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | COMMERCIAL [2001] | CIGNA-CID | $851.67 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Both | COMMERCIAL [2001] | CIGNA-CID | $851.67 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH DYER Both | MANAGED CARE [2000] | CIGNA-CID | $851.67 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | CIGNA-CID | $851.67 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | CIGNA [1037] | CIGNA-CID | $851.67 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | NATIONAL ASSOC OF LETTER CARRIERS [205108] | $851.67 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH DYER Both | CIGNA [1037] | CIGNA-CID | $851.67 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH DYER Both | COMMERCIAL [2001] | CIGNA-CID | $851.67 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | COMMERCIAL [2001] | CIGNA-CID | $851.67 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | CIGNA-CID | $851.67 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Both | CIGNA [1037] | CIGNA-CID | $851.67 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Both | COMMERCIAL [2001] | ENCORE - CID & NID & WID & SSCD | $869.05 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH DYER Both | MANAGED CARE [2000] | SIHO - CID & NID & WID LOCATIONS | $869.05 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | GREAT WEST INSURANCE [1055] | GREAT WEST-CID | $869.05 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Both | MANAGED CARE [2000] | ENCORE - CID & NID & WID & SSCD | $869.05 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | ALLIED BENEFIT SYSTEMS [211401] | $869.05 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | GREAT WEST INSURANCE [1055] | GREAT WEST-CID | $869.05 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | GREAT WEST-CID | $869.05 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Both | MANAGED CARE [2000] | SIHO - CID & NID & WID LOCATIONS | $869.05 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | ENCORE - CID & NID & WID & SSCD | $869.05 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | SIHO - CID & NID & WID LOCATIONS | $869.05 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | SIHO - CID & NID & WID LOCATIONS | $869.05 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | ENCORE - CID & NID & WID & SSCD | $869.05 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | ENCORE PPO [204601] | $869.05 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | SIHO [211500] | $869.05 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | COMMERCIAL [2001] | ENCORE - CID & NID & WID & SSCD | $869.05 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | GREAT WEST-CID | $869.05 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | COMMERCIAL [2001] | ENCORE - CID & NID & WID & SSCD | $869.05 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | COMMERCIAL [2001] | AETNA-CID | $894.32 | $1,298.00 | $341.37 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | AETNA [1005] | AETNA-CID | $894.32 | $1,298.00 | $341.37 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | MANAGED CARE [2000] | AETNA-CID | $894.32 | $1,298.00 | $341.37 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | COMMERCIAL [2001] | AETNA-CID | $921.19 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH DYER Both | AETNA [1005] | AETNA-CID | $921.19 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Both | AETNA [1005] | AETNA-CID | $921.19 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | AETNA-CID | $921.19 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | AETNA [1005] | AETNA-CID | $921.19 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH DYER Both | MANAGED CARE [2000] | AETNA-CID | $921.19 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | AETNA [1005] | AETNA-CID | $921.19 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Both | MANAGED CARE [2000] | AETNA-CID | $921.19 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | AETNA-CID | $921.19 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Both | COMMERCIAL [2001] | AETNA-CID | $921.19 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH DYER Both | COMMERCIAL [2001] | AETNA-CID | $921.19 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | COMMERCIAL [2001] | AETNA-CID | $921.19 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | HUMANA [1066] | CHOICE CARE PPO-CIR | $931.62 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | HUMANA [1066] | CHOICE CARE PPO-CIR | $931.62 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | COMMERCIAL [2001] | UNIFIED GROUP SERVICES-CIR | $935.90 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | COMMERCIAL [2001] | INDIANA BONE MARROW TRANSPLANT-CIR | $935.90 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | COMMERCIAL [2001] | INDIANA BNE MARROW TRANSP [300182] | $935.90 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH DYER Both | COMMERCIAL [2001] | INDIANA BONE MARROW TRANSPLANT-CIR | $935.90 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | UNIFIED GROUP SERVICES [312089] | $935.90 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH DYER Both | MANAGED CARE [2000] | UNIFIED GROUP SERVICES-CIR | $935.90 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | UNIFIED GROUP SERVICES-CIR | $935.90 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | COMMERCIAL [2001] | INDIANA BONE MARROW TRANSPLANT-CIR | $935.90 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | COMMERCIAL [2001] | UNIFIED GROUP SERVICES-CIR | $935.90 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | UNIFIED GROUP SERVICES-CIR | $935.90 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH DYER Both | COMMERCIAL [2001] | UNIFIED GROUP SERVICES-CIR | $935.90 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | COMMERCIAL [2001] | MEDI-SHARE [317015] | $1,030.83 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | COMMERCIAL [2001] | CCN/FIRST HEALTH-CIR | $1,030.83 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | COMMERCIAL [2001] | FIRST HEALTH [300189] | $1,030.83 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH DYER Both | MANAGED CARE [2000] | CCN/FIRST HEALTH-CIR | $1,030.83 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH DYER Both | COMMERCIAL [2001] | CCN/FIRST HEALTH-CIR | $1,030.83 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | FIRST HEALTH [205104] | $1,030.83 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | CCN/FIRST HEALTH-CIR | $1,030.83 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | COMMERCIAL [2001] | CCN/FIRST HEALTH-CIR | $1,030.83 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | CCN/FIRST HEALTH-CIR | $1,030.83 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | ONCOLOGY PATIENT ASSISTANCE PROGRAMS [2295] | BCCS FAMILY CIRCLE OF CARE [229553] | $1,050.01 | $2,561.00 | $1,536.60 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445] | EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501] | $1,050.01 | $2,561.00 | $1,536.60 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | HEALTHCARE HIGHWAYS [2210] | HCH 90 DEGREE BENEFITS [221013] | $1,050.01 | $2,561.00 | $1,536.60 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | HEALTHCARE HIGHWAYS [2210] | HCH JOHN SOULES FOODS [221011] | $1,050.01 | $2,561.00 | $1,536.60 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | PENDING SSI [1616] | PENDING SSI RCA [161601] | $1,050.01 | $2,561.00 | $1,536.60 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | BLACK LUNG [6055] | BLACK LUNG [605500] | $1,050.01 | $2,561.00 | $1,536.60 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | LUCENT HEALTH [6000] | LUCENT HEALTH [600000] | $1,050.01 | $2,561.00 | $1,536.60 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | HEALTHCARE HIGHWAYS [2210] | HCH BROKEN ARROW [221012] | $1,050.01 | $2,561.00 | $1,536.60 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | MODA HEALTH [6100] | MODA HEALTH [610000] | $1,050.01 | $2,561.00 | $1,536.60 | 2026-03-31 | MRF ↗ |
| PORTNEUF MEDICAL CENTER BothFacility | WEB TPA [2115] | WEB TPA HEALTHCARE HIGHWAYS [211504] | $1,050.01 | $2,561.00 | $1,536.60 | 2026-03-31 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | SAGAMORE MODIFIED-CIR | $1,077.89 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | SAGAMORE MODIFIED-CIR | $1,077.89 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH DYER Both | MANAGED CARE [2000] | SAGAMORE PLUS PPO-CIR | $1,090.99 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | SAGAMORE SELECT PPO-CIR | $1,090.99 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | SAGAMORE SELECT PPO-CIR | $1,090.99 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | SAGAMORE PLUS PPO-CIR | $1,090.99 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | SAGAMORE PLUS [212901] | $1,090.99 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | SAGAMORE PLUS PPO-CIR | $1,090.99 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | THE HEALTH PLAN [2915] | THE HEALTH PLAN [291500] | $1,117.53 | $5,424.88 | $1,627.46 | 2025-04-05 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | COMMUNITY HEALTH ALLIANCE-CID & NID& WID | $1,136.45 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | COMMUNITY HEALTH ALLIANCE-CID & NID& WID | $1,136.45 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | COMMUNITY HEALTH ALLIANCE [312054] | $1,136.45 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | CIGNA [3] | CIGNA HMO/POS & PPO: CHILDREN'S | $1,179.22 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | CIGNA [3] | CIGNA HMO/POS & PPO: CHILDREN'S | $1,179.22 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | CIGNA [3] | CIGNA HMO/POS & PPO: CHILDREN'S | $1,179.22 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | BLUE CROSS [2] | BCBS HMO/PPO/POS: CHILDREN'S | $1,183.68 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | UNITED [5] | UNITED HEALTHCARE HMO/POS & PPO: CHILDREN'S | $1,183.68 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | BLUE CROSS [2] | BCBS HMO/PPO/POS: CHILDREN'S | $1,183.68 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | UNITED [5] | UNITED HEALTHCARE HMO/POS & PPO: CHILDREN'S | $1,183.68 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | UNITED [5] | UNITED HEALTHCARE HMO/POS & PPO: CHILDREN'S | $1,183.68 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | BLUE CROSS [2] | BCBS HMO/PPO/POS: CHILDREN'S | $1,183.68 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | AMBETTER PEACHSTATE [227] | AMBETTER: CHILDREN'S | $1,194.39 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | AMBETTER PEACHSTATE [227] | AMBETTER: CHILDREN'S | $1,194.39 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | AMBETTER PEACHSTATE [227] | AMBETTER: CHILDREN'S | $1,194.39 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | OSCAR [228] | OSCAR HEALTH PLAN: CHILDREN'S | $1,195.28 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | OSCAR [228] | OSCAR HEALTH PLAN: CHILDREN'S | $1,195.28 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | OSCAR [228] | OSCAR HEALTH PLAN: CHILDREN'S | $1,195.28 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | AETNA [1] | AETNA HMO/POS & PPO: CHILDREN'S | $1,200.63 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | AETNA [1] | AETNA HMO/POS & PPO: CHILDREN'S | $1,200.63 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | AETNA [1] | AETNA HMO/POS & PPO: CHILDREN'S | $1,200.63 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| FRANCISCAN HEALTH DYER Both | MANAGED CARE [2000] | MULTIPLAN/PHCS-CIR | $1,203.30 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH MOORESVILLE Both | MANAGED CARE [2000] | MULTIPLAN/PHCS-CIR | $1,203.30 | $1,337.00 | $339.60 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | PHCS GENERIC [312006] | $1,203.30 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH INDIANAPOLIS Both | MANAGED CARE [2000] | MULTIPLAN/PHCS-CIR | $1,203.30 | $1,337.00 | $308.85 | 2026-01-01 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | CARESOURCE MARKETPLACE BRONZE/SILVER/GOLD [60] | CARESOURCE MARKETPLACE: CHILDREN'S | $1,212.23 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | CARESOURCE MARKETPLACE BRONZE/SILVER/GOLD [60] | CARESOURCE MARKETPLACE: CHILDREN'S | $1,212.23 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | CARESOURCE MARKETPLACE BRONZE/SILVER/GOLD [60] | CARESOURCE MARKETPLACE: CHILDREN'S | $1,212.23 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | KAISER [6] | KAISER HMO/POS PPO & EPO: CHILDREN'S | $1,214.73 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | KAISER [6] | KAISER HMO/POS PPO & EPO: CHILDREN'S | $1,214.73 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | KAISER [6] | KAISER HMO/POS PPO & EPO: CHILDREN'S | $1,214.73 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | SIDECAR HEALTH [236] | SIDECAR HEALTH: CHILDREN'S | $1,230.96 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | SIDECAR HEALTH [236] | SIDECAR HEALTH: CHILDREN'S | $1,230.96 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | SIDECAR HEALTH [236] | SIDECAR HEALTH: CHILDREN'S | $1,230.96 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | DIRECT EMPLOYER AGREEMENTS [72] | CHEROKEE COUNTY: CHILDREN'S | $1,248.80 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | DIRECT EMPLOYER AGREEMENTS [72] | NORTHSIDE DIRECT: CHILDREN'S | $1,248.80 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | DIRECT EMPLOYER AGREEMENTS [72] | CHEROKEE COUNTY: CHILDREN'S | $1,248.80 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| ATHUR M BLANK HOSPITAL Outpatient | DIRECT EMPLOYER AGREEMENTS [72] | NORTHSIDE DIRECT: CHILDREN'S | $1,248.80 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | DIRECT EMPLOYER AGREEMENTS [72] | CHEROKEE COUNTY: CHILDREN'S | $1,248.80 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE Outpatient | DIRECT EMPLOYER AGREEMENTS [72] | NORTHSIDE DIRECT: CHILDREN'S | $1,248.80 | $1,784.00 | $1,784.00 | 2026-05-14 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | MEDICARE [1635] | MEDICARE PART B ONLY [163501] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | GEHA [1415] | GEHA - ASA [141503] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | MEDICARE [1635] | REHAB MEDICARE [163504] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | CIGNA [1260] | CIGNA BEHAVIORAL HEALTH [126013] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | FIDELIS CARE OF NY MEDICAID REPLACEMENT [3865] | FIDELIS CARE OF NY MEDICAID REPLACEMENT [386500] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | UNITED HEALTHCARE [2060] | UHC SUREST BIND [206032] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | MANAGED MEDICARE [1600] | MANAGED MEDICARE OTHER [160000] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | UNITED HEALTHCARE [2060] | UNITED HEALTHCARE OXFORD [206009] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | FIDELIS CARE OF NJ MEDICAID [3770] | WELLCARE MEDICAID [377500] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | UNITED HEALTHCARE [2060] | UNITED HEALTHCARE STUDENT SVC [206012] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | MANAGED MEDICAID [3845] | MANAGED MEDICAID OTHER [384500] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | HEALTHFIRST [2395] | HEALTHFIRST [239500] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | BLACK LUNG [6055] | BLACK LUNG [605500] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | ALLIED NATIONAL GLOBAL CARE [1035] | ALLIED NATIONAL [103500] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | BCBS MEDICARE REPLACEMENT [1160] | BCBS NJ MEDICARE BLUE [116002] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | ALLIED BENEFIT SYSTEMS INC [1030] | ALLIED BENEFIT SYSTEMS [103000] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | BCBS [1155] | EMPIRE BCBS HMO POS EPO [115558] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | BCBS [1155] | EMPIRE BCBS PPO [115559] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | AMERIGROUP MEDICARE [1100] | WELLPOINT FKA AMERIGROUP MEDICARE [110000] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | AETNA MEDICAID REPLACEMENT [3510] | AETNA BETTER HEALTH [351001] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | AMERIGROUP MEDICAID [1095] | WELLPOINT MEDICAID STAR [109500] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | ADMINISTRATIVE CONCEPTS [1005] | ADMINISTRATIVE CONCEPTS [100502] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | AETNA MEDICARE REPLACEMENT [1020] | AETNA NNJ PRIME HMO [102003] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | LUCENT HEALTH [6000] | LUCENT HEALTH [600000] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | HUMANA MEDICARE REPLACEMENT [1525] | HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | AETNA [1015] | AETNA LIBERTY [101531] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | AETNA [1015] | AETNA SUPPLEMENT [101514] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | WORKER'S COMP [2125] | QUALCARE WC [212530] | — | $2,000.00 | $2,000.00 | 2025-04-05 | MRF ↗ |
| HACKENSACK MERIDIAN MOUNTAINSIDE MEDICAL Outpatient | FIRST HEALTH [1375] | FIRST HEALTH NETWORK [137501] | — | $2,000.00 | $2,000.00 | 2025-04-05 | 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.