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+ (OTHER 0671T) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/0671T?code_type=OTHER
MLA (9th ed.)
“Insj ant sgm aq drg dev 1+ (OTHER 0671T) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/0671T?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“Insj ant sgm aq drg dev 1+ (OTHER 0671T) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/0671T?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $2,963–$6,946 (25th–75th percentile) across 547 hospitals · 526 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 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 |
|---|---|---|---|---|---|---|---|
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $27.20 | $15,110.00 | $2,370.89 | 2024-12-31 | 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 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 | 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 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 ↗ |
| KEARNEY REGIONAL MEDICAL CENTER Outpatient | BCBS NETWORK BLUE-ALL OTHER PLANS | BCBS NETWORK BLUE-ALL OTHER PLANS | $178.20 | $297.00 | $207.90 | 2025-07-17 | MRF ↗ |
| KEARNEY REGIONAL MEDICAL CENTER Outpatient | MIDLANDS CHOICE-ALL PLANS | MIDLANDS CHOICE-ALL PLANS | $222.75 | $297.00 | $207.90 | 2025-07-17 | MRF ↗ |
| KEARNEY REGIONAL MEDICAL CENTER Outpatient | UHC COMMERCIAL-ALL OTHER PLANS | UHC COMMERCIAL-ALL OTHER PLANS | $222.75 | $297.00 | $207.90 | 2025-07-17 | MRF ↗ |
| KEARNEY REGIONAL MEDICAL CENTER Outpatient | HUMANA PPO-ALL OTHER PLANS | HUMANA PPO-ALL OTHER PLANS | $222.75 | $297.00 | $207.90 | 2025-07-17 | 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 ↗ |
| KEARNEY REGIONAL MEDICAL CENTER Outpatient | MULTIPLAN-ALL PLANS | MULTIPLAN-ALL PLANS | $267.30 | $297.00 | $207.90 | 2025-07-17 | 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 | 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 | 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 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 | 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 | Buckeye Community Health | 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 | PARAMOUNT | Medicaid | $286.44 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Safe Program | Medicaid | $286.44 | — | — | 2025-01-01 | MRF ↗ |
| MEDINA HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $302.01 | — | — | 2025-06-28 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $312.30 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $324.47 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $324.47 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $324.47 | — | — | 2026-06-15 | MRF ↗ |
| MEDINA HOSPITAL OutpatientFacility | Paramount | Managed Medicaid | $327.44 | — | — | 2025-06-28 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $330.65 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $330.65 | — | — | 2026-06-15 | MRF ↗ |
| MEDINA HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $333.80 | — | — | 2025-06-28 | MRF ↗ |
| MEDINA HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $333.80 | — | — | 2025-06-28 | MRF ↗ |
| MEDINA HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $333.80 | — | — | 2025-06-28 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | Paramount | Managed Medicaid | $338.60 | — | — | 2026-06-15 | MRF ↗ |
| MEDINA HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $340.15 | — | — | 2025-06-28 | MRF ↗ |
| MEDINA HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $340.15 | — | — | 2025-06-28 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $343.54 | — | — | 2025-06-28 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $345.18 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $345.18 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $345.18 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | United BH | Managed Medicaid | $348.46 | — | — | 2026-06-15 | MRF ↗ |
| MEDINA HOSPITAL OutpatientFacility | AMERIHEALTH | Managed Medicaid | $349.69 | — | — | 2025-06-28 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $351.75 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $351.75 | — | — | 2026-06-15 | MRF ↗ |
| PROVIDENCE CEDARS SINAI TARZANA MEDICAL CENTER 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 LITTLE COMPANY OF MARY MED CTR TORRANCE 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 LITTLE CO OF MARY MED CTR SAN PEDRO OutpatientFacility | Blue Shield | Medicare Managed Care Plan | $353.00 | — | — | 2026-04-01 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | AMERIHEALTH | Managed Medicaid | $361.61 | — | — | 2026-06-15 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | Paramount | Managed Medicaid | $372.47 | — | — | 2025-06-28 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $379.70 | — | — | 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 | 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 ↗ |
| UNION HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $409.10 | — | — | 2026-06-15 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | UHC | Medicaid | $409.65 | — | — | 2025-01-01 | 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 | Molina | 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 | Anthem | Medicaid | $414.29 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | Humana | Medicaid | $417.52 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | AmeriHealth Caritas | Medicaid | $421.46 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | Buckeye Community Health | 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 | AmeriHealth Caritas | 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 | Buckeye (Centene) | 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 | Caresource | Medicaid | $422.18 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | Safe Program | Medicaid | $429.34 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | PARAMOUNT | Medicaid | $429.34 | — | — | 2025-01-01 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $429.56 | — | — | 2026-06-15 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $429.56 | — | — | 2026-06-15 | 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 | 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 ↗ |
| 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 ↗ |
| 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 | 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 | Amerihealth | 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 | Anthem | 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 ↗ |
| 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 | Dean Health Plan | Managed Medicaid | $436.71 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Anthem | Managed Medicaid | $436.71 | — | — | 2025-07-22 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $437.74 | — | — | 2026-06-15 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $437.74 | — | — | 2026-06-15 | 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 ↗ |
| UNION HOSPITAL OutpatientFacility | AMERIHEALTH | Managed Medicaid | $450.01 | — | — | 2026-06-15 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Molina | Medicaid | $454.21 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Molina | Medicaid | $454.21 | — | — | 2025-01-01 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Managed Health Service | Managed Medicaid | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Group Health of South Central | Medicaid HMO | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN PALMER LUTHERAN HOSPITAL AND CLINICS OutpatientFacility | Molina Health | Managed Medicaid | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN PALMER LUTHERAN HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN TRI-COUNTY HOSPITAL & CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Group Health Eau Claire | Medicaid HMO | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Managed Health Service | Managed Medicaid | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | ICare | Medicaid HMO | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN ST JOSEPHS HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Group Health Eau Claire | Medicaid HMO | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | ICare | Medicaid HMO | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Iowa Total Care | Medicaid | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Iowa Total Care | Medicaid | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | UHC | Medicaid | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Group Health of South Central | Medicaid HMO | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Anthem | Medicaid | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | UHC | Medicaid | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Anthem | Medicaid | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN MOUNDVIEW HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $454.50 | — | — | 2025-06-27 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Humana | Medicaid | $458.53 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Humana | Medicaid | $458.53 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | AmeriHealth Caritas | Medicaid | $462.86 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Buckeye Community Health | Medicaid | $462.86 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | AmeriHealth Caritas | Medicaid | $462.86 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Anthem | Medicaid | $462.86 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Buckeye (Centene) | Medicaid | $462.86 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Caresource | Medicaid | $462.86 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Buckeye Community Health | Medicaid | $462.86 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Caresource | Medicaid | $462.86 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Anthem | Medicaid | $462.86 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Buckeye (Centene) | Medicaid | $462.86 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Safe Program | Medicaid | $471.51 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | PARAMOUNT | Medicaid | $471.51 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | Safe Program | Medicaid | $471.51 | — | — | 2025-01-01 | MRF ↗ |
| DILEY RIDGE MEDICAL CENTER OutpatientFacility | PARAMOUNT | Medicaid | $471.51 | — | — | 2025-01-01 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Managed Health Services | Managed Medicaid | $476.01 | — | — | 2025-07-22 | MRF ↗ |
| AKRON CHILDREN'S HOSPITAL OutpatientFacility | Caresource | Managed Medicaid | $519.36 | — | — | 2025-11-11 | MRF ↗ |
| AKRON CHILDREN'S HOSPITAL OutpatientFacility | Anthem | Managed Medicaid | $529.44 | — | — | 2025-11-11 | MRF ↗ |
| AKRON CHILDREN'S HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $529.44 | — | — | 2025-11-11 | MRF ↗ |
| AKRON CHILDREN'S HOSPITAL OutpatientFacility | Cenpatico | Behavioral Health | $529.44 | — | — | 2025-11-11 | MRF ↗ |
| AKRON CHILDREN'S HOSPITAL OutpatientFacility | Aetna OhRise | Managed Medicaid | $529.44 | — | — | 2025-11-11 | MRF ↗ |
| AKRON CHILDREN'S HOSPITAL OutpatientFacility | Buckeye Community Health Plan | Managed Medicaid | $529.44 | — | — | 2025-11-11 | MRF ↗ |
| AKRON CHILDREN'S HOSPITAL OutpatientFacility | Humana | Managed Medicaid | $534.48 | — | — | 2025-11-11 | MRF ↗ |
| AKRON CHILDREN'S HOSPITAL OutpatientFacility | United HealthCare Community Plan Ohio | Managed Medicaid | $544.57 | — | — | 2025-11-11 | MRF ↗ |
| AKRON CHILDREN'S HOSPITAL OutpatientFacility | AmeriHealth Caritas Ohio | Managed Medicaid | $544.57 | — | — | 2025-11-11 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Molina | Managed Medicaid - Non-Cap | $585.51 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Anthem | Managed Medicaid - Non-Cap | $585.51 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Caresource | Managed Medicaid - Non-Cap | $585.51 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Humana | Managed Medicaid - Non-Cap | $585.51 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | UHC | Managed Medicaid - Non-Cap | $585.51 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Amerihealth | Managed Medicaid - Non-Cap | $585.51 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | BCHP | Managed Medicaid - Non-Cap | $585.51 | — | — | 2026-04-01 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Nassaua County Sheriff's Office | Managed Medicaid | $630.99 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Daniel Memorial | Managed Medicaid | $630.99 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Amerigroup of Georgia | Managed Medicaid OOS | $630.99 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Daniel Memorial | Managed Medicaid | $630.99 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Humana | Managed Medicaid | $630.99 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Amerigroup of Georgia | Managed Medicaid OOS | $630.99 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Daniel Memorial | Managed Medicaid | $630.99 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Amerigroup of Georgia | Managed Medicaid OOS | $630.99 | — | — | 2026-02-06 | MRF ↗ |
| UF HEALTH LEESBURG HOSPITAL OutpatientFacility | Simply Healthcare | MANAGED MEDICAID | $630.99 | — | — | 2026-03-31 | MRF ↗ |
| VILLAGES REGIONAL HOSPITAL, THE OutpatientFacility | Humana | MANAGED MEDICAID | $630.99 | — | — | 2026-03-31 | MRF ↗ |
| UF HEALTH LEESBURG HOSPITAL OutpatientFacility | Humana | MANAGED MEDICAID | $630.99 | — | — | 2026-03-31 | MRF ↗ |
| VILLAGES REGIONAL HOSPITAL, THE OutpatientFacility | Simply Healthcare | MANAGED MEDICAID | $630.99 | — | — | 2026-03-31 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Simply Healthcare Plans - CHA | Managed Medicaid | $662.54 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Simply Healthcare Plans | Managed Medicaid | $662.54 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Simply Healthcare Plans - CHA | Managed Medicaid | $662.54 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Simply Healthcare Plans | Managed Medicaid | $662.54 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Simply Healthcare Plans | Managed Medicaid | $662.54 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Simply Healthcare Plans - CHA | Managed Medicaid | $662.54 | — | — | 2026-02-06 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Group Health Cooperative | Badgercare | $666.71 | — | — | 2025-07-22 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $675.73 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $675.73 | — | — | 2025-01-01 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | UHC COMMUNITY | MCAID HMO | $677.56 | — | — | 2025-12-23 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | WEST VOLUSIA | MANAGED MEDICAID | $677.56 | — | — | 2025-07-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | CHA HEALTH PLAN | HMO | $677.56 | — | — | 2025-12-23 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | FLORIDA MEDICAID | MANAGED MEDICAID | $677.56 | — | — | 2025-07-23 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | UHC AMERICHOICE | MANAGED MEDICAID | $677.56 | — | — | 2025-07-23 | 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.