12016 — Rpr Fe/e/en/l/m 12.6-20.0 Cm
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). RPR FE/E/EN/L/M 12.6-20.0 CM (CPT 12016) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/12016?code_type=CPT
MLA (9th ed.)
“RPR FE/E/EN/L/M 12.6-20.0 CM (CPT 12016) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/12016?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“RPR FE/E/EN/L/M 12.6-20.0 CM (CPT 12016) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/12016?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $366–$922 (25th–75th percentile) across 2,504 hospitals · 8,389 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 12016 — 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
$366
$555 typical
$922
The middle 50% of negotiated facility rates for this procedure, measured across 2,504 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. | $555 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $122 × 1.22 commercial. | $149 |
| Likely subtotal | $705 |
Surgical episode (typical)
~$705
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)
~$4,489
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 |
|---|---|---|---|---|---|---|---|
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $0.58 | $664.00 | $498.00 | 2025-03-07 | MRF ↗ |
| HANCOCK COUNTY HEALTH SYSTEM Both | WELLMARK HMO-ALL OTHER PLANS | WELLMARK HMO-ALL OTHER PLANS | $0.84 | $287.00 | $215.25 | 2026-03-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | HMO | — | $455.00 | $373.10 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $455.00 | $373.10 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $455.00 | $373.10 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $455.00 | $373.10 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $455.00 | $373.10 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $455.00 | $373.10 | 2025-11-26 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.11 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.13 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.13 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $2.42 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $2.44 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $2.44 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $2.64 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $2.65 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $2.65 | — | — | 2026-03-18 | MRF ↗ |
| OTTAWA COUNTY HEALTH CENTER Outpatient | CHOICECARE MCR ADV - ALL PLANS | CHOICECARE MCR ADV - ALL PLANS | $3.77 | $305.00 | $305.00 | 2026-03-09 | MRF ↗ |
| COMANCHE COUNTY MEDICAL CENTER Outpatient | MPI - ALL PLANS | MPI - ALL PLANS | $4.15 | $326.00 | $211.90 | 2026-05-07 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $4.65 | $232.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $4.65 | $232.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $4.65 | $232.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $4.65 | $232.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $4.65 | $232.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $4.65 | $232.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $4.65 | $232.50 | — | 2026-03-31 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $5.26 | $506.10 | $506.10 | 2026-04-24 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Both | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $6.07 | $583.25 | $583.25 | 2026-04-24 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $6.28 | $583.00 | $215.71 | 2026-03-31 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $7.54 | $468.00 | $468.00 | 2026-02-13 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $9.52 | $399.00 | $239.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $9.52 | $399.00 | $239.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $9.68 | $399.00 | $239.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $9.68 | $399.00 | $239.40 | 2025-08-11 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | BLUE CROSS-ALL PLANS | BLUE CROSS-ALL PLANS | $17.92 | $56.00 | $44.80 | 2026-03-04 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | BLUE CROSS-ALL PLANS | BLUE CROSS-ALL PLANS | $17.92 | $56.00 | $44.80 | 2026-03-04 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $20.34 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $20.34 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $20.34 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $20.34 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $20.34 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $20.34 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $20.34 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $20.34 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $20.34 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $20.34 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $20.34 | — | — | 2026-01-01 | MRF ↗ |
| HIGH POINT REGIONAL HEALTH SYSTEM OutpatientFacility | Carolina Complete | Medicaid Managed Care | $22.19 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| HIGH POINT REGIONAL HEALTH SYSTEM OutpatientFacility | Partners | Medicaid Tailored Plan | $22.19 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| HIGH POINT REGIONAL HEALTH SYSTEM OutpatientFacility | Healthy Blue | Medicaid Managed Care | $22.19 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| HIGH POINT REGIONAL HEALTH SYSTEM OutpatientFacility | Amerihealth | Medicaid Managed Care | $22.19 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| HIGH POINT REGIONAL HEALTH SYSTEM OutpatientFacility | United Healthcare | Medicaid Managed Care | $22.41 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| HIGH POINT REGIONAL HEALTH SYSTEM OutpatientFacility | Vaya | Medicaid Tailored Plan | $22.41 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| HIGH POINT REGIONAL HEALTH SYSTEM OutpatientFacility | Wellcare | Medicaid Managed Care | $22.41 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| HIGH POINT REGIONAL HEALTH SYSTEM OutpatientFacility | Alliance | Medicaid Tailored Plan | $22.63 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| HIGH POINT REGIONAL HEALTH SYSTEM OutpatientFacility | Trillium | Medicaid Tailored Plan | $22.86 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Blue Cross Blue Shield | Blue Distinctions Transplant Services | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Aetna | Behavioral Health | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Aetna North Carolina Preferred | Behavioral Health | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Blue Cross Blue Shield | Blue Local Individual | $23.68 | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Blue Distinctions Transplant Services | — | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Blue Local Individual | $24.98 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | Magellan | Behavioral Health | — | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | Optum Transplant | Transplant Services | — | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | — | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| JEFFERSON MEDICAL CENTER Outpatient | Unitedhealthcare Medicare Advantage | All Plans | — | $1,102.00 | $551.00 | 2026-05-13 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | CHAMPVA -ALL PLANS | CHAMPVA -ALL PLANS | $25.20 | $56.00 | $44.80 | 2026-03-04 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | CHAMPVA -ALL PLANS | CHAMPVA -ALL PLANS | $25.20 | $56.00 | $44.80 | 2026-03-04 | MRF ↗ |
| CATALINA ISLAND MEDICAL CENTER Outpatient | MEDI-CAL | MEDI-CAL | $26.00 | $322.00 | $225.40 | 2026-03-17 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $26.00 | $414.00 | $111.78 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | UNIVERSAL IPA MCAL OP/PROFEE ONLY | UNIVERSAL IPA MCAL OP/PROFEE ONLY | $26.00 | $414.00 | $111.78 | 2026-01-31 | MRF ↗ |
| CATALINA ISLAND MEDICAL CENTER Outpatient | LA CARE MEDI-CAL-ALL OTHER PLANS | LA CARE MEDI-CAL-ALL OTHER PLANS | $26.00 | $322.00 | $225.40 | 2026-03-17 | MRF ↗ |
| WASHINGTON COUNTY HOSPITAL Outpatient | Alabama Medicaid | PPO | $27.00 | $27.00 | $10.80 | 2025-05-21 | MRF ↗ |
| UNION GENERAL HOSPITAL Outpatient | CARESOURCE NETWORK PARTNERS, LLC. | CARE SOURCE MEDICAID | $27.22 | $178.00 | $89.00 | 2026-03-23 | MRF ↗ |
| The Hospitals of Providence Emergency Room Montwood OutpatientFacility | Imperial Health | Medicare Advantage | $28.00 | $823.56 | $658.85 | 2026-03-24 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $28.49 | $211.00 | $158.25 | 2026-01-16 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| Davie Medical Center OutpatientFacility | MedCost | Employee Managed Care | $28.71 | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | EVERYSTEP HOSPICE-ALL PLANS | EVERYSTEP HOSPICE-ALL PLANS | $29.12 | $56.00 | $44.80 | 2026-03-04 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | EVERYSTEP HOSPICE-ALL PLANS | EVERYSTEP HOSPICE-ALL PLANS | $29.12 | $56.00 | $44.80 | 2026-03-04 | MRF ↗ |
| CATALINA ISLAND MEDICAL CENTER Outpatient | MOLINA MEDICAID-ALL OTHER PLANS | MOLINA MEDICAID-ALL OTHER PLANS | $29.90 | $322.00 | $225.40 | 2026-03-17 | MRF ↗ |
| Riverside Community Hospital Outpatient | LA Care Health | Medi-cal | $30.12 | — | — | 2026-03-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | Molina | MCD | $30.12 | — | — | 2026-03-01 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | TRICARE-ALL PLANS | TRICARE-ALL PLANS | $30.24 | $56.00 | $44.80 | 2026-03-04 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | TRICARE-ALL PLANS | TRICARE-ALL PLANS | $30.24 | $56.00 | $44.80 | 2026-03-04 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | AETNA MCR ADV-ALL PLANS | AETNA MCR ADV-ALL PLANS | $30.24 | $56.00 | $44.80 | 2026-03-04 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | AETNA MCR ADV-ALL PLANS | AETNA MCR ADV-ALL PLANS | $30.24 | $56.00 | $44.80 | 2026-03-04 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | MedCost | Employee Managed Care | $30.29 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | Aetna | Medicare Advantage | $30.48 | $127.00 | — | 2026-04-20 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| MINDEN MEDICAL CENTER Both | MCD UNITED HC LA | MCD UHC NB | $31.30 | $410.50 | $123.15 | 2025-12-04 | MRF ↗ |
| MINDEN MEDICAL CENTER Both | MCD UNITED HC LA | MCD UHC REHAB OP | $31.30 | $410.50 | $123.15 | 2025-12-04 | MRF ↗ |
| MINDEN MEDICAL CENTER Both | MCD UNITED HC LA | MCD UHC IP | $31.30 | $410.50 | $123.15 | 2025-12-04 | MRF ↗ |
| MINDEN MEDICAL CENTER Both | MCD UNITED HC LA | MCD UHC 2ND IP | $31.30 | $410.50 | $123.15 | 2025-12-04 | MRF ↗ |
| MINDEN MEDICAL CENTER Both | MCD UNITED HC LA | MCD UHC 2ND OP | $31.30 | $410.50 | $123.15 | 2025-12-04 | MRF ↗ |
| MINDEN MEDICAL CENTER Both | MCD UNITED HC LA | MCD UHC OP | $31.30 | $410.50 | $123.15 | 2025-12-04 | MRF ↗ |
| MINDEN MEDICAL CENTER Both | MCD UNITED HC LA | MCD UHC REHAB IP | $31.30 | $410.50 | $123.15 | 2025-12-04 | MRF ↗ |
| MINDEN MEDICAL CENTER Both | MCD UNITED HC LA | MCD UHC PSYCH | $31.30 | $410.50 | $123.15 | 2025-12-04 | MRF ↗ |
| HIGH POINT REGIONAL HEALTH SYSTEM OutpatientFacility | Blue Cross Blue Shield | Blue Local Individual | $31.50 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Blue Cross Blue Shield | HPN | $32.44 | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Amerihealth | Medicaid Managed Care | $32.77 | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Carolina Complete | Medicaid Managed Care | $32.77 | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Partners | Medicaid Tailored Plan | $32.77 | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Health Blue | Medicaid Managed Care | $32.77 | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Magee Rehabilitation Hospital OutpatientFacility | Magee Health Partners | Medicaid | $33.08 | — | — | 2026-03-18 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Vaya | Medicaid Tailored Plan | $33.10 | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| Riverside Community Hospital Outpatient | Brand New Day | MCD | $33.13 | — | — | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Brand New Day | MCD | $33.13 | — | — | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Gold Coast Health Plan | MCD | $33.13 | — | — | 2026-03-01 | MRF ↗ |
| Davie Medical Center OutpatientFacility | United Healthcare | Medicaid Managed Care | $33.19 | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Wellcare | Medicaid Managed Care | $33.19 | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Alliance | Medicaid Tailored Plan | $33.42 | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | OPTUM VA | OPTUM VA | $33.60 | $56.00 | $44.80 | 2026-03-04 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | OPTUM VA | OPTUM VA | $33.60 | $56.00 | $44.80 | 2026-03-04 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Trillium | Medicaid Tailored Plan | $33.76 | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Franklin Memorial Hospital OutpatientFacility | Aetna | Medicare Advantage | $33.96 | $113.20 | $113.20 | 2025-09-09 | MRF ↗ |
| Franklin Memorial Hospital OutpatientFacility | Anthem | Medicare Advantage | $33.96 | $113.20 | $113.20 | 2025-09-09 | MRF ↗ |
| Franklin Memorial Hospital OutpatientFacility | United Healthcare | Medicare Advantage | $33.96 | $113.20 | $113.20 | 2025-09-09 | MRF ↗ |
| Franklin Memorial Hospital OutpatientFacility | Aetna | Medicare Advantage | $33.96 | $113.20 | $113.20 | 2025-09-09 | MRF ↗ |
| Franklin Memorial Hospital OutpatientFacility | Anthem | Medicare Advantage | $33.96 | $113.20 | $113.20 | 2025-09-09 | MRF ↗ |
| Franklin Memorial Hospital OutpatientFacility | United Healthcare | Medicare Advantage | $33.96 | $113.20 | $113.20 | 2025-09-09 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Medicare A Ky J15 | Default | $34.10 | $116.00 | $69.60 | 2026-05-22 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Humana Advantage Care Plans Med Advantage | Medicare Advantage | $34.10 | $116.00 | $69.60 | 2026-05-22 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Wellcare Health Plan Inc Mcr Adv | Medicare Advantage | $34.10 | $116.00 | $69.60 | 2026-05-22 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Humana | Default | — | $116.00 | $69.60 | 2026-05-22 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | Blue Cross Blue Shield | HPN | $34.23 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Aetna | IVL Exchange | $34.37 | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | Amerihealth | Medicaid Managed Care | $34.58 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | Partners | Medicaid Tailored Plan | $34.58 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | Carolina Complete | Medicaid Managed Care | $34.58 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | Health Blue | Medicaid Managed Care | $34.58 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | Vaya | Medicaid Tailored Plan | $34.93 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| Franklin Memorial Hospital OutpatientFacility | Wellcare | Medicare Advantage | $34.98 | $113.20 | $113.20 | 2025-09-09 | MRF ↗ |
| Franklin Memorial Hospital OutpatientFacility | Wellcare | Medicare Advantage | $34.98 | $113.20 | $113.20 | 2025-09-09 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | United Healthcare | Medicaid Managed Care | $35.02 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | Wellcare | Medicaid Managed Care | $35.02 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | Alliance | Medicaid Tailored Plan | $35.27 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | Trillium | Medicaid Tailored Plan | $35.62 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| RICHLAND HOSPITAL OutpatientFacility | Dean Health Plan | DHI/DHP Products and ASO Managed Care | $35.62 | $260.00 | $208.00 | 2026-04-24 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Priority Health | PriorityHealthSEMIPartnersNet | $35.81 | — | — | 2025-01-31 | MRF ↗ |
| BRECKINRIDGE MEMORIAL HOSPITAL Both | TRICARE - ALL PLANS | TRICARE - ALL PLANS | $35.96 | $111.00 | $55.50 | 2026-03-24 | MRF ↗ |
| NORTH CAROLINA BAPTIST HOSPITAL OutpatientFacility | Aetna | IVL Exchange | $36.26 | $153.00 | $76.50 | 2025-10-08 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | BENEFIT ADMIN SYSTEM-ALL PLANS | BENEFIT ADMIN SYSTEM-ALL PLANS | $36.40 | $56.00 | $44.80 | 2026-03-04 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | BENEFIT ADMIN SYSTEM-ALL PLANS | BENEFIT ADMIN SYSTEM-ALL PLANS | $36.40 | $56.00 | $44.80 | 2026-03-04 | MRF ↗ |
| Davie Medical Center OutpatientFacility | Blue Cross Blue Shield | Blue Value | $36.69 | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| The Hospitals of Providence Emergency Room Montwood OutpatientFacility | Imperial Health | Medicare Advantage | $37.06 | $823.56 | $658.85 | 2026-03-24 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Uhc Group Medicare Advantage | Medicare Advantage | $37.12 | $116.00 | $69.60 | 2026-05-22 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Medicaid Kentucky | Default | $37.12 | $116.00 | $69.60 | 2026-05-22 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Wellcare Health Plan Mcd Rep | Medicaid Replacement | $37.12 | $116.00 | $69.60 | 2026-05-22 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Blue Cross Blue Shield Of Ky Anthem | Medicare Advantage | $37.12 | $116.00 | $69.60 | 2026-05-22 | MRF ↗ |
| CARROLL COUNTY MEMORIAL HOSPITAL Both | Blue Cross Blue Shield Of Ky Anthem | Medicaid Replacement | $37.12 | $116.00 | $69.60 | 2026-05-22 | MRF ↗ |
| CHAMBERS MEMORIAL HOSPITAL Outpatient | CARESOURCE MCAID | CARESOURCE MCAID | $37.98 | $530.14 | $265.07 | 2026-05-05 | MRF ↗ |
| CHEYENNE COUNTY HOSPITAL Outpatient | BCBS PPO - ALL PLANS | BCBS PPO - ALL PLANS | $38.00 | $1,278.40 | $1,086.64 | 2026-03-02 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | Optum | VACCN | $38.10 | $127.00 | — | 2026-04-20 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | BlueCross BlueShield of Alabama | Medicare Advantage | $38.10 | $127.00 | — | 2026-04-20 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | Centene | Medicare Advantage | $38.10 | $127.00 | — | 2026-04-20 | MRF ↗ |
| Davie Medical Center InpatientFacility | Amerihealth | Medicaid Managed Care | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Humana | Medicare Advantage | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Carolina Complete | Medicaid Managed Care | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Carolina Behavioral Health | Behavioral Health | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna | Managed Care (Pediatrics) | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna | Managed Care (Adult) | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | United Healthcare | Medicaid Managed Care | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Humana | Transplant Services | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | United Healthcare | Medicare Advantage | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Devoted | Medicare Advantage | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Ambetter | Managed Care | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | United Healthcare | Managed Care | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Blue Cross Blue Shield | Medicare Advantage | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | United Healthcare | IEX Individual Managed Care | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Amerihealth | Managed Care | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Trillium | Medicaid Tailored Plan | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Optum Transplant | Transplant Services | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna Evernorth | Behavioral Health | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | United Healthcare/Optum Behavioral Health | Behavioral Health | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Wellcare | Medicaid Managed Care | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Liberty | Medicare Advantage | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Health Blue | Medicaid Managed Care | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| BRECKINRIDGE MEMORIAL HOSPITAL Both | MOLINA MCR ADV - ALL PLANS | MOLINA MCR ADV - ALL PLANS | $38.43 | $111.00 | $55.50 | 2026-03-24 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna LifeSource | Transplant Services | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Vaya | Medicaid Tailored Plan | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Aetna | Medicare Advantage | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Aetna | IVL Exchange | $38.43 | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Magellan | Behavioral Health | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Aetna | Transplant Services | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Blue Cross Blue Shield | HPN | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Blue Cross Blue Shield | HMO/PPO | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | HealthTeam | Medicare Advantage | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Wellcare | Medicare Advantage | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna Healthsprings | Medicare Advantage | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Alliance | Medicaid Tailored Plan | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Cigna Healthsprings | Behavioral Health | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Partners | Medicaid Tailored Plan | — | $145.00 | $72.50 | 2025-10-21 | MRF ↗ |
| Davie Medical Center InpatientFacility | Apex | Medicare Advantage | — | $145.00 | $72.50 | 2025-10-21 | 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.