0671T — Insj Ant Sgm Aq DRG Dev 1+
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). INSJ ANT SGM AQ DRG DEV 1+ (HCPCS 0671T) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/0671T?code_type=HCPCS
MLA (9th ed.)
“INSJ ANT SGM AQ DRG DEV 1+ (HCPCS 0671T) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/0671T?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“INSJ ANT SGM AQ DRG DEV 1+ (HCPCS 0671T) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/0671T?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,614–$7,000 (25th–75th percentile) across 1,114 hospitals · 1,106 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 0671T — 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 |
|---|---|---|---|---|---|---|---|
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $27.20 | $15,110.00 | $2,370.89 | 2024-12-31 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | $4,761.00 | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | $4,761.00 | 2024-12-08 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $47.93 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $47.93 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $47.93 | — | — | 2026-03-18 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | $4,761.00 | 2024-12-08 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $54.93 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $54.93 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $54.93 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $59.81 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $59.81 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $59.81 | — | — | 2026-03-18 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Sheet Metal Workers Union(Smw) | Ucd Hb Blue Shield Referred | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Blue Shield | Ucd Hb Blue Shield Ifp | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Blue Shield | Ucd Hb Blue Shield Calpers | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Pipe Trades | Ucd Hb Blue Shield Referred | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Ufcw | Ucd Hb Blue Shield Referred | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Blue Shield | Ucd Hb Blue Shield Referred | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $130.04 | — | — | 2026-03-18 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $262.79 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $262.79 | — | — | 2025-01-01 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan | $268.46 | — | — | 2026-03-01 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan – Hmo | $268.46 | — | — | 2026-03-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | UHC | Medicaid | $273.30 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | UHC | Medicaid | $273.30 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Anthem | Medicaid | $275.93 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Molina | Medicaid | $275.93 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Molina | Medicaid | $275.93 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Anthem | Medicaid | $275.93 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Humana | Medicaid | $278.56 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Humana | Medicaid | $278.56 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye (Centene) | Medicaid | $281.19 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | AmeriHealth Caritas | Medicaid | $281.19 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye Community Health | Medicaid | $281.19 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Caresource | Medicaid | $281.19 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye Community Health | Medicaid | $281.19 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Caresource | Medicaid | $281.19 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | AmeriHealth Caritas | Medicaid | $281.19 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye (Centene) | Medicaid | $281.19 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | PARAMOUNT | Medicaid | $286.44 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Safe Program | Medicaid | $286.44 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Safe Program | Medicaid | $286.44 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | PARAMOUNT | Medicaid | $286.44 | — | — | 2025-01-01 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $291.15 | — | — | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $294.87 | — | — | 2025-06-28 | MRF ↗ |
| MEDINA REGIONAL HOSPITAL OutpatientFacility | Superior Health Plan | Medicare Advantage | $304.20 | $1,242.65 | $1,118.39 | 2025-06-26 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $308.22 | — | — | 2025-06-28 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | Summacare | MEDICARE ADVANTAGE | $308.22 | — | — | 2025-06-28 | MRF ↗ |
| VANDERBILT TULLAHOMA-HARTON HOSPITAL Both | Aetna | Aetna Better Health | $312.50 | $1,250.00 | $362.50 | 2025-10-01 | MRF ↗ |
| VANDERBILT BEDFORD HOSPITAL Both | Aetna | Aetna Better Health | $312.50 | $1,250.00 | $362.50 | 2025-10-01 | MRF ↗ |
| VANDERBILT WILSON COUNTY HOSPITAL Both | Aetna | Aetna Better Health | $312.50 | $1,250.00 | $362.50 | 2025-10-01 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | WellCare of KY | WellCare of KY Pediatric | $312.50 | $1,250.00 | $675.00 | 2025-10-01 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | Aetna | Aetna Better Health | $312.50 | $1,250.00 | $675.00 | 2025-10-01 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | Paramount | Managed Medicaid | $315.66 | — | — | 2025-06-28 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | Buckeye | Managed Medicaid | $317.47 | — | — | 2025-06-28 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | CARESOURCE | Managed Medicaid | $317.47 | — | — | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | Paramount | Managed Medicaid | $319.70 | — | — | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $321.79 | — | — | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $321.79 | — | — | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $321.79 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $322.70 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $322.70 | — | — | 2025-06-28 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | MOLINA | Managed Medicaid | $323.63 | — | — | 2025-06-28 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | ANTHEM | Managed Medicaid | $323.63 | — | — | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | United BH | Managed Medicaid | $324.86 | — | — | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $325.91 | — | — | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $325.91 | — | — | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $325.91 | — | — | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $327.92 | — | — | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $327.92 | — | — | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | United BH | Managed Medicaid | $329.01 | — | — | 2025-06-28 | MRF ↗ |
| EUCLID HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $329.69 | — | — | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $332.12 | — | — | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $332.12 | — | — | 2025-06-28 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $333.65 | — | — | 2025-06-28 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $333.65 | — | — | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | AMERIHEALTH | Managed Medicaid | $337.12 | — | — | 2025-06-28 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | AMERIHEALTH | Managed Medicaid | $339.04 | — | — | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | AMERIHEALTH | Managed Medicaid | $341.43 | — | — | 2025-06-28 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $343.54 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | Paramount | Managed Medicaid | $349.87 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | Paramount | Managed Medicaid | $349.87 | — | — | 2025-06-28 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $350.33 | — | — | 2025-06-28 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $350.33 | — | — | 2025-06-28 | MRF ↗ |
| SAINT JOHN'S HEALTH CENTER OutpatientFacility | Blue Shield | Medicare Managed Care Plan | $352.70 | — | — | 2026-04-01 | MRF ↗ |
| SAINT JOHN'S HEALTH CENTER OutpatientFacility | Blue Shield | Medicare Managed Care Plan | $352.70 | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE LITTLE CO OF MARY MED CTR SAN PEDRO OutpatientFacility | Blue Shield | Medicare Managed Care Plan | $353.00 | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE LITTLE COMPANY OF MARY MED CTR TORRANCE OutpatientFacility | Blue Shield | Medicare Managed Care Plan | $353.00 | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE HOLY CROSS MEDICAL CENTER OutpatientFacility | Blue Shield | Medicare Managed Care Plan | $353.00 | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE CEDARS SINAI TARZANA MEDICAL CENTER OutpatientFacility | Blue Shield | Medicare Managed Care Plan | $353.00 | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE LITTLE COMPANY OF MARY MED CTR TORRANCE OutpatientFacility | Blue Shield | Medicare Managed Care Plan | $353.00 | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE SAINT JOSEPH MEDICAL CTR OutpatientFacility | Blue Shield | Medicare Managed Care Plan | $353.00 | — | — | 2026-04-01 | MRF ↗ |
| SOUTHWEST GENERAL HEALTH CENTER OutpatientFacility | Molina | Managed Medicaid | $354.44 | — | — | 2025-07-01 | MRF ↗ |
| SOUTHWEST GENERAL HEALTH CENTER OutpatientFacility | Anthem | Managed Medicaid | $354.44 | — | — | 2025-07-01 | MRF ↗ |
| SOUTHWEST GENERAL HEALTH CENTER OutpatientFacility | United Healthcare | Managed Medicaid | $354.44 | — | — | 2025-07-01 | MRF ↗ |
| SOUTHWEST GENERAL HEALTH CENTER OutpatientFacility | Buckeye | Managed Medicaid | $354.44 | — | — | 2025-07-01 | MRF ↗ |
| SOUTHWEST GENERAL HEALTH CENTER OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $354.44 | — | — | 2025-07-01 | MRF ↗ |
| SOUTHWEST GENERAL HEALTH CENTER OutpatientFacility | CareSource | Managed Medicaid | $354.44 | — | — | 2025-07-01 | MRF ↗ |
| SOUTHWEST GENERAL HEALTH CENTER OutpatientFacility | Humana | Managed Medicaid | $354.44 | — | — | 2025-07-01 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $356.66 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $356.66 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $356.66 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $356.66 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $356.66 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $356.66 | — | — | 2025-06-28 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $357.01 | — | — | 2025-06-28 | MRF ↗ |
| EUCLID HOSPITAL OutpatientFacility | Paramount | Managed Medicaid | $357.45 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $363.46 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $363.46 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $363.46 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $363.46 | — | — | 2025-06-28 | MRF ↗ |
| EUCLID HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $364.39 | — | — | 2025-06-28 | MRF ↗ |
| EUCLID HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $364.39 | — | — | 2025-06-28 | MRF ↗ |
| EUCLID HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $364.39 | — | — | 2025-06-28 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | AMERIHEALTH | Managed Medicaid | $367.02 | — | — | 2025-06-28 | MRF ↗ |
| EUCLID HOSPITAL OutpatientFacility | United BH | Managed Medicaid | $367.86 | — | — | 2025-06-28 | MRF ↗ |
| EUCLID HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $371.33 | — | — | 2025-06-28 | MRF ↗ |
| EUCLID HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $371.33 | — | — | 2025-06-28 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | Paramount | Managed Medicaid | $372.47 | — | — | 2025-06-28 | MRF ↗ |
| MEDINA REGIONAL HOSPITAL OutpatientFacility | Community First Health Plan | HIE | $372.80 | $1,242.65 | $1,118.39 | 2025-06-26 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | AMERIHEALTH | Managed Medicaid | $373.65 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | AMERIHEALTH | Managed Medicaid | $373.65 | — | — | 2025-06-28 | MRF ↗ |
| VANDERBILT WILSON COUNTY HOSPITAL Both | Molina | Molina Passport KY MCD | $375.00 | $1,250.00 | $362.50 | 2025-10-01 | MRF ↗ |
| VANDERBILT BEDFORD HOSPITAL Both | Molina | Molina Passport KY MCD | $375.00 | $1,250.00 | $362.50 | 2025-10-01 | MRF ↗ |
| VANDERBILT TULLAHOMA-HARTON HOSPITAL Both | Molina | Molina Passport KY MCD | $375.00 | $1,250.00 | $362.50 | 2025-10-01 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | Molina | Molina Passport KY MCD | $375.00 | $1,250.00 | $675.00 | 2025-10-01 | MRF ↗ |
| CLEVELAND CLINIC OutpatientFacility | OPTUM | Managed Medicaid Transplant | $378.01 | — | — | 2025-06-28 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $379.70 | — | — | 2025-06-28 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $379.70 | — | — | 2025-06-28 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $379.70 | — | — | 2025-06-28 | MRF ↗ |
| EUCLID HOSPITAL OutpatientFacility | AMERIHEALTH | Managed Medicaid | $381.74 | — | — | 2025-06-28 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $386.93 | — | — | 2025-06-28 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $386.93 | — | — | 2025-06-28 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $393.89 | — | — | 2025-01-01 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | AMERIHEALTH | Managed Medicaid | $397.78 | — | — | 2025-06-28 | MRF ↗ |
| CLEVELAND CLINIC OutpatientFacility | CARESOURCE | Managed Medicaid | $397.91 | — | — | 2025-06-28 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | UHC | Medicaid | $409.65 | — | — | 2025-01-01 | MRF ↗ |
| CLEVELAND CLINIC OutpatientFacility | Paramount | Managed Medicaid | $409.85 | — | — | 2025-06-28 | MRF ↗ |
| MEDINA REGIONAL HOSPITAL OutpatientFacility | Amerivantage | Medicare Advantage | $410.07 | $1,242.65 | $1,118.39 | 2025-06-26 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | UHC | Medicaid | $410.34 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | UHC | Medicaid | $410.34 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | Molina | Medicaid | $413.58 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Anthem | Medicaid | $414.29 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Anthem | Medicaid | $414.29 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Molina | Medicaid | $414.29 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Molina | Medicaid | $414.29 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | Humana | Medicaid | $417.52 | — | — | 2025-01-01 | MRF ↗ |
| CLEVELAND CLINIC OutpatientFacility | ANTHEM | Managed Medicaid | $417.81 | — | — | 2025-06-28 | MRF ↗ |
| CLEVELAND CLINIC OutpatientFacility | Buckeye | Managed Medicaid | $417.81 | — | — | 2025-06-28 | MRF ↗ |
| CLEVELAND CLINIC OutpatientFacility | MOLINA | Managed Medicaid | $417.81 | — | — | 2025-06-28 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | Buckeye Community Health | Medicaid | $421.46 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | AmeriHealth Caritas | Medicaid | $421.46 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | Buckeye (Centene) | Medicaid | $421.46 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | Caresource | Medicaid | $421.46 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Caresource | Medicaid | $422.18 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Caresource | Medicaid | $422.18 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Buckeye (Centene) | Medicaid | $422.18 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Buckeye (Centene) | Medicaid | $422.18 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | AmeriHealth Caritas | Medicaid | $422.18 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | AmeriHealth Caritas | Medicaid | $422.18 | — | — | 2025-01-01 | MRF ↗ |
| PETERSON REGIONAL MEDICAL CENTER OutpatientFacility | United Healthcare | STAR+PLUS | $425.44 | — | — | 2025-10-14 | MRF ↗ |
| CLEVELAND CLINIC OutpatientFacility | UNITED | Managed Medicaid | $425.76 | — | — | 2025-06-28 | MRF ↗ |
| MEDINA REGIONAL HOSPITAL OutpatientFacility | Aetna | Managed Medicaid | $426.00 | $1,242.65 | $1,118.39 | 2025-06-26 | MRF ↗ |
| MEDINA REGIONAL HOSPITAL OutpatientFacility | United Healthcare | Medicare Advantage | $426.00 | $1,242.65 | $1,118.39 | 2025-06-26 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | PARAMOUNT | Medicaid | $429.34 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | Safe Program | Medicaid | $429.34 | — | — | 2025-01-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | Molina | Managed Medicaid - Non-Cap | $430.91 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | UHC | Managed Medicaid | $430.91 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | UHC | Managed Medicaid | $430.91 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Molina | Managed Medicaid - Non-Cap | $430.91 | — | — | 2026-04-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $432.58 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $432.58 | — | — | 2025-01-01 | MRF ↗ |
| MEDINA REGIONAL HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | $434.93 | $1,242.65 | $1,118.39 | 2025-06-26 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | Humana | Managed Medicaid | $435.06 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | Amerihealth | Managed Medicaid - Non-Cap | $435.06 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | Anthem | Managed Medicaid - Non-Cap | $435.06 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Humana | Managed Medicaid | $435.06 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | BCHP | Managed Medicaid - Non-Cap | $435.06 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Amerihealth | Managed Medicaid - Non-Cap | $435.06 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | BCHP | Managed Medicaid - Non-Cap | $435.06 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Anthem | Managed Medicaid - Non-Cap | $435.06 | — | — | 2026-04-01 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Dean Health Plan | Managed Medicaid | $436.71 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | MEDICAID | MEDICAID | $436.71 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Quartz | Managed Medicaid | $436.71 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Anthem | Managed Medicaid | $436.71 | — | — | 2025-07-22 | MRF ↗ |
| CLEVELAND CLINIC OutpatientFacility | United BH | Managed Medicaid | $437.70 | — | — | 2025-06-28 | MRF ↗ |
| LODI COMMUNITY HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $444.91 | — | — | 2025-06-28 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $445.44 | — | — | 2025-07-22 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | UHC | Medicaid | $449.88 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | UHC | Medicaid | $449.88 | — | — | 2025-01-01 | 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.