11310 — Shave Skin Lesion 0.5 Cm/<
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). SHAVE SKIN LESION 0.5 CM/< (CPT 11310) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/11310?code_type=CPT
MLA (9th ed.)
“SHAVE SKIN LESION 0.5 CM/< (CPT 11310) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/11310?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“SHAVE SKIN LESION 0.5 CM/< (CPT 11310) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/11310?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $135–$416 (25th–75th percentile) across 2,130 hospitals · 6,517 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 11310 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Estimated complete episode
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.
What hospitals actually negotiate
Measured
$135
$225 typical
$416
The middle 50% of negotiated facility rates for this procedure, measured across 2,130 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. | $225 |
| Surgeon (professional fee) Estimate national typical Medicare $36 × 1.22 commercial. | $44 |
| Likely subtotal | $269 |
Surgical episode (typical)
~$269
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 |
|---|---|---|---|---|---|---|---|
| HANCOCK COUNTY HEALTH SYSTEM Outpatient | WELLMARK HMO-ALL OTHER PLANS | WELLMARK HMO-ALL OTHER PLANS | $0.43 | $76.00 | $57.00 | 2026-03-26 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $0.47 | $157.00 | $117.75 | 2025-03-07 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $0.78 | $211.00 | $200.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.78 | $211.00 | $200.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.78 | $211.00 | $200.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $0.80 | $211.00 | $200.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $0.84 | $211.00 | $200.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.01 | $211.00 | $200.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.01 | $211.00 | $200.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.03 | $211.00 | $200.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.03 | $211.00 | $200.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $1.03 | $211.00 | $200.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.03 | $211.00 | $200.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.05 | $211.00 | $200.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.08 | $211.00 | $200.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.10 | $211.00 | $200.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $1.14 | $211.00 | $200.45 | 2026-02-20 | MRF ↗ |
| OTTAWA COUNTY HEALTH CENTER Outpatient | CHOICECARE MCR ADV - ALL PLANS | CHOICECARE MCR ADV - ALL PLANS | $1.34 | $170.00 | $170.00 | 2026-03-09 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $1.55 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $1.56 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $1.56 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $1.78 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $1.94 | — | — | 2026-03-18 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $2.68 | $233.00 | $233.00 | 2026-02-13 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $2.70 | $135.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $2.70 | $135.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $2.70 | $135.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $2.70 | $135.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $2.70 | $135.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $2.70 | $135.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $2.70 | $135.00 | — | 2026-03-31 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $3.42 | $329.05 | $329.05 | 2026-04-24 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $3.58 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $3.58 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $3.58 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTHEAST OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $3.58 | $55.00 | $35.75 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL SOUTHEAST OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $3.58 | $55.00 | $35.75 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $3.58 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTHEAST OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $3.58 | $55.00 | $35.75 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $3.58 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $3.58 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $3.58 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTHEAST OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $3.58 | $55.00 | $35.75 | 2026-03-18 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $5.12 | $256.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $5.12 | $256.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $5.12 | $256.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $5.12 | $256.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $5.12 | $256.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $5.12 | $256.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $5.12 | $256.00 | — | 2026-03-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $5.81 | — | — | 2025-12-31 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Medica | Medicare Advantage | — | $267.00 | $226.95 | 2026-02-12 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $7.10 | $355.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $7.10 | $355.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $7.10 | $355.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $7.10 | $355.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $7.10 | $355.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $7.10 | $355.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $7.10 | $355.00 | — | 2026-03-31 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Inpatient | SMARTHEALTH PPO | 8842_SMARTHEALTH PPO 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PPO PREFERRED | 9232_ANTHEM PREFERRED VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $7.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $7.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $7.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $7.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $7.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $7.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $7.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $7.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $7.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $7.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $7.49 | — | — | 2026-01-01 | MRF ↗ |
| Southwest Healthcare System-wildomar Both | Anthem Blue Cross Blue Shield | Medicaid | $8.00 | — | — | 2026-05-06 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $8.16 | $217.00 | $217.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $8.16 | $217.00 | $217.00 | 2025-10-04 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MEDICAID [20240] | HB STLO CAPE IL MEDICAID | $8.25 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MEDICAID [20240] | HB WASH JEFN LINC SAMC PCMH STOD IL MEDICAID | $8.25 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTHEAST OutpatientFacility | COUNTYCARE HEALTH PLAN MEDICAID CONTRACTED [320523] | HB STLO CAPE IL MEDICAID | $8.25 | $55.00 | $35.75 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $8.25 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | AETNA MEDICAID [20009] | HB WASH JEFN LINC SAMC AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $8.25 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTHEAST OutpatientFacility | MEDICAID [20240] | HB STLO CAPE IL MEDICAID | $8.25 | $55.00 | $35.75 | 2026-03-18 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Medica | Medicare Advantage | — | $40.00 | $25.40 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | UCare | Managed Medicaid | — | $40.00 | $25.40 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Triwest Healthcare Alliance | Tricare/Champus | — | $40.00 | $25.40 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Blue Cross Blue Shield of Minnesota | Managed Medicaid | $8.64 | $40.00 | $25.40 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Health Partners | Medicare Advantage | — | $40.00 | $25.40 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | PrimeWest | Medicare Advantage | — | $40.00 | $25.40 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | UCare | Medicare Advantage | — | $40.00 | $25.40 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | PrimeWest | Managed Medicaid | — | $40.00 | $25.40 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | United Healthcare | Medicare Advantage/VACCN | — | $40.00 | $25.40 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Humana | Medicare Advantage | — | $40.00 | $25.40 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Medica | Managed Medicaid | — | $40.00 | $25.40 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Aetna-Allina | Medicare Advantage | — | $40.00 | $25.40 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Sanford Health | Medicare Advantage | — | $40.00 | $25.40 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Blue Cross Blue Shield of Minnesota | Medicare Advantage | — | $40.00 | $25.40 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | UCare | Commercial | — | $40.00 | $25.40 | 2026-03-17 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Martins Point | Default | $10.80 | $30.00 | $22.50 | 2026-05-18 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Blue Cross Blue Shield Of Vt | Default | $11.12 | $30.00 | $22.50 | 2026-05-18 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Blue Cross Blue Shield Of Vt | Ppo | $11.12 | $30.00 | $22.50 | 2026-05-18 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Blue Cross Blue Shield Of Vt | Federal | $11.12 | $30.00 | $22.50 | 2026-05-18 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MEDI-CAL | MEDI-CAL | $13.00 | $164.00 | $29.52 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHCARE INC MEDI-CAL | HEALTHCARE INC MEDI-CAL | $13.00 | $164.00 | $29.52 | 2026-01-30 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $13.00 | $217.00 | $217.00 | 2025-10-04 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | MEDI-CAL | MEDI-CAL | $13.00 | $155.00 | $29.45 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC IPA MEDI-CAL | PACIFIC IPA MEDI-CAL | $13.00 | $164.00 | $29.52 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $13.00 | $155.00 | $29.45 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BC MEDI-CAL | BC MEDI-CAL | $13.00 | $164.00 | $29.52 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | HEALTHNET MEDI-CAL | HEALTHNET MEDI-CAL | $13.00 | $155.00 | $29.45 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC ALLIANCE MEDI-CAL | PACIFIC ALLIANCE MEDI-CAL | $13.00 | $164.00 | $29.52 | 2026-01-30 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $13.00 | $217.00 | $217.00 | 2025-10-04 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ALTAMED MEDI-CAL - ALL OTHER PLANS | ALTAMED MEDI-CAL - ALL OTHER PLANS | $13.00 | $164.00 | $29.52 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ACCESS MEDI-CAL | ACCESS MEDI-CAL | $13.00 | $164.00 | $29.52 | 2026-01-30 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $13.00 | $217.00 | $217.00 | 2025-10-04 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | CARE FIRST MEDI-CAL | CARE FIRST MEDI-CAL | $13.00 | $164.00 | $29.52 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | $13.00 | $155.00 | $29.45 | 2026-01-31 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $13.00 | $217.00 | $217.00 | 2025-10-04 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BLUE SHIELD MEDI-CAL | BLUE SHIELD MEDI-CAL | $13.00 | $164.00 | $29.52 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | LASALLE MG MEDI-CAL | LASALLE MG MEDI-CAL | $13.00 | $164.00 | $29.52 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PREFERRED MEDI-CAL | PREFERRED MEDI-CAL | $13.00 | $164.00 | $29.52 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | CCIPA MEDI-CAL - ALL PLANS | CCIPA MEDI-CAL - ALL PLANS | $13.00 | $155.00 | $29.45 | 2026-01-31 | MRF ↗ |
| UPMC COLE OutpatientFacility | Highmark BCBS of PA | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $13.58 | $49.00 | $29.40 | 2026-03-06 | MRF ↗ |
| UPMC COLE OutpatientFacility | AmeriHealth Caritas | Medicare | $13.72 | $49.00 | $29.40 | 2026-03-06 | MRF ↗ |
| UPMC COLE OutpatientFacility | United Healthcare | Medicare | $13.72 | $49.00 | $29.40 | 2026-03-06 | MRF ↗ |
| UPMC COLE OutpatientFacility | UPMC Health Plan | Managed Medicare | $13.72 | $49.00 | $29.40 | 2026-03-06 | MRF ↗ |
| UPMC COLE OutpatientFacility | Humana | Medicare | $13.86 | $49.00 | $29.40 | 2026-03-06 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Tricare | Tricare | $14.00 | $81.00 | $40.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - United | Medicaid - United | $14.00 | $81.00 | $40.00 | 2025-02-03 | MRF ↗ |
| UPMC COLE OutpatientFacility | AmeriHealth Caritas | Medicaid | $14.06 | $49.00 | $29.40 | 2026-03-06 | MRF ↗ |
| UPMC COLE OutpatientFacility | AmeriHealth Caritas | Community HealthChoices (CHC) | $14.06 | $49.00 | $29.40 | 2026-03-06 | MRF ↗ |
| BOONE MEMORIAL HOSPITAL Both | Medicaid West Virginia UNISYS | Default | $14.10 | $47.00 | $32.90 | 2026-04-07 | MRF ↗ |
| BOONE MEMORIAL HOSPITAL Both | Medicaid West Virginia UNISYS | Default | $14.10 | $47.00 | $32.90 | 2025-07-14 | MRF ↗ |
| UPMC COLE OutpatientFacility | UPMC Health Plan | Managed Medicaid | $14.21 | $49.00 | $29.40 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Aetna | Medicare | $14.22 | $79.00 | $63.20 | 2026-03-06 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MEDICA CONTRACTED [320239] | HB JEFN MEDICA EXCHANGE | $14.36 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MEDICA CONTRACTED [320239] | HB STLO MEDICA EXCHANGE | $14.36 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | UNITED HEALTH CARE COMMUNITY PLAN MEDICAID [9004] | UNITED HEALTH CARE MEDICAID [900401] | $14.38 | $162.00 | $162.00 | 2026-03-23 | MRF ↗ |
| UPMC COLE OutpatientFacility | Cigna | Medicare | $14.41 | $49.00 | $29.40 | 2026-03-06 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $14.72 | $109.00 | $81.75 | 2026-01-16 | MRF ↗ |
| CLARKE COUNTY HOSPITAL OutpatientFacility | Wellpoint | Managed Medicaid | $14.75 | $25.00 | $25.00 | 2025-05-01 | MRF ↗ |
| CLARKE COUNTY HOSPITAL OutpatientFacility | Molina Healthcare | Managed Medicaid | $14.75 | $25.00 | $25.00 | 2025-05-01 | MRF ↗ |
| CLARKE COUNTY HOSPITAL OutpatientFacility | Iowa Total Care | Managed Medicaid | $14.75 | $25.00 | $25.00 | 2025-05-01 | MRF ↗ |
| UPMC COLE OutpatientFacility | PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $14.82 | $49.00 | $29.40 | 2026-03-06 | MRF ↗ |
| UPMC COLE OutpatientFacility | PA Health & Wellness | Allwell Medicare Advantage DSNP | $14.82 | $49.00 | $29.40 | 2026-03-06 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | SUNFLOWER HEALTH PLAN CONTRACTED [320369] | HB STLO WASH JEFN CENTENE EXCHANGE/AMBETTER EFF 090118 | $14.85 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | NOVASYS CONTRACTED [320285] | HB STLO WASH JEFN CENTENE EXCHANGE/AMBETTER EFF 090118 | $14.85 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | SUNFLOWER HEALTH PLAN CONTRACTED [320369] | HB STLO WASH JEFN CENTENE EXCHANGE/AMBETTER EFF 090118 | $14.85 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | AMBETTER CONTRACTED [320452] | HB STLO WASH JEFN CENTENE EXCHANGE/AMBETTER EFF 090118 | $14.85 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | HOME STATE HEALTH PLAN CONTRACTED [320187] | HB STLO WASH JEFN CENTENE EXCHANGE/AMBETTER EFF 090118 | $14.85 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | AMBETTER [20452] | HB STLO WASH JEFN CENTENE EXCHANGE/AMBETTER EFF 090118 | $14.85 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | NOVASYS CONTRACTED [320285] | HB STLO WASH JEFN CENTENE EXCHANGE/AMBETTER EFF 090118 | $14.85 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | AMBETTER CONTRACTED [320452] | HB STLO WASH JEFN CENTENE EXCHANGE/AMBETTER EFF 090118 | $14.85 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | AMBETTER [20452] | HB STLO WASH JEFN CENTENE EXCHANGE/AMBETTER EFF 090118 | $14.85 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | HOME STATE HEALTH PLAN CONTRACTED [320187] | HB STLO WASH JEFN CENTENE EXCHANGE/AMBETTER EFF 090118 | $14.85 | $55.00 | $35.75 | 2026-03-12 | MRF ↗ |
| UPMC COLE OutpatientFacility | Aetna | Medicare | $14.95 | $49.00 | $29.40 | 2026-03-06 | MRF ↗ |
| MCLAREN MACOMB Outpatient | WC - Workers Compensation | WC - Workers Compensation | $15.00 | $81.00 | $40.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - Molina | Medicaid - Molina | $15.00 | $81.00 | $40.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - Molina | Medicaid - Molina | $15.00 | $81.00 | $40.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicare - United | Medicare - United | $15.00 | $81.00 | $40.00 | 2025-02-03 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $15.48 | $164.00 | $29.52 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | FCS IPA MEDI-CAL OP/PROFEE ONLY | FCS IPA MEDI-CAL OP/PROFEE ONLY | $15.60 | $164.00 | $29.52 | 2026-01-30 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Aetna | Medicare | $15.66 | $87.00 | $52.20 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Highmark Wholecare (prev Gateway) | Medicare | $15.80 | $79.00 | $63.20 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Highmark BCBS of PA | Medicare | $15.80 | $79.00 | $63.20 | 2026-03-06 | 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.