SUP-402967 — Sponge Gz 4x4in Cot Wvn 12 Ply C Fld Dsgn
Cite this view
HANK Price Transparency. (n.d.). SPONGE GZ 4X4IN COT WVN 12 PLY C FLD DSGN (CDM SUP-402967) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/SUP-402967?code_type=CDM
“SPONGE GZ 4X4IN COT WVN 12 PLY C FLD DSGN (CDM SUP-402967) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/SUP-402967?code_type=CDM. Accessed .
“SPONGE GZ 4X4IN COT WVN 12 PLY C FLD DSGN (CDM SUP-402967) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/SUP-402967?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $171,478–$612,196 (25th–75th percentile) across 1 hospital · 15 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM SUP-402967 — 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 |
|---|---|---|---|---|---|---|---|
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | NLFH AETNA NM EMPLOYEES | $104,230.26 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | NLFH BCBS BLUECHOICE SELECT | $131,606.40 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | CIGNA HEALTH PLAN [178] | NLFH CIGNA ALTERNATIVE | $131,857.56 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | NLFH BCBS HMO | $133,050.56 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | ALTERNATE BLUE CROSS [1402] | NLFH BCBS HMO | $133,050.56 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | NLFH BCBS BLUECHOICE PREFERRED | $138,199.28 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | NLFH BCBS BLUECHOICE OPTIONS | $146,110.73 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | ALTERNATE BLUE CROSS [1402] | NLFH BCBS PPO | $171,477.62 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | NLFH BCBS PPO | $171,477.62 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | NLFH AETNA | $269,994.06 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | NLFH BC LAKE COUNTY PHYS ASSOC IPA | $282,551.90 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | NLFH AETNA ASA | $285,691.38 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | UNITED HEALTHCARE [158] | NLFH UHC CORE | $297,621.34 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | CIGNA HEALTH PLAN [178] | NLFH CIGNA BROAD | $305,156.06 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | HEALTHLINK [125] | NLFH SEIU HEALTHLINK | $313,946.56 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | UNITED HEALTHCARE [158] | NLFH UHC HMO/PPO | $330,899.70 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | HEALTH'S FINEST NETWORK [126] | NLFH HFN PLATINUM/CHC ELITE | $401,223.72 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | THE ALLIANCE [1703] | NLFH THE ALLIANCE | $403,295.75 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BEECHSTREET [176] | NLFH PHCS | $448,943.60 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | MULTIPLAN/PHCS [142] | NLFH PHCS | $448,943.60 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | FIRST HEALTH PLAN [6034] | NLFH FIRST HEALTH | $514,872.38 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | HEALTH'S FINEST NETWORK [126] | NLFH HFN PPO | $565,103.80 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | UNITED HEALTHCARE [158] | NLFH UHC NON-CONTRACTED OON - ED ONLY | $627,893.10 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | MULTIPLAN/PHCS [142] | NLFH NON-CONTRACTED PAYORS | $627,893.10 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | GLOBAL EXCEL [1712] | NLFH MEDICARE | — | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | ALTERNATE BLUE CROSS MEDICARE ADV [2304] | NLFH BLUE CROSS MEDICARE ADVT | — | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | ALTERNATE HUMANA MEDICARE ADV [2409] | NLFH HUMANA MEDICARE ADVT | — | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | NLFH ADVOCATE IPA | — | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | HUMANA HEALTH PLAN [130] | NLFH ADVOCATE IPA | — | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | NLFH BCBS PAR/INDEMNITY ADP | $627,893.10 | $627,893.10 | $439,525.20 | 2026-04-01 | MRF ↗ |