Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Q4138 — Biodfence Dryflex, 1cm

Per-row negotiated rates, exactly as filed by each hospital. Aggregated views below summarize across hospitals; the bottom table shows the underlying rows.

Typical negotiated price $181

Usually $124–$470 (25th–75th percentile) across 1,035 hospitals · 853 payers.

“Negotiated” is the hospital’s negotiated facility rate for this HCPCS Q4138 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.

What this costs at this hospital

The hospital facility charge for this code — an actual negotiated rate from our data. A separate professional fee isn’t separately estimable for this code (see the note below).

Pick your insurer to anchor on your plan’s negotiated rate.
Measured
$124 $181 typical $470

The middle 50% of negotiated facility rates for this procedure, measured across 1,035 hospitals.

What you’ll likely be billed

Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. $181
Likely subtotal $181
Facility charge (no separate professional fee) $181

Not included in this estimate:

  • Rehab, physical therapy, and other post-acute care after discharge
  • Complications, revisions, or readmissions
  • Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)

The biggest swing: which insurer's rate applies — negotiated prices here run $124–$470.

How each figure is sourced
Hospital facility (actual)
source: Hospital MRF (45 CFR 180)

Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).

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
HEYWOOD HOSPITAL - Outpatient United Healthcare CommercialAllPlans — — — 2025-04-16 MRF ↗
HEYWOOD HOSPITAL - Outpatient Aetna MedicareAdvantage — — — 2025-04-16 MRF ↗
HEYWOOD HOSPITAL - Outpatient Aetna Commercial — — — 2025-04-16 MRF ↗
HEYWOOD HOSPITAL - Outpatient Health New England Commercial — — — 2025-04-16 MRF ↗
HEYWOOD HOSPITAL - Outpatient BCBS-MA PPA — — — 2025-04-16 MRF ↗
HEYWOOD HOSPITAL - Outpatient BCBS-MA HMO — — — 2025-04-16 MRF ↗
HEYWOOD HOSPITAL - Outpatient Cigna Commercial — — — 2025-04-16 MRF ↗
HEYWOOD HOSPITAL - Outpatient BCBS-MA Indemnity — — — 2025-04-16 MRF ↗
HEYWOOD HOSPITAL - Outpatient BCBS-MA HMO — — — 2025-04-16 MRF ↗
HEYWOOD HOSPITAL - Outpatient BCBS-MA Indemnity — — — 2025-04-16 MRF ↗
HEYWOOD HOSPITAL - Outpatient Health New England Commercial — — — 2025-04-16 MRF ↗
HEYWOOD HOSPITAL - Outpatient BCBS-MA PPA — — — 2025-04-16 MRF ↗
HEYWOOD HOSPITAL - Outpatient Cigna Commercial — — — 2025-04-16 MRF ↗
HEYWOOD HOSPITAL - Outpatient Aetna Commercial — — — 2025-04-16 MRF ↗
HEYWOOD HOSPITAL - Outpatient Aetna MedicareAdvantage — — — 2025-04-16 MRF ↗
HEYWOOD HOSPITAL - Outpatient United Healthcare CommercialAllPlans — — — 2025-04-16 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 BCBSSCBlueChoice $34.60 — — 2024-12-08 MRF ↗
EAST COOPER MEDICAL CENTER Outpatient BCBS-SC BCBSSCPreferredBlue $34.60 — — 2024-12-08 MRF ↗
M HEALTH FAIRVIEW ST JOHN'S HOSPITAL OutpatientFacility Blue Cross of Minnesota Aware Federal $36.47 — — 2026-02-05 MRF ↗
M HEALTH FAIRVIEW WOODWINDS HOSPITAL OutpatientFacility Blue Cross of Minnesota Aware Federal $36.47 — — 2026-02-05 MRF ↗
M HEALTH FAIRVIEW UNIVERSITY OF MN MEDICAL CENTER OutpatientFacility Blue Cross of Minnesota National Transplant $36.47 — — 2026-02-06 MRF ↗
FAIRVIEW LAKES HEALTH SERVICES OutpatientFacility Blue Cross of Minnesota Aware Federal $36.47 — — 2026-02-05 MRF ↗
M HEALTH FAIRVIEW RIDGES HOSPITAL OutpatientFacility Blue Cross of Minnesota Aware Federal $36.47 — — 2026-02-06 MRF ↗
M HEALTH FAIRVIEW UNIVERSITY OF MN MEDICAL CENTER OutpatientFacility Blue Cross of Minnesota Aware Federal $36.47 — — 2026-02-06 MRF ↗
FAIRVIEW NORTHLAND REGIONAL HOSPITAL OutpatientFacility Blue Cross of Minnesota Aware Federal $36.47 — — 2026-01-29 MRF ↗
RANGE REGIONAL HEALTH SERVICES OutpatientFacility Blue Cross of Minnesota Aware Federal $36.47 — — 2026-01-29 MRF ↗
M HEALTH FAIRVIEW SOUTHDALE HOSPITAL OutpatientFacility Blue Cross of Minnesota Aware Federal $36.47 — — 2026-02-06 MRF ↗
GRAND ITASCA CLINIC AND HOSPITAL OutpatientFacility Blue Cross of Minnesota Aware Federal $36.47 — — 2026-01-28 MRF ↗
M HEALTH FAIRVIEW ST JOHN'S HOSPITAL OutpatientFacility Blue Cross of Minnesota Aware/Blue Plus $37.13 — — 2026-02-05 MRF ↗
M HEALTH FAIRVIEW RIDGES HOSPITAL OutpatientFacility Blue Cross of Minnesota Aware/Blue Plus $37.13 — — 2026-02-06 MRF ↗
M HEALTH FAIRVIEW SOUTHDALE HOSPITAL OutpatientFacility Blue Cross of Minnesota Aware/Blue Plus $37.13 — — 2026-02-06 MRF ↗
RANGE REGIONAL HEALTH SERVICES OutpatientFacility Blue Cross of Minnesota Aware/Blue Plus $37.13 — — 2026-01-29 MRF ↗
M HEALTH FAIRVIEW WOODWINDS HOSPITAL OutpatientFacility Blue Cross of Minnesota Aware/Blue Plus $37.13 — — 2026-02-05 MRF ↗
FAIRVIEW LAKES HEALTH SERVICES OutpatientFacility Blue Cross of Minnesota Aware/Blue Plus $37.13 — — 2026-02-05 MRF ↗
FAIRVIEW NORTHLAND REGIONAL HOSPITAL OutpatientFacility Blue Cross of Minnesota Aware/Blue Plus $37.13 — — 2026-01-29 MRF ↗
GRAND ITASCA CLINIC AND HOSPITAL OutpatientFacility Blue Cross of Minnesota Aware/Blue Plus $37.13 — — 2026-01-28 MRF ↗
M HEALTH FAIRVIEW UNIVERSITY OF MN MEDICAL CENTER OutpatientFacility Blue Cross of Minnesota Aware/Blue Plus $37.13 — — 2026-02-06 MRF ↗
GOOD SAMARITAN HOSPITAL Outpatient Mdwise Hip $37.56 — — 2026-07-17 MRF ↗
GOOD SAMARITAN HOSPITAL Outpatient Anthem Medicaid $37.56 — — 2026-07-17 MRF ↗
GOOD SAMARITAN HOSPITAL Outpatient Caresource Commercial $37.56 — — 2026-07-17 MRF ↗
GOOD SAMARITAN HOSPITAL Outpatient Mdwise Medicaid $37.56 — — 2026-07-17 MRF ↗
LAKE GRANBURY MEDICAL CENTER Outpatient Self Pay Self Pay $39.48 $658.00 $118.44 2026-07-15 MRF ↗
INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient Ccbh - Behavioral Health Behavioral — — — 2026-07-19 MRF ↗
GRITMAN MEDICAL CENTER OutpatientFacility United Healthcare POS — — — 2026-08-19 MRF ↗
GRITMAN MEDICAL CENTER OutpatientFacility Molina Medicare Advantage — — — 2026-08-19 MRF ↗
GRITMAN MEDICAL CENTER OutpatientFacility Washington L & I Workers Comp — — — 2026-08-19 MRF ↗
GRITMAN MEDICAL CENTER OutpatientFacility Regence Blueshield of Idaho Medicare Advantage — — — 2026-08-19 MRF ↗
GRITMAN MEDICAL CENTER OutpatientFacility Blue Cross of Idaho Medicare Advantage — — — 2026-08-19 MRF ↗
GRITMAN MEDICAL CENTER OutpatientFacility Kaiser Foundation Health Plan of Washington Medicare Advantage — — — 2026-08-19 MRF ↗
GRITMAN MEDICAL CENTER OutpatientFacility Aetna Medicare Advantage — — — 2026-08-19 MRF ↗
GRITMAN MEDICAL CENTER OutpatientFacility Molina of ID Medicaid Advantage $40.42 — — 2026-08-19 MRF ↗
GRITMAN MEDICAL CENTER OutpatientFacility Cigna PPO — — — 2026-08-19 MRF ↗
GRITMAN MEDICAL CENTER OutpatientFacility Tricare POS — — — 2026-08-19 MRF ↗
GRITMAN MEDICAL CENTER OutpatientFacility Aetna All Other Plans — — — 2026-08-19 MRF ↗
GRITMAN MEDICAL CENTER OutpatientFacility Blue Cross of Idaho All Other Plans — — — 2026-08-19 MRF ↗
GRITMAN MEDICAL CENTER OutpatientFacility Pacific Source Medicare Advantage — — — 2026-08-19 MRF ↗
GRITMAN MEDICAL CENTER OutpatientFacility United Healthcare Medicare Advantage — — — 2026-08-19 MRF ↗
PALMETTO GENERAL HOSPITAL Outpatient Bc/Bs Of Fl Network Blue Bc/Bs Of Fl Network Blue $42.45 $278.00 $278.00 2026-07-15 MRF ↗
EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient Molina MCD $45.00 — — 2024-10-01 MRF ↗
EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient Blue Cross MMCP $45.00 — — 2024-10-01 MRF ↗
EASTERN IDAHO REGIONAL MEDICAL CENTER Outpatient Blue Cross MLTSS $45.00 — — 2024-10-01 MRF ↗
PALMETTO GENERAL HOSPITAL Outpatient Bc/Bs Of Fl Blue Select Exchange Non Par Bc/Bs Of Fl Blue Select Exchange Non Par $45.06 $278.00 $278.00 2026-07-15 MRF ↗
PALMETTO GENERAL HOSPITAL Inpatient Molina Marketplace Program Exchange Molina Marketplace Program Exchange $46.43 $278.00 $278.00 2026-07-15 MRF ↗
MEMORIAL HOSPITAL OF SOUTH BEND Outpatient Uhc Pathways For Aging $47.71 — — 2026-09-21 MRF ↗
UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient Anthem In Medicaid $47.71 — — 2026-05-14 MRF ↗
MEMORIAL HOSPITAL OF SOUTH BEND Outpatient Anthem In Medicaid Hcc $47.71 — — 2026-09-21 MRF ↗
MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility MDWise Managed Medicaid $47.71 — — 2026-02-13 MRF ↗
MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility Anthem Managed Medicaid $47.71 — — 2026-02-13 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Humana Pathways For Aging $47.71 — — 2026-05-13 MRF ↗
UOFL HEALTH - SHELBYVILLE HOSPITAL Outpatient Anthem In Medicaid $47.71 — — 2026-07-15 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Caresource In Medicaid Hhw $47.71 — — 2026-05-13 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Anthem In Medicaid Hip $47.71 — — 2026-05-13 MRF ↗
MEMORIAL HOSPITAL OF SOUTH BEND Outpatient Mhs In Medicaid Hcc $47.71 — — 2026-09-21 MRF ↗
MEMORIAL HOSPITAL OF SOUTH BEND Outpatient Anthem Pathways For Aging $47.71 — — 2026-09-21 MRF ↗
MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility MHS Hoosier Care Connect Managed Medicaid $47.71 — — 2026-02-13 MRF ↗
REID HEALTH OutpatientFacility Anthem Blue Cross Blue Shield Managed Medicaid $47.71 — — 2025-07-21 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Mhs In Medicaid Hcc Bh $47.71 — — 2026-05-13 MRF ↗
NORTON CLARK HOSPITAL OutpatientFacility CareSource Indiana Healthy Indiana Plan (HIP) Managed Medicaid $47.71 — — 2025-04-24 MRF ↗
NORTON CLARK HOSPITAL OutpatientFacility Managed Health Services (MHS) Hoosier Care Connect Managed Medicaid $47.71 — — 2025-04-24 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Mdwise In Medicaid Hhw $47.71 — — 2026-05-13 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Caresource In Medicaid Hip $47.71 — — 2026-09-16 MRF ↗
MEMORIAL HOSPITAL OF SOUTH BEND Outpatient Anthem In Medicaid Hip $47.71 — — 2026-09-21 MRF ↗
MEMORIAL HOSPITAL OF SOUTH BEND Outpatient Caresource In Medicaid Hhw $47.71 — — 2026-09-21 MRF ↗
UofL Health - South Hospital Outpatient Anthem In Medicaid $47.71 — — 2026-07-15 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Mdwise In Medicaid Hip $47.71 — — 2026-05-13 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Mdwise In Medicaid Hhw $47.71 — — 2026-09-16 MRF ↗
MEMORIAL HOSPITAL OF SOUTH BEND Outpatient Caresource In Medicaid Hip $47.71 — — 2026-09-21 MRF ↗
MEMORIAL HOSPITAL OF SOUTH BEND Outpatient Mdwise In Medicaid Hip $47.71 — — 2026-09-21 MRF ↗
MEMORIAL HOSPITAL OF SOUTH BEND Outpatient Mdwise In Medicaid Hhw $47.71 — — 2026-09-21 MRF ↗
MEMORIAL HOSPITAL OF SOUTH BEND Outpatient Humana Pathways For Aging $47.71 — — 2026-09-21 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Uhc Pathways For Aging $47.71 — — 2026-09-16 MRF ↗
MEMORIAL HOSPITAL OF SOUTH BEND Outpatient Mhs In Medicaid Hip $47.71 — — 2026-09-21 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Anthem In Medicaid Hip $47.71 — — 2026-09-16 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Mhs In Medicaid Hhw $47.71 — — 2026-09-16 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Mhs In Medicaid Hip $47.71 — — 2026-09-16 MRF ↗
MEMORIAL HOSPITAL OF SOUTH BEND Outpatient Mhs In Medicaid Hhw $47.71 — — 2026-09-21 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Mhs In Medicaid Hcc $47.71 — — 2026-05-13 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Mhs In Medicaid Hhw $47.71 — — 2026-05-13 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Mhs In Medicaid Hip Bh $47.71 — — 2026-05-13 MRF ↗
REID HEALTH OutpatientFacility MDWise Managed Medicaid $47.71 — — 2025-07-21 MRF ↗
NORTON SCOTT HOSPITAL OutpatientFacility Managed Health Services (MHS) Hoosier Care Connect Managed Medicaid $47.71 — — 2026-06-03 MRF ↗
NORTON SCOTT HOSPITAL OutpatientFacility Managed Health Services (MHS) Managed Medicaid $47.71 — — 2026-06-03 MRF ↗
MEMORIAL HOSPITAL OF SOUTH BEND Outpatient Anthem In Medicaid Hhw $47.71 — — 2026-09-21 MRF ↗
REID HEALTH OutpatientFacility Anthem Blue Cross Blue Shield Pathways for Aging/Managed Medicaid $47.71 — — 2025-07-21 MRF ↗
NORTON CLARK HOSPITAL OutpatientFacility Managed Health Services (MHS) Hoosier Healthwise (HHW) Managed Medicaid $47.71 — — 2025-04-24 MRF ↗
NORTON CLARK HOSPITAL OutpatientFacility Anthem Blue Cross Blue Shield Managed Medicaid $47.71 — — 2025-04-24 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Anthem Pathways For Aging $47.71 — — 2026-05-13 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Anthem In Medicaid Hcc $47.71 — — 2026-09-16 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Caresource In Medicaid Hip $47.71 — — 2026-05-13 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Anthem In Medicaid Hhw $47.71 — — 2026-05-13 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Anthem In Medicaid Hcc $47.71 — — 2026-05-13 MRF ↗
UofL Health - Frazier Rehabilitation Hospital - Brownsboro Outpatient Anthem In Medicaid $47.71 — — 2026-07-15 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Mdwise In Medicaid Hip $47.71 — — 2026-09-16 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Humana Pathways For Aging $47.71 — — 2026-09-16 MRF ↗
UofL Health - Peace Hospital Outpatient Anthem In Medicaid $47.71 — — 2026-07-15 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Mhs In Medicaid Hip $47.71 — — 2026-05-13 MRF ↗
UofL Health - Medical Center Northeast Outpatient Anthem In Medicaid $47.71 — — 2026-07-15 MRF ↗
REID HEALTH OutpatientFacility Humana of Indiana Pathways for Aging/Managed Medicaid $47.71 — — 2025-07-21 MRF ↗
UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient Anthem In Medicaid $47.71 — — 2026-08-01 MRF ↗
NORTON SCOTT HOSPITAL OutpatientFacility CareSource Indiana Healthy Indiana Plan (HIP) Managed Medicaid $47.71 — — 2026-06-03 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Uhc Pathways For Aging $47.71 — — 2026-05-13 MRF ↗
NORTON SCOTT HOSPITAL OutpatientFacility United Healthcare of Indiana Managed Medicaid $47.71 — — 2026-06-03 MRF ↗
REID HEALTH OutpatientFacility MHS Managed Medicaid $47.71 — — 2025-07-21 MRF ↗
UofL Health - Medical Center Southwest Outpatient Anthem In Medicaid $47.71 — — 2026-07-15 MRF ↗
UofL Health - Medical Center East Outpatient Anthem In Medicaid $47.71 — — 2026-08-01 MRF ↗
UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient Anthem In Medicaid $47.71 — — 2026-05-22 MRF ↗
REID HEALTH OutpatientFacility Caresource of Indiana Managed Medicaid $47.71 — — 2025-07-21 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Anthem Exchange $47.71 — — 2026-09-16 MRF ↗
NORTON CLARK HOSPITAL OutpatientFacility Humana Managed Medicaid $47.71 — — 2025-04-24 MRF ↗
NORTON SCOTT HOSPITAL OutpatientFacility CareSource Indiana Hoosier Healthwise (HHW) Managed Medicaid $48.19 — — 2026-06-03 MRF ↗
PALMETTO GENERAL HOSPITAL Outpatient Cigna Surefit Cigna Surefit $48.37 $278.00 $278.00 2026-07-15 MRF ↗
REID HEALTH OutpatientFacility United Healthcare Pathways for Aging/Managed Medicaid $48.66 — — 2025-07-21 MRF ↗
REID HEALTH OutpatientFacility United Healthcare Managed Medicaid $48.66 — — 2025-07-21 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Mhs In Medicaid Hip $48.68 — — 2026-07-15 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Mdwise In Medicaid Hip $48.68 — — 2026-07-15 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Mhs In Medicaid Hhw $48.68 — — 2026-07-15 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Mdwise In Medicaid Hhw $48.68 — — 2026-07-15 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Anthem Pathways For Aging $48.68 — — 2026-07-15 MRF ↗
GOOD SAMARITAN HOSPITAL Outpatient Bcbs Medicaid $48.68 — — 2026-07-17 MRF ↗
GOOD SAMARITAN HOSPITAL Outpatient Aetna Medicaid $48.68 — — 2026-07-17 MRF ↗
THE WOMEN'S HOSPITAL OutpatientFacility Anthem HIP Managed Medicaid $48.68 — — 2026-02-13 MRF ↗
THE WOMEN'S HOSPITAL OutpatientFacility Anthem IN Managed Medicaid $48.68 — — 2026-02-13 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Caresource In Medicaid Hip $48.68 — — 2026-07-15 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Caresource In Medicaid Hhw $48.68 — — 2026-07-15 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Anthem In Medicaid Hcc $48.68 — — 2026-07-15 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Anthem In Medicaid Hip $48.68 — — 2026-07-15 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Humana Pathways For Aging $48.68 — — 2026-07-15 MRF ↗
COMMUNITY HOSPITAL OF BREMEN INC Outpatient Uhc Pathways For Aging $48.68 — — 2026-07-15 MRF ↗
GOOD SAMARITAN HOSPITAL Outpatient Molina Medicaid $48.68 — — 2026-07-17 MRF ↗
UOFL HEALTH - SHELBYVILLE HOSPITAL Outpatient Anthem In Medicaid $48.68 — — 2026-07-17 MRF ↗
GOOD SAMARITAN HOSPITAL Outpatient Caresource Hip Medicaid $48.68 — — 2026-07-17 MRF ↗
UNIVERSITY OF LOUISVILLE HOSPITAL Outpatient Anthem In Medicaid $48.68 — — 2026-07-17 MRF ↗
GOOD SAMARITAN HOSPITAL Outpatient Anthem Indiana Medicaid $48.68 — — 2026-07-17 MRF ↗
UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient Anthem In Medicaid $48.68 — — 2026-07-17 MRF ↗
THE WOMEN'S HOSPITAL OutpatientFacility Anthem IN Pathways for Aging Managed Medicaid $48.68 — — 2026-02-13 MRF ↗
GOOD SAMARITAN HOSPITAL Outpatient Uhc Medicaid $48.68 — — 2026-07-17 MRF ↗
GOOD SAMARITAN HOSPITAL Outpatient Uhc Pathways Medicaid $48.68 — — 2026-07-17 MRF ↗
GOOD SAMARITAN HOSPITAL Outpatient Anthem Medicaid $48.68 — — 2026-07-17 MRF ↗
MEMORIAL HOSPITAL OF SOUTH BEND Outpatient Uhc In Medicaid Hcc $48.68 — — 2026-09-21 MRF ↗
GOOD SAMARITAN HOSPITAL Outpatient Mdwise Bhmi Medicaid $48.68 — — 2026-07-17 MRF ↗
GOOD SAMARITAN HOSPITAL Outpatient Meridian Medicaid $48.68 — — 2026-07-17 MRF ↗
NORTON-KING'S DAUGHTERS' HEALTH OutpatientFacility Anthem of Indiana Managed Medicaid $48.68 — — 2026-05-05 MRF ↗
GOOD SAMARITAN HOSPITAL Outpatient Caresource Hhw Medicaid $48.68 — — 2026-07-17 MRF ↗
UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient Anthem In Medicaid $48.68 — — 2026-07-17 MRF ↗
TERRE HAUTE REGIONAL HOSPITAL Outpatient Hospice of Bloomington Hospital MCR $48.68 — — 2024-10-01 MRF ↗
TERRE HAUTE REGIONAL HOSPITAL Outpatient Hospice of Bloomington Hospital MCR $48.68 — — 2024-10-01 MRF ↗
ELKHART GENERAL HOSPITAL Outpatient Mhs In Medicaid Hhw Bh $48.68 — — 2026-05-13 MRF ↗
THE WOMEN'S HOSPITAL OutpatientFacility United Healthcare IN Managed Medicaid $48.68 — — 2026-02-13 MRF ↗
THE WOMEN'S HOSPITAL OutpatientFacility MDWise HIP Managed Medicaid $48.68 — — 2026-02-13 MRF ↗
THE WOMEN'S HOSPITAL OutpatientFacility MHS Behavioral Managed Medicaid $48.68 — — 2026-02-13 MRF ↗
THE WOMEN'S HOSPITAL OutpatientFacility Caresource IN Managed Medicaid $48.68 — — 2026-02-13 MRF ↗
THE WOMEN'S HOSPITAL OutpatientFacility Caresource HIP Managed Medicaid $48.68 — — 2026-02-13 MRF ↗
NORTON CLARK HOSPITAL OutpatientFacility CareSource Indiana Hoosier Healthwise (HHW) Managed Medicaid $49.14 — — 2025-04-24 MRF ↗
NORTON CLARK HOSPITAL OutpatientFacility United Healthcare Managed Medicaid $49.14 — — 2025-04-24 MRF ↗
UNIVERSITY OF LOUISVILLE HOSPITAL Outpatient Anthem In Medicaid $49.24 — — 2026-05-14 MRF ↗
UNIVERSITY OF LOUISVILLE HOSPITAL Outpatient Anthem In Medicaid $49.24 — — 2026-05-22 MRF ↗
TERRE HAUTE REGIONAL HOSPITAL Outpatient CareSource MCD $49.65 — — 2024-10-01 MRF ↗
TERRE HAUTE REGIONAL HOSPITAL Outpatient CareSource MCD $49.65 — — 2024-10-01 MRF ↗
INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient United Healthcare Golden Rule Ins — — — 2026-07-15 MRF ↗
INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient United Healthcare United Healthcare — — — 2026-07-15 MRF ↗
LUTHERAN MEDICAL CENTER Outpatient United Healthcare Umr-United Med Resources — — — 2026-07-15 MRF ↗
SAINT JOSEPH HOSPITAL Outpatient United Healthcare Uhc Other/Supplemental — — — 2026-07-14 MRF ↗
LUTHERAN MEDICAL CENTER Outpatient United Healthcare Uhc Other/Supplemental — — — 2026-07-15 MRF ↗
SAINT JOSEPH HOSPITAL Outpatient United Healthcare Uhc Exchange Plan — — — 2026-07-14 MRF ↗
SAINT JOSEPH HOSPITAL Outpatient United Healthcare Uhc Charter/Navigate — — — 2026-07-14 MRF ↗
LUTHERAN MEDICAL CENTER Outpatient United Healthcare All Savers Alternative Funding — — — 2026-07-15 MRF ↗
SAINT JOSEPH HOSPITAL Outpatient United Healthcare United Healthcare — — — 2026-07-14 MRF ↗
LUTHERAN MEDICAL CENTER Outpatient United Healthcare Golden Rule Ins — — — 2026-07-15 MRF ↗
SAINT JOSEPH HOSPITAL Outpatient United Healthcare Umr-United Med Resources — — — 2026-07-14 MRF ↗
SAINT JOSEPH HOSPITAL Outpatient United Healthcare All Savers Alternative Funding — — — 2026-07-14 MRF ↗
INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient United Healthcare Umr-United Med Resources — — — 2026-07-15 MRF ↗
SAINT JOSEPH HOSPITAL Outpatient United Healthcare Surest — — — 2026-07-14 MRF ↗
SAINT JOSEPH HOSPITAL Outpatient United Healthcare Golden Rule Ins — — — 2026-07-14 MRF ↗
SAINT JOSEPH HOSPITAL Outpatient United Healthcare Medica — — — 2026-07-14 MRF ↗
LUTHERAN MEDICAL CENTER Outpatient United Healthcare Uhc Exchange Plan — — — 2026-07-15 MRF ↗
LUTHERAN MEDICAL CENTER Outpatient Geha Geha — — — 2026-07-15 MRF ↗
INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient United Healthcare Golden Rule Ins — — — 2026-07-15 MRF ↗
SAINT JOSEPH HOSPITAL Outpatient United Healthcare Selectcolorado — — — 2026-07-14 MRF ↗

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