RX-178214 — Gemtuzumab Ozogamicin 4.5 Mg (1 Mg/ml Initial Concentration) IV Soln
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONCENTRATION) IV SOLN (CDM RX-178214) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/RX-178214?code_type=CDM
MLA (9th ed.)
“GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONCENTRATION) IV SOLN (CDM RX-178214) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/RX-178214?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“GEMTUZUMAB OZOGAMICIN 4.5 MG (1 MG/ML INITIAL CONCENTRATION) IV SOLN (CDM RX-178214) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/RX-178214?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $10,648–$116,338 (25th–75th percentile) across 3 hospitals · 16 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM RX-178214 — 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 |
|---|---|---|---|---|---|---|---|
| NORTH BALDWIN INFIRMARY Outpatient | BLUE CROSS [85294] | NB Blue Cross (BCBS) | $9,784.35 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | BLUE CROSS [85294] | MI Blue Cross (BCBS) | $9,784.35 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | BLUE CROSS [85294] | NB Blue Cross (BCBS) | $9,784.35 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | BLUE CROSS [85294] | MI Blue Cross (BCBS) | $9,784.35 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | BLUE CROSS [85294] | NB Blue Cross (BCBS) | $9,784.35 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | BLUE CROSS [85294] | MI Blue Cross (BCBS) | $9,784.35 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | GENERIC HOSPICE [85998] | MI COMFORTCARE MERCY HOSPICE 90% - MEDICARE OUTPT | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | VIVA MEDICARE ADVANTAGE [85132] | NB VIVA MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | UNITED HEALTHCARE MEDICARE ADVANTAGE [85098] | NB UHC MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | GENERIC HOSPICE [85998] | NB COMFORTCARE MERCY HOSPICE - MEDICARE OUTPT | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | US DEPARTMENT OF LABOR [5361] | NB DEPT OF LABOR WC - MEDICARE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | BLUE ADVANTAGE [85293] | NB BLUE ADVANTAGE - MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | VIVA MEDICARE ADVANTAGE [85132] | MI VIVA MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | BLUE ADVANTAGE [85293] | MI BLUE ADVANTAGE - MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | UNITED HEALTHCARE MEDICARE ADVANTAGE VACCINE [85099] | MI UHC MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | US DEPARTMENT OF LABOR [5361] | MI DEPT OF LABOR WC - MEDICARE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | BLUE ADVANTAGE [85293] | MI BLUE ADVANTAGE - MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | GENERIC HOSPICE [85998] | MI COMFORTCARE MERCY HOSPICE 90% - MEDICARE OUTPT | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | UNITED HEALTHCARE MEDICARE ADVANTAGE VACCINE [85099] | MI UHC MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | VIVA MEDICARE ADVANTAGE [85132] | MI VIVA MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | US DEPARTMENT OF LABOR [5361] | MI DEPT OF LABOR WC - MEDICARE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | BLUE ADVANTAGE [85293] | NB BLUE ADVANTAGE - MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | GENERIC HOSPICE [85998] | NB COMFORTCARE MERCY HOSPICE - MEDICARE OUTPT | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | UNITED HEALTHCARE MEDICARE ADVANTAGE [85098] | NB UHC MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | VIVA MEDICARE ADVANTAGE [85132] | NB VIVA MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | US DEPARTMENT OF LABOR [5361] | NB DEPT OF LABOR WC - MEDICARE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | GENERIC HOSPICE [85998] | NB COMFORTCARE MERCY HOSPICE - MEDICARE OUTPT | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | US DEPARTMENT OF LABOR [5361] | NB DEPT OF LABOR WC - MEDICARE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | GENERIC HOSPICE [85998] | MI COMFORTCARE MERCY HOSPICE 90% - MEDICARE OUTPT | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | BLUE ADVANTAGE [85293] | MI BLUE ADVANTAGE - MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | UNITED HEALTHCARE MEDICARE ADVANTAGE [85098] | NB UHC MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | BLUE ADVANTAGE [85293] | NB BLUE ADVANTAGE - MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | US DEPARTMENT OF LABOR [5361] | MI DEPT OF LABOR WC - MEDICARE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | VIVA MEDICARE ADVANTAGE [85132] | NB VIVA MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | UNITED HEALTHCARE MEDICARE ADVANTAGE VACCINE [85099] | MI UHC MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | VIVA MEDICARE ADVANTAGE [85132] | MI VIVA MEDICARE ADVANTAGE | $10,647.72 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | AETNA COMMERCIAL [85189] | MI AETNA | $94,524.89 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | AETNA COMMERCIAL [85189] | MI AETNA | $94,524.89 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | AETNA COMMERCIAL [85189] | MI AETNA | $94,524.89 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | HEALTH CHOICE [85751] | MI Health Choice | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | HUMANA COMMERCIAL [85368] | MI HUMANA | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | CIGNA COMMERCIAL [85040] | CIGNA | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | HUMANA COMMERCIAL [85368] | MI HUMANA | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | CIGNA COMMERCIAL [85040] | CIGNA | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | CIGNA COMMERCIAL [85040] | CIGNA | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | CIGNA COMMERCIAL [85040] | CIGNA | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | CIGNA COMMERCIAL [85040] | CIGNA | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | FIRST HEALTH NETWORK [85081] | MI FIRST HEALTH COMMERCIAL | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | FIRST HEALTH NETWORK [85081] | MI FIRST HEALTH COMMERCIAL | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | FIRST HEALTH NETWORK [85081] | MI FIRST HEALTH COMMERCIAL | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | HEALTH CHOICE [85751] | NB/TH HEALTH CHOICE | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | HEALTH CHOICE [85751] | MI Health Choice | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | HEALTH CHOICE [85751] | NB/TH HEALTH CHOICE | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | HEALTH CHOICE [85751] | MI Health Choice | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | HUMANA COMMERCIAL [85368] | MI HUMANA | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | CIGNA COMMERCIAL [85040] | CIGNA | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | HEALTH CHOICE [85751] | NB/TH HEALTH CHOICE | $101,796.03 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| Infirmary Ltac Hospital Outpatient | CIGNA COMMERCIAL [85040] | CIGNA | $101,796.03 | $145,422.90 | $145,422.90 | 2025-11-02 | MRF ↗ |
| Infirmary Ltac Hospital Outpatient | CIGNA COMMERCIAL [85040] | CIGNA | $101,796.03 | $145,422.90 | $145,422.90 | 2025-11-02 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | GENERIC HOME HEALTH [85997] | BAY POINTE EAST POINTE ALTAPOINTE | $109,067.18 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | GENERIC HOME HEALTH [85997] | BAY POINTE EAST POINTE ALTAPOINTE | $109,067.18 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | GENERIC HOME HEALTH [85997] | BAY POINTE EAST POINTE ALTAPOINTE | $109,067.18 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | GENERIC HOME HEALTH [85997] | BAY POINTE EAST POINTE ALTAPOINTE | $109,067.18 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | GENERIC HOME HEALTH [85997] | BAY POINTE EAST POINTE ALTAPOINTE | $109,067.18 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | GENERIC HOME HEALTH [85997] | BAY POINTE EAST POINTE ALTAPOINTE | $109,067.18 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | FIRST HEALTH NETWORK [85081] | NB FIRST HEALTH COMMERCIAL | $116,338.32 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | VIVA COMMERCIAL [85130] | MI VIVA | $116,338.32 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| Infirmary Ltac Hospital Outpatient | AETNA COMMERCIAL [85189] | LTCH AETNA | $116,338.32 | $145,422.90 | $145,422.90 | 2025-11-02 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | MULTIPLAN NETWORK [85552] | MI MULTI PLAN | $116,338.32 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | MULTIPLAN NETWORK [85552] | MI MULTI PLAN | $116,338.32 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | VIVA COMMERCIAL [85130] | MI VIVA | $116,338.32 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | MULTIPLAN NETWORK [85552] | MI MULTI PLAN | $116,338.32 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| MOBILE INFIRMARY MEDICAL CENTER Outpatient | VIVA COMMERCIAL [85130] | MI VIVA | $116,338.32 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | FIRST HEALTH NETWORK [85081] | NB FIRST HEALTH COMMERCIAL | $116,338.32 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | FIRST HEALTH NETWORK [85081] | NB FIRST HEALTH COMMERCIAL | $116,338.32 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| Infirmary Ltac Hospital Outpatient | AETNA COMMERCIAL [85189] | LTCH AETNA | $116,338.32 | $145,422.90 | $145,422.90 | 2025-11-02 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | VIVA COMMERCIAL [85130] | NB VIVA | $123,609.47 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | VIVA COMMERCIAL [85130] | NB VIVA | $123,609.47 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | HUMANA COMMERCIAL [85368] | NB HUMANA | $123,609.47 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | VIVA COMMERCIAL [85130] | NB VIVA | $123,609.47 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | HUMANA COMMERCIAL [85368] | NB HUMANA | $123,609.47 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | HUMANA COMMERCIAL [85368] | NB HUMANA | $123,609.47 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | MULTIPLAN NETWORK [85552] | NB MULTI PLAN | $130,880.61 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | PHCS NETWORK [85240] | NB PRIVATE HEALTHCARE SYSTEMS (PHCS) | $130,880.61 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | PHCS NETWORK [85240] | NB PRIVATE HEALTHCARE SYSTEMS (PHCS) | $130,880.61 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | MULTIPLAN NETWORK [85552] | NB MULTI PLAN | $130,880.61 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | MULTIPLAN NETWORK [85552] | NB MULTI PLAN | $130,880.61 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| NORTH BALDWIN INFIRMARY Outpatient | PHCS NETWORK [85240] | NB PRIVATE HEALTHCARE SYSTEMS (PHCS) | $130,880.61 | $145,422.90 | $145,422.90 | 2025-10-30 | MRF ↗ |
| Infirmary Ltac Hospital Outpatient | BLUE ADVANTAGE [85293] | LTCH BLUE ADVANTAGE - MEDICARE ADVANTAGE | $145,422.90 | $145,422.90 | $145,422.90 | 2025-11-02 | MRF ↗ |
| Infirmary Ltac Hospital Outpatient | BLUE ADVANTAGE [85293] | LTCH BLUE ADVANTAGE - MEDICARE ADVANTAGE | $145,422.90 | $145,422.90 | $145,422.90 | 2025-11-02 | MRF ↗ |
| Infirmary Ltac Hospital Outpatient | CIGNA HEALTHSPRING MEDICARE ADVANTAGE [85203] | LTCH HEALTHSPRING - MEDICARE ADVANTAGE | $149,640.16 | $145,422.90 | $145,422.90 | 2025-11-02 | MRF ↗ |
| Infirmary Ltac Hospital Outpatient | CIGNA HEALTHSPRING MEDICARE ADVANTAGE [85203] | LTCH HEALTHSPRING - MEDICARE ADVANTAGE | $149,640.16 | $145,422.90 | $145,422.90 | 2025-11-02 | MRF ↗ |