11970 — Rplcmt Tiss Xpndr Perm Implt
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). RPLCMT TISS XPNDR PERM IMPLT (HCPCS 11970) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/11970?code_type=HCPCS
MLA (9th ed.)
“RPLCMT TISS XPNDR PERM IMPLT (HCPCS 11970) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/11970?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“RPLCMT TISS XPNDR PERM IMPLT (HCPCS 11970) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/11970?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,415–$9,600 (25th–75th percentile) across 1,707 hospitals · 3,136 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 11970 — 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 fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$3,415
$7,130 typical
$9,600
The middle 50% of negotiated facility rates for this procedure, measured across 1,707 hospitals. The surgeon and 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. | $7,130 |
| Surgeon (professional fee) Estimate national typical Medicare $517 × 1.22 commercial. | $631 |
| Anesthesia Estimate national typical Generic anesthesia (~90 min typical, median CMS base units). Medicare $225 × 3.14 commercial. Approximate — no procedure-specific anesthesia mapping for this code. | $708 |
| Likely subtotal | $8,469 |
Surgical episode (typical)
~$8,469
Your recovery plan — adjust to what your doctor told you
After your procedure, 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)
~$12,254
- The anesthesia component is a generic, approximate estimate — no procedure-specific anesthesia mapping exists for this code, so a typical anesthesia for this procedure type is shown.
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
- Anesthesia (estimate)
- base_units_version: CY2022 file (base units unchanged for CY2026 per CMS) · anesthesia_cf: $20.49754 (National) · cf_rule: CMS-1832-F · multiplier_source: AJMC/Duffy 2016-2017 (PMID 34156223) national · basis: generic surgical anesthesia — 5 base units (typical CMS value) × ~90 min; approximate, NOT a procedure-specific crosswalk
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 |
|---|---|---|---|---|---|---|---|
| Highsmith Rainey Memorial Hospital Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $10,553.00 | $6,331.80 | 2026-05-17 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $23,061.50 | $2,306.15 | 2026-05-14 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $23,061.50 | $2,306.15 | 2026-05-06 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $23,061.50 | $2,306.15 | 2026-05-22 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $2.28 | — | $97,242.03 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $2.28 | — | $48,443.75 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $4.77 | — | $7,520.57 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $4.77 | — | $7,520.57 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $4.77 | — | $7,520.57 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $4.77 | — | $7,520.57 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $8.15 | — | $8,834.35 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $8.15 | — | $8,834.35 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $8.15 | — | $8,834.35 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $8.15 | — | $8,834.35 | 2026-03-31 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | UHC COMMUNITY MEDICAID [2175] | HB XR UHC INDIANA PATHWAYS MEDICAID | $10.09 | $26,667.24 | $16,448.04 | 2025-12-19 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | UHC COMMUNITY MEDICAID [2175] | HB XR UHC INDIANA PATHWAYS MEDICAID | $10.09 | $27,887.00 | $17,302.84 | 2025-12-19 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | LA Care Health | Medi-cal | $12.00 | — | — | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Molina | MCD | $12.00 | — | — | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Physicians Medical Group | MCD | $12.00 | — | — | 2024-10-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | Molina | MCD | $12.91 | — | — | 2026-03-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | LA Care Health | Medi-cal | $12.91 | — | — | 2026-03-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | Brand New Day | MCD | $13.20 | — | — | 2024-10-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | Gold Coast Health Plan | MCD | $13.20 | — | — | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Brand New Day | MCD | $13.20 | — | — | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Anthem | Medi-Cal | $13.20 | — | — | 2024-10-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Brand New Day | MCD | $14.20 | — | — | 2026-03-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | Brand New Day | MCD | $14.20 | — | — | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Gold Coast Health Plan | MCD | $14.20 | — | — | 2026-03-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Inland Empire Health Plan | MGMCD | $17.40 | — | — | 2024-10-01 | MRF ↗ |
| MERCY MEDICAL CTR OutpatientFacility | CARELON HEALTH MEDICAID | CARELON MEDICAID | $17.54 | — | $15,564.04 | 2026-03-31 | MRF ↗ |
| Riverside Community Hospital Outpatient | Inland Empire Health Plan | MGMCD | $18.72 | — | — | 2026-03-01 | MRF ↗ |
| MERCY MEDICAL CTR OutpatientFacility | WELLSENSE HEALTH PLAN | WELLSENSE SILVER | $19.21 | — | $15,564.04 | 2026-03-31 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $20.10 | $11,165.00 | $7,262.33 | 2024-12-31 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL AETNA CARE [700912] | $25.98 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL AETNA BETTER HEALTH MEDICAID [300612] | $29.87 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | 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 ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | $12,253.50 | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | $12,253.50 | 2024-12-08 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL UNITED HEALTHCARE LABS [106809] | $35.16 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL UNITED HEALTHCARE CARE [300609] | $35.16 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL UNITED HEALTHCARE CARE [700909] | $35.16 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Tricare | All | $36.55 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $36.55 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | VA Health | All | $36.55 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | UHC | Medicare Advantage | $36.55 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $36.55 | — | — | 2026-03-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE CROSS [1013] | BLUE CROSS MEDI-CAL UNLISTED IPA [10130011] | $39.00 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE CROSS [1013] | MEDI-CAL | $39.00 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | COMMUNITY ELDERCARE [1027] | MEDI-CAL | $39.00 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| Southwest Healthcare System-wildomar Both | Anthem Blue Cross Blue Shield | Medicaid | $39.00 | — | — | 2026-05-06 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BRAND NEW DAY [1089] | MEDI-CAL | $39.00 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | XIMED [2016] | MEDI-CAL | $39.00 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CAREMORE [2028] | MEDI-CAL | $39.00 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | VANTAGE [1092] | PROSPECT VANTAGE MEDICAL GROUP MEDI-CAL | $39.00 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MEDI-CAL [2001] | MEDI-CAL | $39.00 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MEDI-CAL [1048] | MEDI-CAL | $39.00 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | AETNA [1003] | AETNA MEDI-CAL | $39.00 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL MERIDIAN CAID [300605] | $41.40 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL MED PLUS BLUE CARE [700903] | $44.93 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL WELLCARE CARE [700920] | $44.93 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $45.74 | — | — | 2026-04-14 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MOLINA [1055] | MOLINA MEDI-CAL | $49.14 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MOLINA [1240] | MOLINA MEDI-CAL | $49.14 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MOLINA [1055] | MOLINA MEDI-CAL COMMUNITY CARE [10550015] | $49.14 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MOLINA [1240] | MOLINA MEDI-CAL [12400001] | $49.14 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MOLINA [1055] | MOLINA MEDI-CAL [10550002] | $49.14 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL BLUE CROSS COMPLETE [300610] | $49.78 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | $12,253.50 | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | COMMUNITY HEALTH GROUP [1022] | COMMUNITY HEALTH GROUP (MEDI-CAL) | $50.31 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL MIDWEST HEALTH CAID [300607] | $50.83 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL HAP EMPOWERED [300613] | $50.83 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | HEALTH NET [1039] | HEALTH NET MEDI-CAL | $52.65 | $67,563.26 | $37,159.79 | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $55.41 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $55.41 | — | — | 2026-04-01 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $55.54 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $55.54 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $55.54 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $55.54 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $55.54 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $55.54 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $55.54 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $55.54 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $55.54 | — | — | 2026-04-14 | MRF ↗ |
| Riverside Community Hospital Outpatient | LA Care Health | Medi-cal | $55.94 | — | — | 2026-03-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | Molina | MCD | $55.94 | — | — | 2026-03-01 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL HAP CARE [700904] | $56.16 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL PRIORITY HEALTH CARE [700911] | $56.16 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL MIDWEST HEALTHCARE CARE [700907] | $56.16 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL AMERIHEALTH CARITAS VIP [700921] | $56.16 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | OMNICARE CARE [700906] | $56.16 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL GENERIC MEDICARE [700914] | $56.16 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL VACCN [106827] | $56.16 | $42,627.65 | $42,627.65 | 2026-03-23 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $60.34 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $60.34 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $60.34 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $60.34 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $60.34 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $60.34 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $60.34 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $60.34 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $60.34 | — | — | 2026-04-14 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Brand New Day | MCD | $61.53 | — | — | 2026-03-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | Brand New Day | MCD | $61.53 | — | — | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Gold Coast Health Plan | MCD | $61.53 | — | — | 2026-03-01 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP GOLD PPO | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | VALUE OPTIONS [145] | VALUE OPTIONS GOLD [14502] | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP|CIGNA|GWH CIGNA|NALC CIGNA | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | VALUE OPTIONS [145] | VALUE OPTIONS OPTION [14503] | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MAGNACARE [115] | MAGNACARE | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | VALUE OPTIONS [145] | VALUE OPTIONS [14501] | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP DUAL ACCESS|MVP DUAL ACCESS COMPLETE | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 3&4 | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | MEDICARE HMO INDEPENDENT HLTH|NOVA HEALTHCARE MEDICARE | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA MEDICAID MANAGED CARE|MOLINA CHILD HEALTH PLUS | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK MEDICAID|HIGHMARK ESSENTIALS|HIGHMARK CHP | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | INDEPENDENT HEALTH ASSOC|NOVA HEALTHCARE-IHA | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | EMBLEM GHI [113] | EMBLEM GHI | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK MEDICARE | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK|HIGHMARK INDEMNITY- OUT OF AREA|HIGHMARK HMO BLUE | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP GOLD HMO | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | AETNA [100] | AETNA MEDICARE ADVANTAGE | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 1&2|MVP ESSENTIAL 3&4 | $78.50 | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE|TRICARE FOR LIFE|MARTINS POINT/US FAMILY | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 1&2 | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS ESSENTIAL 1&2|FIDELIS ESSENTIAL 3&4 | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC DUAL COMPLETE | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | GENERIC CARRIER [107] | COMMERCIAL|HUMANA|MULTIPLAN|CDPHP COMMERCIAL | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | FIDELIS CARE NEW YORK [112] | FIDELIS CARE NEW YORK|FIDELIS FHP|FIDELIS CHP | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS(INCLUDING GOLD,SILVER,BRONZE AND PLATINUM) | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UNITED HEALTHCARE|UHC EMPIRE PLAN (KINGSTON)|UNITEDHEALTHCARE OXFORD|UNITED MEDICAL RESOURCES (UMR)|UHC STUDENT RESOURCES|UHC SUREST|UNITED HEALTHCARE SHARED SERVICES | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC MEDICARE COMPLETE | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN|UHC COMMUNITY MEDICAID DENTAL|UHC ESSENTIAL 1&2|UHC CHPS|UHC ESSENTIAL 3&4 | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE DUAL | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE MEDICARE HMO|WELLCARE DENTAL | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | FIDELIS MEDICARE [176] | FIDELIS MEDICARE|FIDELIS DUAL ADVANTAGE | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | EXCELLUS HMO [104] | CHILD HEALTH PLUS|EXCELLUS ESSENTIAL 1&2|EXCELLUS ESSENTIAL 3&4|UNIVERA MYHEALTH|UNIVERA ESSENTIAL 1&2|UNIVERA ESSENTIAL 1&2 | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | HUMANA MEDICARE HMO|GENERIC MEDICARE HMO|ELDERPLAN|MH OPTUM MEDICARE|CDPHP MEDICARE HMO | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | EXCELLUS HMO [104] | BLUE CHOICE OPTION|UNIVERA MYHEALTH PLUS|HEALTHY NY | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP OPTION|MVP CHILD HEALTH PLUS | $78.50 | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | EXCELLUS HMO [104] | MEDICARE BLUE CHOICE|MEDICARE BLUE DUAL|UNIVERA SENIOR | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | EXCELLUS INDEMNITY [127] | BLUE CHOICE|RGHS EMPLOYEE MEDICAL PLAN|EXCELLUS UNITY EMPLOYEE PLAN|RRH CDHP|EMPIRE BLUE CROSS (NYC)|BLUE CROSS & BLUE SHIELD|DENTAL BLUE SHIELD|UNIVERA|EMPIRE PLAN B/C (KINGSTON)|EXCELLUS BCBS RIT|FEDERAL BLUE CROSS & BLUE SHIELD | — | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP EXCHANGE-INDIVIDUAL | $78.50 | $12,954.14 | $10,363.31 | 2024-12-30 | MRF ↗ |
| Riverside Community Hospital Outpatient | Inland Empire Health Plan | MGMCD | $81.11 | — | — | 2026-03-01 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $81.95 | $607.00 | $455.25 | 2026-01-16 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $86.91 | — | — | 2026-04-14 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $88.79 | — | — | 2025-12-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $95.08 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $95.08 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $95.08 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $95.08 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $95.08 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $95.08 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $95.08 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $95.08 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $95.08 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $95.08 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $95.08 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $101.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $101.07 | — | — | 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.