12047 — Intmd Rpr N-hf/genit >30.0cm
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). INTMD RPR N-HF/GENIT >30.0CM (HCPCS 12047) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/12047?code_type=HCPCS
MLA (9th ed.)
“INTMD RPR N-HF/GENIT >30.0CM (HCPCS 12047) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/12047?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“INTMD RPR N-HF/GENIT >30.0CM (HCPCS 12047) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/12047?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $890–$2,794 (25th–75th percentile) across 1,961 hospitals · 5,900 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 12047 — 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
$890
$1,847 typical
$2,794
The middle 50% of negotiated facility rates for this procedure, measured across 1,961 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. | $1,847 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $346 × 1.22 commercial. | $422 |
| Likely subtotal | $2,269 |
Surgical episode (typical)
~$2,269
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)
~$6,054
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 | — | — | 2026-02-28 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $6.60 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $7.19 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $7.23 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $7.23 | — | — | 2026-03-18 | MRF ↗ |
| WASHINGTON COUNTY HOSPITAL Outpatient | Alabama Medicaid | PPO | $10.00 | $10.00 | $4.00 | 2025-05-21 | MRF ↗ |
| OTTAWA COUNTY HEALTH CENTER Outpatient | CHOICECARE MCR ADV - ALL PLANS | CHOICECARE MCR ADV - ALL PLANS | $10.13 | $750.00 | $750.00 | 2026-03-09 | MRF ↗ |
| COMANCHE COUNTY MEDICAL CENTER Outpatient | MPI - ALL PLANS | MPI - ALL PLANS | $11.14 | $633.00 | $411.45 | 2026-05-07 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $13.03 | $1,252.50 | $1,252.50 | 2026-04-24 | MRF ↗ |
| MORRIS HOSPITAL & HEALTHCARE CENTERS Outpatient | CATERPILLAR - ALL PLANS | CATERPILLAR - ALL PLANS | $14.40 | $32.00 | $7.70 | 2026-05-07 | MRF ↗ |
| MORRIS HOSPITAL & HEALTHCARE CENTERS Outpatient | CAPP CARE PPO-OTH | CAPP CARE PPO-OTH | $15.36 | $32.00 | $7.70 | 2026-05-07 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $18.40 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Aetna | Aetna Better Health CHIP | $18.40 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $18.40 | — | — | 2026-04-14 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $19.00 | $1,491.00 | $1,491.00 | 2025-10-04 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | CCIPA MEDI-CAL - ALL PLANS | CCIPA MEDI-CAL - ALL PLANS | $19.00 | $1,201.00 | $228.19 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $19.00 | $1,201.00 | $228.19 | 2026-01-31 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $19.00 | $1,491.00 | $1,491.00 | 2025-10-04 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | $19.00 | $1,201.00 | $228.19 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | HEALTHNET MEDI-CAL | HEALTHNET MEDI-CAL | $19.00 | $1,201.00 | $228.19 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | MEDI-CAL | MEDI-CAL | $19.00 | $1,201.00 | $228.19 | 2026-01-31 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $19.32 | — | — | 2026-04-14 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $19.38 | $1,491.00 | $1,491.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $19.38 | $1,491.00 | $1,491.00 | 2025-10-04 | MRF ↗ |
| WASHINGTON COUNTY HOSPITAL Outpatient | Alabama Medicaid | PPO | $19.71 | $19.71 | $7.88 | 2025-05-21 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | GEISINGER | MANAGED MEDICAID | $20.24 | — | — | 2025-08-01 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $20.24 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $20.24 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $20.24 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $20.24 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | GEISINGER | MANAGED MEDICAID | $20.24 | — | — | 2025-08-01 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $20.24 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $20.24 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | CHIP | $21.16 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $21.16 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | CHIP | $21.16 | — | — | 2025-08-01 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $21.16 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $21.16 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $21.16 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $21.16 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $21.16 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $21.16 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $21.16 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | CHIP | $21.16 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $21.16 | — | — | 2025-08-01 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $21.16 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $21.16 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $21.16 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | GEISINGER | MANAGED MEDICAID | $21.90 | — | — | 2025-08-01 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $22.08 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $22.08 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $22.08 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $22.08 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $22.63 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MANAGED MEDICAID | $23.00 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MANAGED MEDICAID | $23.00 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | GEISINGER | MANAGED MEDICAID | $23.00 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $23.37 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $23.37 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $23.37 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $23.37 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $23.37 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $23.37 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AETNA | MANAGED MEDICAID | $23.92 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AETNA | MANAGED MEDICAID | $23.92 | — | — | 2025-08-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $24.29 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $24.29 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $24.29 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $24.29 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $24.29 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $24.29 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $24.29 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $24.29 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $24.29 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $24.29 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $24.29 | — | — | 2026-04-14 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $24.70 | $1,491.00 | $1,491.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $24.70 | $1,491.00 | $1,491.00 | 2025-10-04 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $24.84 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $24.84 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $24.84 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $24.84 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $24.84 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $24.84 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $24.84 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $24.84 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $24.84 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $24.84 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $24.84 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $24.84 | — | — | 2025-08-01 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $25.39 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $25.39 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $25.39 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $25.39 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $25.39 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $25.39 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $25.39 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $25.39 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $25.39 | — | — | 2026-04-14 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | MANAGED MEDICAID | $26.67 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | MANAGED MEDICAID | $26.67 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AETNA | MANAGED MEDICAID | $26.67 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | AETNA | MANAGED MEDICAID | $26.67 | — | — | 2025-08-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $26.68 | — | — | 2025-08-01 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $26.68 | — | — | 2025-08-01 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Geisinger | Geisinger CHIP | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | United Healthcare | United Healthcare Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Geisinger | Geisinger CHIP | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | United Healthcare | United Healthcare Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Geisinger | Geisinger Medicaid HC | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $26.68 | — | — | 2025-08-01 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Geisinger | Geisinger Medicaid HC | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | KEYSTONE FIRST | MANAGED MEDICAID | $26.68 | — | — | 2025-08-01 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Geisinger | Geisinger CHIP | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | United Healthcare | United Healthcare Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Geisinger | Geisinger Medicaid HC | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $26.68 | — | — | 2026-04-14 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | LA Care Health | Medi-cal | $27.00 | — | — | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Physicians Medical Group | MCD | $27.00 | — | — | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Molina | MCD | $27.00 | — | — | 2024-10-01 | MRF ↗ |
| MORRIS HOSPITAL & HEALTHCARE CENTERS Outpatient | HFN ALL PLANS - ALL PLANS | HFN ALL PLANS - ALL PLANS | $27.20 | $32.00 | $7.70 | 2026-05-07 | MRF ↗ |
| Riverside Community Hospital Outpatient | LA Care Health | Medi-cal | $27.25 | — | — | 2026-03-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | Molina | MCD | $27.25 | — | — | 2026-03-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $27.60 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $27.60 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $27.60 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $27.60 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $27.60 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $27.60 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $27.60 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $27.60 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $27.60 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $27.60 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $27.60 | — | — | 2026-04-14 | 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.