SUP-175702 — Stent Endoprosthesis Gore Tag Dryseal Flex L20 Mm L10 Cm Od28 Mm Odsec22 Fr Id8 Mm Thoracic Aorta Portal Aortic Component Delivery System
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). STENT ENDOPROSTHESIS GORE TAG DRYSEAL FLEX L20 MM L10 CM OD28 MM ODSEC22 FR ID8 MM THORACIC AORTA PORTAL AORTIC COMPONENT DELIVERY SYSTEM (CDM SUP-175702) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/SUP-175702?code_type=CDM
MLA (9th ed.)
“STENT ENDOPROSTHESIS GORE TAG DRYSEAL FLEX L20 MM L10 CM OD28 MM ODSEC22 FR ID8 MM THORACIC AORTA PORTAL AORTIC COMPONENT DELIVERY SYSTEM (CDM SUP-175702) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/SUP-175702?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“STENT ENDOPROSTHESIS GORE TAG DRYSEAL FLEX L20 MM L10 CM OD28 MM ODSEC22 FR ID8 MM THORACIC AORTA PORTAL AORTIC COMPONENT DELIVERY SYSTEM (CDM SUP-175702) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/SUP-175702?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $121,248–$134,720 (25th–75th percentile) across 1 hospital · 59 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM SUP-175702 — 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 |
|---|---|---|---|---|---|---|---|
| LOVELACE MEDICAL CENTER Outpatient | THE HEALTH PLAN [2915] | THE HEALTH PLAN [291500] | $27,752.32 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | UMR - ARDENT EMPLOYEE [2036] | UMR - ARDENT EMPLOYEE [203601] | $34,367.07 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | CORVEL CORP [2235] | CORVEL CORP [223500] | $39,203.52 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | ENABLECOMP [1350] | W/C WORK COMP ENABLECOMP [135000] | $39,998.37 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | WORKER'S COMP [2125] | CNA INSURANCE WC [2125100] | $39,998.37 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | PRESBYTERIAN HEALTH PLAN [1830] | PRESBYTERIAN HIX [183001] | $67,360.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | BENEFIT MANAGEMENT [1175] | NEW MEXICO INSURANCE POOL [117501] | $67,360.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | MAGELLAN BEHAVIORAL COMMERCIAL [2895] | MAGELLAN BEHAVIORAL COMMERCIAL [289500] | $67,360.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | ZELIS [2385] | NEW MEXICO MEDICAL INSURANCE POOL [238502] | $67,360.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | AETNA [1015] | AETNA ACO WILCO [101532] | $74,634.88 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | NORTHAMERICA ADMINISTRATORS [1725] | NORTHAMERICA ADMINISTRATORS [172500] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | UNITED HEALTHCARE [2060] | THE EMPIRE PLAN [206029] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | UNITED HEALTHCARE [2060] | UNITED HEALTHCARE STUDENT SVC [206012] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | AETNA [1015] | COVENTRY HEALTHCARE [101502] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | PHCS [1780] | GROUP HEALTH COOPERATIVE SCW [178012] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | UMR [2035] | UMR OPTIONS [203501] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | ADMINISTRATIVE CONCEPTS [1005] | ADMINISTRATIVE CONCEPTS [100502] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | ALLIED BENEFIT SYSTEMS INC [1030] | ALLIED BENEFIT SYSTEMS [103000] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | ALLIED NATIONAL GLOBAL CARE [1035] | ALLIED NATIONAL [103500] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | CORESOURCE [1315] | CORESOURCE [131500] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | COVENTRY HEALTHCARE [1320] | COVENTRY HEALTH CARE [132000] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | FMH BENEFIT SERVICES [1390] | FMH [139000] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | GEHA [1415] | GEHA [141500] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | HEALTHNET [1495] | HEALTHNET [149500] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | KAISER PERMANENTE [1560] | KAISER FOUNDATION HEALTH PLAN [156001] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | MULTIPLAN [1680] | IHC HS [168011] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | MUTUAL OF OMAHA [1685] | MUTUAL OF OMAHA [168500] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | UNITED HEALTHCARE [2060] | GOLDEN RULE [206003] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | PAN AMERICAN LIFE INSURANCE CO [1770] | PAN AMERICAN LIFE [177000] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | TRUSTMARK [2030] | STARMARK [203000] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | FIRST HEALTH [1375] | QUALCHOICE [137513] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | HEALTHSMART [1505] | HEALTHSMART PREFERRED CARE (HSPC) [150500] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | EMPLOYEE BENEFIT MANAGEMENT SERVICES [2445] | EMPLOYEE BENEFIT MANAGEMENT SERVICES [244501] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | HEALTHCOST SOLUTIONS [2415] | HEALTHCOST SOLUTIONS [241501] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | AMERICAN MEDICAL SECURITY [2190] | AMERICAN MEDICAL SECURITY [219000] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | BOON-CHAPMAN [2375] | BOON-CHAPMAN [237501] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | EMBLEM HEALTH [2430] | EMBLEM HEALTH [243001] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | NATIONAL TELEPHONE COOPERATIVE [1700] | NATIONAL TELEPHONE COOP ASSO [170000] | $121,248.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | HEALTHSMART [1505] | HEALTHSMART [150501] | $125,289.60 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | MEDICARE [1635] | MEDICARE PART A ONLY [163502] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | MAYO CLINIC HEALTH SOLUTIONS [2280] | MAYO CLINIC HEALTH SOLUTIONS [228000] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | VA CCN OPTUM [3920] | VA CCN OPTUM [392000] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | HEALTHSCOPE BENEFITS [2290] | HEALTHSCOPE BENEFITS [229000] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | MEDICARE [1635] | MEDICARE PART A AND B [163500] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | MOLINA MEDICARE REPLACEMENT [1675] | MOLINA MEDICARE ADVANTAGE [167500] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | MULTIPLAN [1680] | HMA [168003] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | BCBS IPA PAYOR [2945] | BCBS BEHAVIORAL HEALTH [294500] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | TOTAL COMMUNITY CARE [2245] | TOTAL COMM CARE MEDICARE REPL [224501] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | CHRISTUS HEALTH PLAN [2330] | CHRISTUS HP GENERATIONS HMO [233000] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | TRUE HEALTH NEW MEXICO [2810] | TRUE HEALTH NEW MEXICO [281000] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | PENDING SSI [1616] | PENDING SSI RCA [161601] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | TRIWEST [3750] | TRIWEST TWVACCN [375000] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | MEDICARE [1635] | REHAB MEDICARE [163504] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | AETNA MEDICARE REPLACEMENT [1020] | AETNA COVENTRY MEDICARE REPLACEMENT [102002] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | BCBS [1155] | BLUE CROSS BLUE COMMUNITY HMO OF NM [115528] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | BCBS [1155] | BCBS TRAD/HMO/PPO/POS NM [115513] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | BCBS MEDICAID [1165] | BLUE CROSS MEDICAID NEW MEXICO [116500] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | BCBS MEDICARE REPLACEMENT [1160] | BLUE CROSS MEDICARE ADVANTAGE OOS [116005] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | BLACK LUNG [6055] | BLACK LUNG [605500] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | CIGNA MEDICARE REPLACEMENT [1265] | CIGNA MEDICARE REPLACEMENT [126500] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | GROUP PENSION ADMIN [1450] | GPA-TLC [145007] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | HUMANA COMMERCIAL [2140] | HUMANA CHOICECARE [214003] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | HUMANA MEDICARE REPLACEMENT [1525] | HUMANA MEDICARE ADVANTAGE/PPO/GOLD [152503] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | LUCENT HEALTH [6000] | LUCENT HEALTH [600000] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | MANAGED MEDICARE [1600] | MANAGED MEDICARE OTHER [160000] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | MOLINA MEDICAID [2255] | MOLINA MEDICAID NEW MEXICO [225500] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | UNITED HEALTHCARE CENTENNIAL CARE [2250] | UHC MEDICAID NEW MEXICO [225000] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | MOLINA HEALTHCARE [1670] | MOLINA HEALTHCARE HIX [167001] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | UNITED HEALTHCARE MEDICARE REPLACEMENT [2065] | UHC MEDICARE ADVANTAGE [206511] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | BCBS [1155] | BLUE CROSS IMAGINE HEALTH OF NEW MEXICO [115527] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | WORKER'S COMP [2125] | DEPARTMENT OF LABOR (WC) [212507] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | MEDICARE [1635] | MEDICARE PART B ONLY [163501] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | IHS HEALTH SERVICES [1535] | WITHDRAWAL STABILIZATION-CHICKASAW [153543] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | BCBS [1155] | BLUE CROSS NLP NEW MEXICO [115529] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | CAPROCK HEALTH PLANS [1200] | CAPROCK HEALTH PLAN [120004] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | AETNA [1015] | AETNA SUPPLEMENT [101514] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | AMERIGROUP MEDICARE [1100] | WELLPOINT FKA AMERIGROUP MEDICARE [110000] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |
| LOVELACE MEDICAL CENTER Outpatient | PENDING COUNTY RCA [3910] | PENDING COUNTY RCA [391000] | $134,720.00 | $134,720.00 | $40,416.00 | 2025-04-05 | MRF ↗ |