Q4150 — Allowrap Ds Or Dry 1 Sq Cm
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HANK Price Transparency. (n.d.). Allowrap ds or dry 1 sq cm (OTHER Q4150) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Q4150?code_type=OTHER
“Allowrap ds or dry 1 sq cm (OTHER Q4150) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Q4150?code_type=OTHER. Accessed .
“Allowrap ds or dry 1 sq cm (OTHER Q4150) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Q4150?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $74–$135 (25th–75th percentile) across 85 hospitals · 181 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER Q4150 — 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 |
|---|---|---|---|---|---|---|---|
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $46.90 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $46.90 | — | — | 2026-05-14 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Caresource | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Humana | Pathways For Aging | $47.71 | — | — | 2026-05-14 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mdwise | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Humana | Pathways For Aging | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hhw | $47.71 | — | — | 2026-05-23 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hhw | $47.71 | — | — | 2026-05-23 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mdwise | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hip | $47.71 | — | — | 2026-05-23 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Uhc | Pathways For Aging | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hip Bh | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mhs | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| UOFL HEALTH - SHELBYVILLE HOSPITAL Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-14 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Humana | Pathways For Aging | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-22 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | Exchange | $47.71 | — | — | 2026-05-23 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Anthem | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Uhc | Pathways For Aging | $47.71 | — | — | 2026-05-23 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Caresource | In Medicaid Hip | $47.71 | — | — | 2026-05-23 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mhs | In Medicaid Hcc | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hhw | $47.71 | — | — | 2026-05-14 | MRF ↗ |
| UofL Health - South Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-22 | MRF ↗ |
| UofL Health - Peace Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-23 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hip | $47.71 | — | — | 2026-05-14 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-14 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hcc Bh | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Caresource | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hip | $47.71 | — | — | 2026-05-14 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mdwise | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hcc | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Anthem | In Medicaid Hcc | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Caresource | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Caresource | In Medicaid Hip | $47.71 | — | — | 2026-05-14 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hcc | $47.71 | — | — | 2026-05-23 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Uhc | Pathways For Aging | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Caresource | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hcc | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Uhc | Pathways For Aging | $47.71 | — | — | 2026-05-14 | MRF ↗ |
| UOFL HEALTH - SHELBYVILLE HOSPITAL Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-22 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Anthem | Pathways For Aging | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Anthem | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mdwise | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hip | $47.71 | — | — | 2026-05-23 | MRF ↗ |
| UofL Health - Medical Center Northeast Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-23 | MRF ↗ |
| UofL Health - Frazier Rehabilitation Hospital - Brownsboro Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-23 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hcc | $47.71 | — | — | 2026-05-14 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hip | $47.71 | — | — | 2026-05-23 | MRF ↗ |
| UofL Health - Medical Center Southwest Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-22 | MRF ↗ |
| UofL Health - Medical Center East Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-22 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | Pathways For Aging | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hip | $47.71 | — | — | 2026-05-14 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hhw | $47.71 | — | — | 2026-05-14 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-22 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mhs | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Humana | Pathways For Aging | $47.71 | — | — | 2026-05-23 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | Exchange | $47.71 | — | — | 2026-05-14 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hhw | $48.68 | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hip | $48.68 | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Caresource | In Medicaid Hip | $48.68 | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Caresource | In Medicaid Hhw | $48.68 | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | Pathways For Aging | $48.68 | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Uhc | Pathways For Aging | $48.68 | — | — | 2026-05-09 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Uhc | In Medicaid Hcc | $48.68 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hip | $48.68 | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hcc | $48.68 | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Humana | Pathways For Aging | $48.68 | — | — | 2026-05-09 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hip | $48.68 | — | — | 2026-05-09 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hhw Bh | $48.68 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hhw | $48.68 | — | — | 2026-05-09 | MRF ↗ |
| UNIVERSITY OF LOUISVILLE HOSPITAL Outpatient | Anthem | In Medicaid | $49.24 | — | — | 2026-05-22 | MRF ↗ |
| UNIVERSITY OF LOUISVILLE HOSPITAL Outpatient | Anthem | In Medicaid | $49.24 | — | — | 2026-05-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-05-18 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-05-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-05-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-05-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-05-22 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Medica | — | — | — | 2026-05-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | Geha | Geha | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Medica | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-05-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-05-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-05-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Surest | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Healthscope | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | Geha | Geha | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-05-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-05-14 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-05-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | Geha | Geha | — | — | — | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-05-22 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Surest | — | — | — | 2026-05-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Healthscope | — | — | — | 2026-05-22 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-05-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | Geha | Geha | — | — | — | 2026-05-17 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Surest | — | — | — | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-05-18 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-05-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Healthscope | — | — | — | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Medica | — | — | — | 2026-05-18 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-05-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | Geha | Geha | — | — | — | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Medica | — | — | — | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-05-18 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-05-17 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-05-18 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Medica | — | — | — | 2026-05-17 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-05-18 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-05-17 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Healthscope | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Surest | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-05-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-05-17 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Surest | — | — | — | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-05-22 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-05-17 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $71.92 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $71.92 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $71.92 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $71.92 | — | — | 2026-05-24 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Bcbs | Exchange | $73.74 | — | — | 2026-05-09 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Bcbs | Commercial | $73.74 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicaid | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Healthy U | Medicaid | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Healthy U | Medicaid | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Medicaid | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Signature Individual Aca | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Med Individual Aca | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Value Individual Aca | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Uhc | Medicare Advantage | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Molina | Medicare Choice Care Hmo | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Molina | Medicare Advantage | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| AMERICAN FORK HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Molina | Medicaid | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Humana | Medicare Choice Ppo | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Molina | Medicare Complete Care Hmo Snp | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Health Partners Of Nevada | Medicare Advantage | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Selecthealth | Medicaid | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Uhc | Medicare Advantage | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Uhc | Medicare Advantage | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | American Health | Medicare Adv Ut Hmo I-Snp | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH SANPETE VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Adv Ppo | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Uhc | Medicare Advantage | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Selecthealth | Medicare Advantage | $74.30 | — | — | 2026-05-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Medadvantage Ppo | $74.30 | — | — | 2026-05-09 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Aetna | Medicare Adv Hmo | $74.30 | — | — | 2026-05-14 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.