0469U — Rare Ds Whl Gen Seq Ftl Samp
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Rare ds whl gen seq ftl samp (OTHER 0469U) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/0469U?code_type=OTHER
MLA (9th ed.)
“Rare ds whl gen seq ftl samp (OTHER 0469U) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/0469U?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“Rare ds whl gen seq ftl samp (OTHER 0469U) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/0469U?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,198–$1,917 (25th–75th percentile) across 569 hospitals · 400 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 0469U — 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 |
|---|---|---|---|---|---|---|---|
| SOUTH BROOKLYN HEALTH OutpatientFacility | UNITED | EXCHANGE | $1.00 | $2,994.85 | $1,197.94 | 2026-09-05 | MRF ↗ |
| ST ELIZABETH EDGEWOOD OutpatientFacility | Anthem | All Commercial Plans | $33.20 | — | — | 2026-04-01 | MRF ↗ |
| STAMFORD HOSPITAL OutpatientFacility | Bcbs | Empire Ppo | $33.20 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF KENTUCKY HOSPITAL OutpatientFacility | BCBS | Anthem HMO Exchange | $33.20 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF KENTUCKY HOSPITAL OutpatientFacility | BCBS | Anthem UK Health Plan Other Commercial Plan | $33.20 | — | — | 2026-04-01 | MRF ↗ |
| STAMFORD HOSPITAL OutpatientFacility | Bcbs | Anthem Hmo Pathway Exchange | $33.20 | — | — | 2026-04-01 | MRF ↗ |
| STAMFORD HOSPITAL OutpatientFacility | Bcbs | Anthem Ppo | $33.20 | — | — | 2026-04-01 | MRF ↗ |
| STAMFORD HOSPITAL OutpatientFacility | Bcbs | Anthem Ppo Pathway Exchange | $33.20 | — | — | 2026-04-01 | MRF ↗ |
| STAMFORD HOSPITAL OutpatientFacility | Bcbs | Anthem Hmo | $33.20 | — | — | 2026-04-01 | MRF ↗ |
| ST ELIZABETH GRANT OutpatientFacility | Anthem | All Commercial Plans | $33.20 | — | — | 2026-04-01 | MRF ↗ |
| STAMFORD HOSPITAL OutpatientFacility | Bcbs | Empire Hmo | $33.20 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF KENTUCKY HOSPITAL OutpatientFacility | BCBS | Anthem HPN Other Commercial Plan | $33.20 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF KENTUCKY HOSPITAL OutpatientFacility | BCBS | Anthem All Commercial Plans | $33.20 | — | — | 2026-04-01 | MRF ↗ |
| BEAVER COUNTY MEMORIAL HOSPITAL OutpatientFacility | BCBS | ALL PRODUCTS | $42.56 | — | — | 2025-12-30 | MRF ↗ |
| PARKVIEW DEKALB HOSPITAL OutpatientFacility | BCBS | Anthem PPO | $46.66 | — | — | 2026-09-01 | MRF ↗ |
| COMMUNITY HOSPITALS AND WELLNESS CENTERS OutpatientFacility | BCBS | Anthem PPO | $46.66 | — | — | 2026-09-01 | MRF ↗ |
| RIVERSIDE WALTER REED HOSPITAL Outpatient | Aetna | Managed Medicaid | $48.49 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE WALTER REED HOSPITAL Outpatient | Anthem | Managed Medicaid | $48.49 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Molina | Managed Medicaid | $48.49 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE REGIONAL MEDICAL CENTER Outpatient | United Healthcare | Managed Medicaid | $48.49 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE WALTER REED HOSPITAL Outpatient | United Healthcare | Managed Medicaid | $48.49 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | United Healthcare | Managed Medicaid | $48.49 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE REGIONAL MEDICAL CENTER Outpatient | Molina | Managed Medicaid | $48.49 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | United Healthcare | Managed Medicaid | $48.49 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Molina | Managed Medicaid | $48.49 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Aetna | Managed Medicaid | $48.49 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE REGIONAL MEDICAL CENTER Outpatient | Aetna | Managed Medicaid | $48.49 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Aetna | Managed Medicaid | $48.49 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | United Healthcare | Managed Medicaid | $48.79 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | United Healthcare | Managed Medicaid | $48.79 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Anthem | Managed Medicaid | $48.79 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Aetna | Managed Medicaid | $48.79 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Anthem | Managed Medicaid | $48.79 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Aetna | Managed Medicaid | $48.79 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE REGIONAL MEDICAL CENTER Outpatient | Sentara Health Plans | Managed Medicaid | $49.71 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Sentara Health Plans | Managed Medicaid | $49.71 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Sentara Health Plans | Managed Medicaid | $49.71 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE WALTER REED HOSPITAL Outpatient | Sentara Health Plans | Managed Medicaid | $49.71 | — | — | 2026-01-02 | MRF ↗ |
| UPLAND HILLS HEALTH OutpatientFacility | GHC OF SC WI | POS | $49.73 | — | — | 2026-03-20 | MRF ↗ |
| UPLAND HILLS HEALTH OutpatientFacility | GHC OF SC WI | POS | $49.73 | — | — | 2026-03-20 | MRF ↗ |
| UPLAND HILLS HEALTH OutpatientFacility | MHS | MANAGED MEDICAID | $49.73 | — | — | 2026-03-20 | MRF ↗ |
| UPLAND HILLS HEALTH OutpatientFacility | MHS | MANAGED MEDICAID | $49.73 | — | — | 2026-03-20 | MRF ↗ |
| UPLAND HILLS HEALTH OutpatientFacility | GHC OF EAU CLAIRE | MANAGED MEDICAID | $49.73 | — | — | 2026-03-20 | MRF ↗ |
| UPLAND HILLS HEALTH OutpatientFacility | GHC OF EAU CLAIRE | MANAGED MEDICAID | $49.73 | — | — | 2026-03-20 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Sentara Health Plans | Managed Medicaid | $50.02 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Sentara Health Plans | Managed Medicaid | $50.02 | — | — | 2026-01-02 | MRF ↗ |
| PARKVIEW LAGRANGE HOSPITAL OutpatientFacility | BCBS | Anthem All Commercial Plans | $50.83 | — | — | 2026-09-01 | MRF ↗ |
| PARKVIEW HUNTINGTON HOSPITAL OutpatientFacility | BCBS | Anthem All Commercial Plans | $50.83 | — | — | 2026-09-01 | MRF ↗ |
| PARKVIEW REGIONAL MEDICAL CENTER OutpatientFacility | Bcbs | Anthem All Commercial Plans | $50.83 | — | — | 2026-04-01 | MRF ↗ |
| PARKVIEW DEKALB HOSPITAL OutpatientFacility | Bcbs | Anthem All Commercial Plans | $50.83 | — | — | 2026-04-01 | MRF ↗ |
| PARKVIEW LAGRANGE HOSPITAL OutpatientFacility | Bcbs | Anthem All Commercial Plans | $50.83 | — | — | 2026-04-01 | MRF ↗ |
| PARKVIEW NOBLE HOSPITAL OutpatientFacility | Bcbs | Anthem All Commercial Plans | $50.83 | — | — | 2026-04-01 | MRF ↗ |
| PARKVIEW WHITLEY HOSPITAL OutpatientFacility | Bcbs | Anthem All Commercial Plans | $50.83 | — | — | 2026-04-01 | MRF ↗ |
| ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH OutpatientFacility | Bcbs | Anthem All Commercial Plans | $50.83 | — | — | 2026-04-01 | MRF ↗ |
| RIVERSIDE REGIONAL MEDICAL CENTER Outpatient | Humana | Managed Medicaid | $50.91 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Humana | Managed Medicaid | $50.91 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Humana | Managed Medicaid | $50.91 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE WALTER REED HOSPITAL Outpatient | Humana | Managed Medicaid | $50.91 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Humana | Managed Medicaid | $51.23 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Humana | Managed Medicaid | $51.23 | — | — | 2026-01-02 | MRF ↗ |
| VCU HEALTH TAPPAHANNOCK HOSPITAL Outpatient | ANTHEM | MANAGED MEDICAID | $52.49 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | SENTARA | MANAGED MEDICAID | $52.49 | — | — | 2026-01-02 | MRF ↗ |
| VCU HEALTH TAPPAHANNOCK HOSPITAL Outpatient | SENTARA | MANAGED MEDICAID | $52.49 | — | — | 2026-01-02 | MRF ↗ |
| VCU HEALTH TAPPAHANNOCK HOSPITAL Outpatient | AETNA | MANAGED MEDICAID | $52.49 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | ANTHEM | MANAGED MEDICAID | $52.49 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | AETNA | MANAGED MEDICAID | $53.01 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | ANTHEM | MANAGED MEDICAID | $53.51 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | SENTARA | MANAGED MEDICAID | $53.51 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | UNITED | MANAGED MEDICAID | $53.54 | — | — | 2026-01-02 | MRF ↗ |
| VCU HEALTH TAPPAHANNOCK HOSPITAL Outpatient | UNITED | MANAGED MEDICAID | $53.54 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | AETNA | MANAGED MEDICAID | $54.05 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | UNITED | MANAGED MEDICAID | $54.58 | — | — | 2026-01-02 | MRF ↗ |
| VCU HEALTH TAPPAHANNOCK HOSPITAL Outpatient | MOLINA | MANAGED MEDICAID | $55.11 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | MOLINA | MANAGED MEDICAID | $55.11 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | MOLINA | MANAGED MEDICAID | $56.19 | — | — | 2026-01-02 | MRF ↗ |
| BAPTIST MEDICAL CENTER EAST OutpatientFacility | Blue Cross Blue Shield | All Products | $64.13 | — | — | 2025-12-30 | MRF ↗ |
| BAPTIST MEDICAL CENTER EAST OutpatientFacility | Blue Cross Blue Shield | All Products | $64.13 | — | — | 2025-12-30 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $68.78 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $71.46 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $71.46 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $71.46 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $72.82 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $72.82 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | Paramount | Managed Medicaid | $74.57 | — | — | 2026-06-15 | MRF ↗ |
| WESTERN WISCONSIN HEALTH OutpatientFacility | United Healthcare | Managed Medicaid | $74.80 | — | — | 2025-06-24 | MRF ↗ |
| WESTERN WISCONSIN HEALTH OutpatientFacility | BC Anthem | Managed Medicaid | $74.80 | — | — | 2025-06-24 | MRF ↗ |
| WESTERN WISCONSIN HEALTH OutpatientFacility | BC Anthem | Managed Medicaid | $74.80 | — | — | 2025-06-24 | MRF ↗ |
| WESTERN WISCONSIN HEALTH OutpatientFacility | Ucare | Managed Medicaid | $74.80 | — | — | 2025-06-24 | MRF ↗ |
| WESTERN WISCONSIN HEALTH OutpatientFacility | United Healthcare | Managed Medicaid | $74.80 | — | — | 2025-06-24 | MRF ↗ |
| WESTERN WISCONSIN HEALTH OutpatientFacility | Ucare | Managed Medicaid | $74.80 | — | — | 2025-06-24 | MRF ↗ |
| BAPTIST MEDICAL CENTER SOUTH OutpatientFacility | Blue Cross Blue Shield | All Products | $75.95 | — | — | 2025-12-30 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $76.02 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $76.02 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $76.02 | — | — | 2026-06-15 | MRF ↗ |
| CHILDREN'S NEBRASKA OutpatientFacility | Nebraska Medicaid | Community Plan - All Products | $76.62 | — | — | 2026-03-31 | MRF ↗ |
| CHILDREN'S NEBRASKA OutpatientFacility | Nebraska Medicaid | Managed Medicaid Community Plan | $76.62 | — | — | 2026-03-31 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | United BH | Managed Medicaid | $76.74 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $77.47 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $77.47 | — | — | 2026-06-15 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Meridian | Managed Medicaid | $78.23 | — | — | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Aetna Better Health | Managed Medicaid | $78.23 | — | — | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Illinois Medicaid | Illinois Medicaid | $78.23 | — | — | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Molina | Managed Medicaid | $78.23 | — | — | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Illinois Medicaid | Illinois Medicaid | $78.23 | — | — | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Meridian | Managed Medicaid | $78.23 | — | — | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Molina | Managed Medicaid | $78.23 | — | — | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Aetna Better Health | Managed Medicaid | $78.23 | — | — | 2025-01-21 | MRF ↗ |
| PRATTVILLE BAPTIST HOSPITAL OutpatientFacility | Blue Cross Blue Shield | All Products | $78.52 | — | — | 2025-12-30 | MRF ↗ |
| PRATTVILLE BAPTIST HOSPITAL OutpatientFacility | Blue Cross Blue Shield | All Products | $78.52 | — | — | 2025-12-30 | MRF ↗ |
| CHILDREN'S NEBRASKA OutpatientFacility | Nebraska Medicaid | Total Care | $78.92 | — | — | 2026-03-31 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | AMERIHEALTH | Managed Medicaid | $79.64 | — | — | 2026-06-15 | MRF ↗ |
| CHILDREN'S NEBRASKA OutpatientFacility | Molina (Nebraska) | Managed Medicaid | $81.98 | — | — | 2026-03-31 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $90.10 | — | — | 2026-06-15 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $94.61 | — | — | 2026-06-15 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $94.61 | — | — | 2026-06-15 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Molina | Managed Medicaid - Non-Cap | $94.90 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | Molina | Managed Medicaid - Non-Cap | $94.90 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | UHC | Managed Medicaid | $94.90 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | UHC | Managed Medicaid | $94.90 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Humana | Managed Medicaid | $95.81 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | BCHP | Managed Medicaid - Non-Cap | $95.81 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | Amerihealth | Managed Medicaid - Non-Cap | $95.81 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | Humana | Managed Medicaid | $95.81 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | Anthem | Managed Medicaid - Non-Cap | $95.81 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | BCHP | Managed Medicaid - Non-Cap | $95.81 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Anthem | Managed Medicaid - Non-Cap | $95.81 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Amerihealth | Managed Medicaid - Non-Cap | $95.81 | — | — | 2026-04-01 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $96.41 | — | — | 2026-06-15 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $96.41 | — | — | 2026-06-15 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | AMERIHEALTH | Managed Medicaid | $99.11 | — | — | 2026-06-15 | MRF ↗ |
| VALLEYWISE HEALTH MEDICAL CENTER OutpatientFacility | BCBS | INDIVIDUAL EXCHANGE | $123.08 | — | — | 2025-06-28 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Caresource | Managed Medicaid - Non-Cap | $128.95 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Anthem | Managed Medicaid - Non-Cap | $128.95 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Humana | Managed Medicaid - Non-Cap | $128.95 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | BCHP | Managed Medicaid - Non-Cap | $128.95 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | UHC | Managed Medicaid - Non-Cap | $128.95 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Molina | Managed Medicaid - Non-Cap | $128.95 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Amerihealth | Managed Medicaid - Non-Cap | $128.95 | — | — | 2026-04-01 | MRF ↗ |
| VALLEYWISE HEALTH MEDICAL CENTER OutpatientFacility | BCBS | ALL PRODUCTS | $136.75 | — | — | 2025-06-28 | MRF ↗ |
| NYACK HOSPITAL Outpatient | Anthem | Connection SG | $189.24 | — | — | 2026-04-01 | MRF ↗ |
| NYACK HOSPITAL Outpatient | Anthem | SG EPO/PPO | $201.19 | — | — | 2026-04-01 | MRF ↗ |
| MACNEAL HOSPITAL OutpatientFacility | BCBS IL | PPO | $206.05 | — | — | 2026-03-31 | MRF ↗ |
| VALLEYWISE HEALTH MEDICAL CENTER OutpatientFacility | BCBS | WORKERS COMP | $207.20 | — | — | 2025-06-28 | MRF ↗ |
| NYACK HOSPITAL Outpatient | Anthem | Blue Access | $212.81 | — | — | 2026-04-01 | MRF ↗ |
| NYACK HOSPITAL Outpatient | Anthem | Connection LG | $212.81 | — | — | 2026-04-01 | MRF ↗ |
| NYACK HOSPITAL Outpatient | Anthem | HMO, POS, PPO, EPO, Indemnity | $236.72 | — | — | 2026-04-01 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | WELLCARE | MCARE HMO DUAL PLAN | $263.55 | — | — | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | WELLCARE | MCARE HMO | $263.55 | — | — | 2025-12-23 | MRF ↗ |
| MONTEFIORE ST LUKE'S CORNWALL Outpatient | Anthem | Connection SG | $322.04 | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE ST LUKE'S CORNWALL Outpatient | Anthem | SG EPO/PPO | $342.29 | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE ST LUKE'S CORNWALL Outpatient | Anthem | Blue Access | $362.54 | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE ST LUKE'S CORNWALL Outpatient | Anthem | Connection LG | $362.54 | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE ST LUKE'S CORNWALL Outpatient | Anthem | HMO, POS, PPO, EPO, Indemnity | $402.72 | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE ST LUKE'S CORNWALL Outpatient | Anthem | Fed Employee Program | $402.72 | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE ST LUKE'S CORNWALL Outpatient | Anthem | Local 32BJ | $402.72 | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE ST LUKE'S CORNWALL Outpatient | Anthem | Hotel Trades Council | $402.72 | — | — | 2026-04-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | BLUE CROSS | EXCLUSIVE NETWORK | $415.94 | — | — | 2026-01-01 | MRF ↗ |
| AFFILIATE OF VITRUVIAN HEALTH OutpatientFacility | Wellpoint | Tenncare Medicaid Managed Care Plan | $419.28 | — | — | 2026-04-01 | MRF ↗ |
| HILL HOSPITAL OF SUMTER COUNTY OutpatientFacility | BCBSAL | All Products | $429.00 | — | — | 2026-04-10 | MRF ↗ |
| HILL HOSPITAL OF SUMTER COUNTY OutpatientFacility | BCBSAL | All Products | $429.00 | — | — | 2026-04-10 | MRF ↗ |
| ENGLEWOOD HOSPITAL AND MEDICAL CENTER OutpatientFacility | Oxford_741 | All Commercial Products | $431.26 | — | — | 2026-02-02 | MRF ↗ |
| ENGLEWOOD HOSPITAL AND MEDICAL CENTER OutpatientFacility | United Healthcare_742 | All Commercial Products | $431.26 | — | — | 2026-02-02 | MRF ↗ |
| ADVENTHEALTH SHAWNEE MISSION OutpatientFacility | Unitedhealthcare | Hmo/Ppo | $503.13 | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCE COMMUNITY HOSPITAL OutpatientFacility | UnitedHealthCare | All Commercial Plans | $503.13 | — | — | 2026-04-01 | MRF ↗ |
| OKLAHOMA SURGICAL HOSPITAL, LLC OutpatientFacility | United Healthcare | All Products | $503.13 | — | — | 2025-10-31 | MRF ↗ |
| ADVENTHEALTH OTTAWA OutpatientFacility | Unitedhealthcare | Hmo/Ppo | $503.13 | — | — | 2026-04-01 | MRF ↗ |
| ADVENTHEALTH SOUTH OVERLAND PARK, INC OutpatientFacility | Unitedhealthcare | Hmo/Ppo | $503.13 | — | — | 2026-04-01 | MRF ↗ |
| SOUTHWEST GENERAL HEALTH CENTER OutpatientFacility | Medical Mutual | ACA Exchange | $515.11 | — | — | 2026-07-01 | MRF ↗ |
| SOUTHWEST GENERAL HEALTH CENTER OutpatientFacility | MEDICAL MUTUAL-OHIO | All Products | $515.11 | — | — | 2026-07-01 | MRF ↗ |
| SOUTHWEST GENERAL HEALTH CENTER OutpatientFacility | Medical Mutual | All Products | $575.01 | — | — | 2026-07-01 | MRF ↗ |
| BETHESDA BUTLER HOSPITAL OutpatientFacility | Cigna | All Commercial Plans | $589.83 | — | — | 2026-04-01 | MRF ↗ |
| BETHESDA NORTH OutpatientFacility | Cigna | All Commercial Plans | $589.83 | — | — | 2026-04-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL OutpatientFacility | Cigna | All Commercial Plans | $589.83 | — | — | 2026-04-01 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Healthfirst | Small Group | $598.97 | $2,994.85 | $1,197.94 | 2026-09-05 | MRF ↗ |
| ST ELIZABETH EDGEWOOD OutpatientFacility | Medical Mutual Of Ohio | All Commercial Plans | $610.95 | — | — | 2026-04-01 | MRF ↗ |
| ST ELIZABETH EDGEWOOD OutpatientFacility | Medical Mutual Of Ohio | Medflex | $610.95 | — | — | 2026-04-01 | MRF ↗ |
| ST ELIZABETH GRANT OutpatientFacility | Medical Mutual Of Ohio | All Commercial Plans | $610.95 | — | — | 2026-04-01 | MRF ↗ |
| ST ELIZABETH GRANT OutpatientFacility | Medical Mutual Of Ohio | Medflex | $610.95 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Independent Health Association | Essential Other Commercial Plan | $625.56 | — | — | 2026-04-01 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $642.10 | — | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | McLaren | MEDICAID | $642.10 | — | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna Better Health | MEDICAID | $642.10 | — | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Priority Health | MEDICAID | $642.10 | — | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | HAP Caresource Medicaid | $642.10 | — | — | 2025-06-28 | MRF ↗ |
| METROHEALTH SYSTEM OutpatientFacility | Medical Mutual | Cle-Care Hmo | $652.13 | — | — | 2026-04-01 | MRF ↗ |
| JACOBI MEDICAL CENTER OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $652.88 | — | — | 2025-09-05 | MRF ↗ |
| KINGS COUNTY HOSPITAL CENTER OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $652.88 | — | — | 2025-09-05 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $652.88 | — | — | 2025-09-05 | MRF ↗ |
| WOODHULL MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $652.88 | — | — | 2025-09-05 | MRF ↗ |
| METROPOLITAN HOSPITAL CENTER OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $652.88 | — | — | 2025-09-05 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $652.88 | — | — | 2025-09-05 | MRF ↗ |
| BELLEVUE HOSPITAL CENTER OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $652.88 | — | — | 2025-09-05 | MRF ↗ |
| JACOBI MEDICAL CENTER OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $652.88 | — | — | 2025-09-05 | MRF ↗ |
| METROPOLITAN HOSPITAL CENTER OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $652.88 | — | — | 2025-09-05 | MRF ↗ |
| QUEENS HOSPITAL CENTER OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $652.88 | — | — | 2025-09-05 | MRF ↗ |
| ELMHURST HOSPITAL CENTER OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $652.88 | — | — | 2025-09-05 | MRF ↗ |
| LINCOLN MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $652.88 | — | — | 2025-09-05 | MRF ↗ |
| WOODHULL MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $652.88 | — | — | 2025-09-05 | MRF ↗ |
| QUEENS HOSPITAL CENTER OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $652.88 | — | — | 2025-09-05 | MRF ↗ |
| KINGS COUNTY HOSPITAL CENTER OutpatientFacility | Aetna | MEDICARE ADVANTAGE | $652.88 | — | — | 2025-09-05 | 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.