11604 — Exc Tr-ext Mal+marg 3.1-4 Cm
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). EXC TR-EXT MAL+MARG 3.1-4 CM (HCPCS 11604) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/11604?code_type=HCPCS
MLA (9th ed.)
“EXC TR-EXT MAL+MARG 3.1-4 CM (HCPCS 11604) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/11604?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“EXC TR-EXT MAL+MARG 3.1-4 CM (HCPCS 11604) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/11604?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $608–$1,689 (25th–75th percentile) across 2,320 hospitals · 7,194 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 11604 — 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 surgeon and anesthesia figures are estimates from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$608
$884 typical
$1,689
The middle 50% of negotiated facility rates for this procedure, measured across 2,320 hospitals. Surgeon & anesthesia fees 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. | $884 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $181 × 1.22 commercial. | $221 |
| Likely subtotal | $1,105 |
Surgical episode (typical)
~$1,105
Your recovery plan — adjust to what your surgeon told you
After surgery, recovery care is billed separately. We pre-fill the typical plan; change it to your situation.
Recovery cost modeled
~$3,785
With your recovery plan (typical)
~$4,890
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 |
|---|---|---|---|---|---|---|---|
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | $4,085.00 | $1,209.16 | 2026-02-28 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $2.17 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $2.17 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $2.17 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $2.23 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $2.29 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $2.35 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $2.81 | $448.00 | $336.00 | 2025-03-07 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $2.82 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $2.82 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $2.88 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $2.88 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $2.88 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $2.88 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $2.94 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $2.99 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $3.05 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $3.17 | $587.00 | $557.65 | 2026-02-20 | MRF ↗ |
| HANCOCK COUNTY HEALTH SYSTEM Outpatient | WELLMARK HMO-ALL OTHER PLANS | WELLMARK HMO-ALL OTHER PLANS | $3.81 | $209.00 | $156.75 | 2026-03-26 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $5.54 | $3,080.00 | $712.52 | 2024-12-31 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $5.57 | $535.85 | $535.85 | 2026-04-24 | MRF ↗ |
| OTTAWA COUNTY HEALTH CENTER Outpatient | CHOICECARE MCR ADV - ALL PLANS | CHOICECARE MCR ADV - ALL PLANS | $6.12 | $430.00 | $430.00 | 2026-03-09 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $6.12 | $538.00 | $102.22 | 2026-01-25 | MRF ↗ |
| Ventura County Medical Center - Santa Paula Hospital Outpatient | UHC MCR ADV | UHC MCR ADV | $6.12 | $2,640.00 | $1,320.00 | 2026-03-23 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $12.24 | $825.00 | $825.00 | 2026-02-13 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $14.64 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $14.73 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $14.73 | — | — | 2026-03-18 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Anthem | MCR Advantage | $14.85 | $33.00 | $29.70 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Martins Point | MCR Advantage | $14.85 | $33.00 | $29.70 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | United Healthcare | MCR Advantage | $14.85 | $33.00 | $29.70 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Cigna | MCR Advantage | $14.85 | $33.00 | $29.70 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Aetna | MCR Advantage | $14.85 | $33.00 | $29.70 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Wellcare | MCR Advantage | $14.85 | $33.00 | $29.70 | 2026-04-05 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $15.00 | $925.00 | $925.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $15.00 | $925.00 | $925.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $15.00 | $925.00 | $925.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $15.00 | $925.00 | $925.00 | 2025-10-04 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $16.77 | — | — | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL SOUTHEAST OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $16.84 | $259.00 | $168.35 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL SOUTHEAST OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $16.84 | $259.00 | $168.35 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL SOUTHEAST OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $16.84 | $259.00 | $168.35 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $16.84 | $259.00 | $168.35 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $16.84 | $259.00 | $168.35 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $16.84 | $259.00 | $168.35 | 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 | $16.84 | $259.00 | $168.35 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $16.84 | $259.00 | $168.35 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $16.84 | $259.00 | $168.35 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $16.84 | $259.00 | $168.35 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTHEAST OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $16.84 | $259.00 | $168.35 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $16.88 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $16.88 | — | — | 2026-03-18 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.12 | $595.00 | $107.10 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.12 | $595.00 | $136.85 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.12 | $595.00 | $107.10 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.12 | $595.00 | $142.80 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.12 | $595.00 | $136.85 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.12 | $595.00 | $136.85 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.12 | $595.00 | $130.90 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.12 | $595.00 | $136.85 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.12 | $595.00 | $154.70 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.12 | $595.00 | $130.90 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.12 | $595.00 | $113.05 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.12 | $595.00 | $130.90 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.12 | $595.00 | $113.05 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.12 | $595.00 | $130.90 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.12 | $595.00 | $130.90 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.12 | $595.00 | $160.65 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.12 | $595.00 | $160.65 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.12 | $595.00 | $154.70 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.12 | $595.00 | $130.90 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.12 | $595.00 | $142.80 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.12 | $595.00 | $130.90 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.12 | $595.00 | $130.90 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $17.25 | — | — | 2026-04-14 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $18.26 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $18.38 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $18.38 | — | — | 2026-03-18 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $19.50 | $925.00 | $925.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $19.50 | $925.00 | $925.00 | 2025-10-04 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | United Healthcare | Commercial | $19.80 | $33.00 | $29.70 | 2026-04-05 | MRF ↗ |
| FAIRCHILD MEDICAL CENTER Outpatient | MEDI-CAL | MEDI-CAL | $20.00 | $531.00 | $531.00 | 2025-12-03 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $20.93 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $20.93 | — | — | 2026-04-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $20.95 | — | — | 2026-04-14 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | HealthNet | Commercial | $21.45 | $33.00 | $29.70 | 2026-04-05 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $22.76 | — | — | 2026-04-14 | MRF ↗ |
| LEXINGTON REGIONAL HEALTH CENTER OutpatientFacility | BCBS | ALL PRODUCTS | $23.75 | $25.00 | $24.00 | 2025-12-28 | MRF ↗ |
| LEXINGTON REGIONAL HEALTH CENTER OutpatientFacility | UHC | ALL PRODUCTS | $24.00 | $25.00 | $24.00 | 2025-12-28 | MRF ↗ |
| LEXINGTON REGIONAL HEALTH CENTER OutpatientFacility | MIDLANDS CHOICE | ALL PRODUCTS | $25.00 | $25.00 | $24.00 | 2025-12-28 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Anthem | Commercial | $25.67 | $33.00 | $29.70 | 2026-04-05 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER HA [122] Plans | $27.79 | $11,650.03 | $11,650.03 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER HA [122] Plans | $27.79 | $8,201.06 | $8,201.06 | 2026-03-26 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Community Health Options | Commercial | $28.05 | $33.00 | $29.70 | 2026-04-05 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | $8,705.63 | 2024-12-08 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Phcs/Multiplan | Commercial | — | $2,171.00 | $1,628.25 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Sunflower | Medicaid | — | $2,171.00 | $1,628.25 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Wppa/Providrscare | Commercial | — | $2,171.00 | $1,628.25 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Aetna | Commercial | — | $2,171.00 | $1,628.25 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Ks | Commercial | $29.82 | $2,171.00 | $1,628.25 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | United Healthcare | Commercial | — | $2,171.00 | $1,628.25 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Healthy Blue | Medicaid | — | $2,171.00 | $1,628.25 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Hpk (Incl. Cigna) | Commercial | — | $2,171.00 | $1,628.25 | 2026-05-18 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Harvard Pilgrim | Commercial | $29.86 | $33.00 | $29.70 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Aetna | Commercial | $30.20 | $33.00 | $29.70 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Cigna | Commercial | $30.69 | $33.00 | $29.70 | 2026-04-05 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | $8,705.63 | 2024-12-08 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | First Health | Commercial | $31.35 | $33.00 | $29.70 | 2026-04-05 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $31.45 | — | $8,460.30 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $31.45 | — | $8,460.30 | 2026-03-31 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | United Healthcare | Medicare Advantage/VACCN | — | $146.00 | $92.71 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Medica | Medicare Advantage | — | $146.00 | $92.71 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Blue Cross Blue Shield of Minnesota | Medicare Advantage | — | $146.00 | $92.71 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Medica | Managed Medicaid | — | $146.00 | $92.71 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | UCare | Medicare Advantage | — | $146.00 | $92.71 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Blue Cross Blue Shield of Minnesota | Managed Medicaid | $31.54 | $146.00 | $92.71 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | UCare | Commercial | — | $146.00 | $92.71 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Triwest Healthcare Alliance | Tricare/Champus | — | $146.00 | $92.71 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | PrimeWest | Managed Medicaid | — | $146.00 | $92.71 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Health Partners | Medicare Advantage | — | $146.00 | $92.71 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Sanford Health | Medicare Advantage | — | $146.00 | $92.71 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Humana | Medicare Advantage | — | $146.00 | $92.71 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | PrimeWest | Medicare Advantage | — | $146.00 | $92.71 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | UCare | Managed Medicaid | — | $146.00 | $92.71 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Aetna-Allina | Medicare Advantage | — | $146.00 | $92.71 | 2026-03-17 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - Meridian | Medicaid - Meridian | $33.00 | $334.00 | $167.00 | 2025-02-03 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $33.66 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $33.66 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $33.66 | — | — | 2026-01-01 | 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.