11104 — Punch Bx Skin Single Lesion
Cite this view
HANK Price Transparency. (n.d.). PUNCH BX SKIN SINGLE LESION (HCPCS 11104) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/11104?code_type=HCPCS
“PUNCH BX SKIN SINGLE LESION (HCPCS 11104) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/11104?code_type=HCPCS. Accessed .
“PUNCH BX SKIN SINGLE LESION (HCPCS 11104) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/11104?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $226–$645 (25th–75th percentile) across 3,468 hospitals · 9,760 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 11104 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
What the whole episode might cost
Your hospital facility price plus the separately-billed professional fees a complete episode adds. The facility figure is an actual negotiated rate from our data; the the surgeon's fee are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
The middle 50% of negotiated facility rates for this procedure, measured across 3,468 hospitals. The the surgeon's fee are modeled estimates added on top.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $402 |
| Surgeon (professional fee) Estimate national typical Medicare $38 × 1.22 commercial. | $46 |
| Likely subtotal | $448 |
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge
- Complications, revisions, or readmissions
- Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)
The biggest swing: which insurer's rate applies — negotiated prices here run $226–$645.
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Surgeon (professional fee) (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
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 |
|---|---|---|---|---|---|---|---|
| SELF REGIONAL HEALTHCARE Outpatient | Cigna | Cigna/Fuji | $0.03 | $321.34 | $192.80 | 2026-07-18 | MRF ↗ |
| SELF REGIONAL HEALTHCARE Outpatient | Cigna | Cigna Hmo Ppo Oa Netwk Pos Epo Indem | $0.03 | $321.34 | $192.80 | 2026-07-18 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | HEALTHSMART | HEALTHSMART WORKERS COMP | $0.17 | — | — | 2026-05-20 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Ohana Care | Medicaid | $0.18 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Hmsa | Medicaid | $0.19 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $0.20 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | HEALTHSMART | HEALTHSMART WORKERS COMP | $0.22 | $705.00 | $528.75 | 2026-09-02 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | Hmsa | Medicaid | $0.28 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | Hmsa | Medicaid | $0.28 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Carolina Complete Health | Managed Medicaid | $0.28 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | Ohana Care | Medicaid | $0.28 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | Ohana Care | Medicaid | $0.28 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | United Healthcare | Compass | $0.35 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | United Healthcare | Managed Medicaid | $0.37 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Wellcare | Managed Medicaid | $0.37 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Healthy Blue | Managed Medicaid | $0.37 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $0.47 | $110.00 | $82.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $0.47 | $110.00 | $82.50 | 2026-07-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Aetna Nc State Health Plan | Commercial | $0.48 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.49 | — | — | 2026-09-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Aetna New Business | Commerical | $0.58 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Aetna | Commercial | $0.58 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Cigna | Commercial | $0.60 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Medcost | Commercial | $0.60 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| James Cancer Hospital & Solove Research Institute Outpatient | Cigna | Cigna - Transplant | $0.62 | $975.00 | — | 2026-07-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Nc | Commercial | $0.64 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | $873.00 | $258.41 | 2026-02-28 | MRF ↗ |
| NORTHRIDGE HOSPITAL MEDICAL CENTER Outpatient | Alliant Health | Commercial|All Plans | $0.65 | $873.00 | $369.28 | 2026-02-28 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | $873.00 | $258.41 | 2026-02-28 | MRF ↗ |
| The Queen's Medical Center Outpatient | University Health Alliance | Commercial | $0.68 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | University Health Alliance | Commercial | $0.68 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | University Health Alliance | Commercial | $0.68 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | Multiplan | Commercial | $0.70 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | Multiplan | Commercial | $0.70 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Hawaii Western Management Group | Commercial | $0.72 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | Hawaii Western Management Group | Commercial | $0.72 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | Hawaii Western Management Group | Commercial | $0.72 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Hawaii Mainland Administrators | Non Trust Local | $0.75 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | Hawaii Mainland Administrators | Non Trust Local | $0.75 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Hawaii Community Health Alliance | Commercial | $0.75 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | Hawaii Community Health Alliance | Commercial | $0.75 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | Hawaii Mainland Administrators | Nontrust Local | $0.75 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Humana Choicecare | Commercial | $0.75 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| The Queen's Medical Center Outpatient | Hawaii Mainland Administrators | Ufcw | $0.75 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Hawaii Mainland Administrators | Ufcw | $0.75 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | Hawaii Mainland Administrators | Ufcw | $0.75 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | Hawaii Community Health Alliance | Commercial | $0.75 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Humana | Commercial | $0.75 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | United Healthcare | Commercial | $0.77 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| The Queen's Medical Center Outpatient | Hawaii Laborers | Commercial | $0.80 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | United Healthcare | All Payer | $0.80 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | First Health | Commercial | $0.80 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | First Health | Commercial | $0.80 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | Hawaii Laborers | Commercial | $0.80 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Hawaii Laborers | Commercial | $0.80 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | First Health | Commercial | $0.80 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | United Healthcare | All Payer | $0.80 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | United Healthcare | All Payer | $0.80 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Multiplan | Commercial | $0.82 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.87 | $234.00 | $222.30 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.87 | $234.00 | $222.30 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $0.87 | $234.00 | $222.30 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $0.89 | $234.00 | $222.30 | 2026-02-20 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Mdx Hawaii | Commercial | $0.90 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | Humana | Commercial | $0.90 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | Mdx Hawaii | Commercial | $0.90 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | Mdx Hawaii | Commercial | $0.90 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | Humana | Commercial | $0.90 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Humana | Commercial | $0.90 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $0.91 | $234.00 | $222.30 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $0.94 | $234.00 | $222.30 | 2026-02-20 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE SHIELD - MANTECA SURGERY CENTER MEDICARE ADVANTAGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| CITIZENS BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| CITIZENS BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE CHARTER | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE CHARTER | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | $705.00 | $528.75 | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR PLUS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR KIDS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA HMO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | CARE1ST MEDICARE ADVANTAGE | CARE1ST MEDICARE ADVANTAGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | CARE1ST MEDICARE ADVANTAGE | CARE1ST MEDICARE ADVANTAGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR PLUS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID NON UHRIP | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE COMMERCIAL | $1.00 | $705.00 | $528.75 | 2026-09-02 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE - OPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $1,330.00 | $1,090.60 | 2025-11-26 | MRF ↗ |
| Harper University Hospital BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | $705.00 | $528.75 | 2026-09-02 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $1,330.00 | $1,090.60 | 2025-11-26 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM NON UHRIP | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $1,330.00 | $1,090.60 | 2025-11-26 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | $705.00 | $528.75 | 2026-09-02 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | $705.00 | $528.75 | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE COMMERCIAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | $705.00 | $528.75 | 2026-09-02 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA HMO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PRINCETON BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $1.00 | $902.00 | $676.50 | 2024-12-11 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR KIDS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE SHIELD PROMISE MEDICARE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW BUSINESS | $1.00 | $705.00 | $528.75 | 2026-09-02 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $1,330.00 | $1,090.60 | 2025-11-26 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE SHIELD PROMISE MEDICARE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SHELBY BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $1.00 | $951.00 | $713.25 | 2024-12-11 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $1,330.00 | $1,090.60 | 2025-11-26 | MRF ↗ |
| SHELBY BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $1.00 | $951.00 | $713.25 | 2024-12-11 | MRF ↗ |
| PRINCETON BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $1.00 | $902.00 | $676.50 | 2024-12-11 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID STAR KIDS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | $705.00 | $528.75 | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE - OPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID STAR | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NON OPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | $705.00 | $528.75 | 2026-09-02 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Medicaid | Medicaid | $1.00 | $1,106.00 | $553.00 | 2026-07-01 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | $705.00 | $528.75 | 2026-09-02 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | $705.00 | $528.75 | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW BUSINESS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | SCAN Health Plan | Medicare Advantage | — | $2,682.44 | $1,743.59 | 2025-11-26 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NON OPTIONS PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $2,063.43 | $1,341.23 | 2025-11-26 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID STAR PLUS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | HMO | — | $1,330.00 | $1,090.60 | 2025-11-26 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.06 | — | — | 2026-09-02 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $1.07 | $1,106.00 | $553.00 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $1.10 | $1,106.00 | $553.00 | 2026-07-01 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.15 | $234.00 | $222.30 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.15 | $234.00 | $222.30 | 2026-02-20 | MRF ↗ |
| HANCOCK COUNTY HEALTH SYSTEM Outpatient | WELLMARK HMO-ALL OTHER PLANS | WELLMARK HMO-ALL OTHER PLANS | $1.16 | $22.00 | $16.50 | 2026-03-26 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.17 | $234.00 | $222.30 | 2026-02-20 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $1.18 | $1,106.00 | $553.00 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Jefferson Health Plan | Jefferson Health Plan - Managed Medicaid | $1.20 | $1,106.00 | $553.00 | 2026-07-01 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.22 | $234.00 | $222.30 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $1.26 | $234.00 | $222.30 | 2026-02-20 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.30 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.30 | — | — | 2026-09-01 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $1.40 | $117.00 | $22.23 | 2026-01-25 | MRF ↗ |
| OTTAWA COUNTY HEALTH CENTER Outpatient | CHOICECARE MCR ADV - ALL PLANS | CHOICECARE MCR ADV - ALL PLANS | $1.40 | $180.00 | $180.00 | 2026-03-09 | MRF ↗ |
| Ventura County Medical Center - Santa Paula Hospital Outpatient | UHC MCR ADV | UHC MCR ADV | $1.40 | $216.00 | $108.00 | 2026-03-23 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $1.40 | $160.00 | $30.40 | 2026-05-20 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - Managed Medicaid | $1.47 | $1,106.00 | $553.00 | 2026-07-01 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Both | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $1.95 | $187.45 | $187.45 | 2026-04-24 | MRF ↗ |
| JACKSONVILLE MEMORIAL HOSPITAL Outpatient | Commercial Workers Compensation | Commercial Workers Compensation | $2.02 | $834.00 | $834.00 | 2026-07-15 | MRF ↗ |
| DECATUR MEMORIAL HOSPITAL Outpatient | Commercial Workers Compensation | Commercial Workers Compensation | $2.02 | $834.00 | $834.00 | 2026-07-15 | MRF ↗ |
| DECATUR MEMORIAL HOSPITAL Outpatient | Hfn | Hfn Workers Compensation | $2.02 | $834.00 | $834.00 | 2026-07-15 | MRF ↗ |
| WALLOWA MEMORIAL HOSPITAL Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $2.03 | $239.00 | $239.00 | 2026-07-09 | MRF ↗ |
| MOBRIDGE REGIONAL HOSPITAL - CAH Outpatient | SANFORD HEALTHPLAN-ALL PLANS | SANFORD HEALTHPLAN-ALL PLANS | $2.15 | $680.00 | $680.00 | 2026-07-16 | MRF ↗ |
| GRUNDY COUNTY MEMORIAL HOSPITAL Outpatient | Healthpartners | Uph Self Funded | $2.20 | $4.00 | $3.20 | 2026-05-08 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $2.31 | $1,285.00 | $409.60 | 2024-12-31 | MRF ↗ |
| GRUNDY COUNTY MEMORIAL HOSPITAL Outpatient | Healthpartners | Open Access | $2.41 | $4.00 | $3.20 | 2026-05-08 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - CHIP - Managed Medicare | $2.50 | $1,106.00 | $553.00 | 2026-07-01 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Serenity Pace | Medicare Managed Care | $2.52 | $503.55 | $503.55 | 2026-06-05 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $2.80 | $845.00 | $845.00 | 2026-02-13 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $2.80 | $845.00 | $845.00 | 2026-06-03 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [3202651] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $3.12 | $48.00 | $31.20 | 2026-06-10 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $3.12 | $48.00 | $31.20 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [3202651] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $3.12 | $48.00 | $31.20 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $3.12 | $48.00 | $31.20 | 2026-06-10 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $3.12 | $48.00 | $31.20 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL SOUTHEAST OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $3.12 | $48.00 | $31.20 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $3.12 | $48.00 | $31.20 | 2026-06-10 | 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.