15400 — Pr Skin Xenograft Trnk/arm/leg <100 Sqcm
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PR SKIN XENOGRAFT TRNK/ARM/LEG <100 SQCM (HCPCS 15400) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/15400?code_type=HCPCS
MLA (9th ed.)
“PR SKIN XENOGRAFT TRNK/ARM/LEG <100 SQCM (HCPCS 15400) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/15400?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“PR SKIN XENOGRAFT TRNK/ARM/LEG <100 SQCM (HCPCS 15400) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/15400?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,319–$5,545 (25th–75th percentile) across 391 hospitals · 155 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 15400 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
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 |
|---|---|---|---|---|---|---|---|
| AUBURN COMMUNITY HOSPITAL Outpatient | NYSDOH_1400 | NY MEDICAID CLINIC EPISODE | $22.22 | $1,683.68 | $672.25 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELIS_1400 | FIDELIS CLINIC | $22.22 | $1,683.68 | $672.25 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | UNITED_1400 | UNITED COMMUNITY CLINIC | $23.33 | $1,683.68 | $672.25 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELIS_1402 | FIDELIS EMERGENCY ROOM | $25.44 | $1,683.68 | $672.25 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | NYSDOH_1402 | NY MEDICAID EMERGENCY ROOM | $25.44 | $1,683.68 | $672.25 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | UNITED_1402 | UNITED COMMUNITY EMERGENCY ROOM | $26.71 | $1,683.68 | $672.25 | 2025-01-19 | MRF ↗ |
| LOGAN REGIONAL HOSPITAL OutpatientFacility | None | — | — | — | — | 2026-03-23 | MRF ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELIS-EP_1402 | FIDELIS ESSENTIAL PLAN 1-2 EMERGENCY ROOM | $57.24 | $1,683.68 | $672.25 | 2025-01-19 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Caresource | Wv Marketplace | — | — | — | 2026-05-06 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | NYSDOH_1401 | NY MEDICAID AMBULATORY SURGERY | $108.48 | $1,683.68 | $672.25 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELIS_1401 | FIDELIS AMBULATORY SURGERY | $108.48 | $1,683.68 | $672.25 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | UNITED_1401 | UNITED COMMUNITY AMBULATORY SURGERY | $113.90 | $1,683.68 | $672.25 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | UNITED-EP/CHP_1401 | UNITED ESSENTIAL-CHIP AMBULATORY SURGERY | $113.90 | $1,683.68 | $672.25 | 2025-01-19 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Aetna | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Aetna | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | United Healthcare | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Healthnet | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Great West Other Plans | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Blue Cross Blue Shield Of Ca | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Nordian Healthcare Solutions | Medicare Advantage | $126.00 | $1,834.32 | $1,284.02 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Coventry | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Innovative Integrated Health | Medicare Advantage | — | $1,834.32 | $1,284.02 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Blue Cross Blue Shield Of Ca | Medicare Advantage | — | $1,834.32 | $1,284.02 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Great West Other Plans | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Healthnet | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Universal Care | Medicare Advantage | — | $1,834.32 | $1,284.02 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Blue Cross Blue Shield Of Ca | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Universal Care | Managed Medicaid | — | $1,834.32 | $1,284.02 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | United Healthcare | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Great West Ppo | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Universal Care | Managed Medicaid | — | $1,834.32 | $1,284.02 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Great West Ppo | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Innovative Integrated Health | Medicare Advantage | — | $1,834.32 | $1,284.02 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Interplan | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Interplan | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Nordian Healthcare Solutions | Medicare Advantage | $126.00 | $1,834.32 | $1,284.02 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Universal Care | Medicare Advantage | — | $1,834.32 | $1,284.02 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Blue Cross Blue Shield Of Ca | Medicare Advantage | — | $1,834.32 | $1,284.02 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Coventry | Commercial | — | $1,834.32 | $1,284.02 | 2026-05-22 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | ChoiceCare Network | Commercial | $160.00 | $667.00 | $667.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Superior HealthPlan | Commercial | $160.00 | $667.00 | $667.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Amerigroup | Children's Health Insurance Program | $160.00 | $667.00 | $667.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Amerigroup | Medicare Advantage | $160.00 | $667.00 | $667.00 | 2025-07-03 | MRF ↗ |
| ARBUCKLE MEMORIAL HOSPITAL Outpatient | Medica | Commercial | $167.00 | $307.00 | $246.00 | 2026-05-22 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Connecticut General Cigna | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | GEHA Multiplan Network | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Primewell Vantage Health Plan | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Private Healthcare Systems PHCS | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicare A MS JH | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Blue Cross Blue Shield of MS INST | Default | $170.00 | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Advanced Health | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Multiplan Inc. for American Family | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicaid Mississippi | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | UHC Community Plan MS | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Magnolia Health Plan MCD Rep | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicare B MS JH | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | First Choice Health Network | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Mississippi Physicians Care Network | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Mississippi Select Health Care | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | MCD | $172.41 | — | — | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | CHIP | $172.41 | — | — | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | MCD | $172.41 | — | — | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Amerigroup | CHIP | $172.41 | — | — | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Amerigroup | MCD | $172.41 | — | — | 2026-03-01 | MRF ↗ |
| ST DAVID'S MEDICAL CENTER Outpatient | Amerigroup | MCD | $172.41 | — | — | 2026-03-01 | MRF ↗ |
| ST DAVID'S MEDICAL CENTER Outpatient | Amerigroup | CHIP | $172.41 | — | — | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | CHIP | $172.41 | — | — | 2026-03-01 | MRF ↗ |
| HEART HOSPITAL OF AUSTIN Outpatient | Amerigroup | MCD | $172.41 | — | — | 2026-03-01 | MRF ↗ |
| HEART HOSPITAL OF AUSTIN Outpatient | Amerigroup | CHIP | $172.41 | — | — | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | Amerigroup | CHIP | $172.41 | — | — | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | Amerigroup | MCD | $172.41 | — | — | 2026-03-01 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | UHC-ALL PLANS | UHC-ALL PLANS | $184.00 | $1,575.00 | $1,023.75 | 2025-12-29 | MRF ↗ |
| THE NEBRASKA MEDICAL CENTER Outpatient | UHC-ALL PLANS | UHC-ALL PLANS | $184.00 | $1,575.00 | $1,023.75 | 2026-01-05 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Wellpoint | Commercial | $216.00 | $667.00 | $667.00 | 2025-07-03 | MRF ↗ |
| ARBUCKLE MEMORIAL HOSPITAL Outpatient | Aetna | Commercial | $230.00 | $307.00 | $246.00 | 2026-05-22 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELIS-EP_1401 | FIDELIS ESSENTIAL PLAN 1-2 AMBULATORY SURGERY | $244.08 | $1,683.68 | $672.25 | 2025-01-19 | MRF ↗ |
| ARBUCKLE MEMORIAL HOSPITAL Outpatient | MultiPlan | Commercial | $246.00 | $307.00 | $246.00 | 2026-05-22 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Curative | Commercial | $250.00 | $667.00 | $667.00 | 2025-07-03 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $253.38 | — | — | 2026-05-06 | MRF ↗ |
| ARBUCKLE MEMORIAL HOSPITAL Outpatient | OK Health Network | Commercial | $276.00 | $307.00 | $246.00 | 2026-05-22 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Outpatient | SEIU1199 | Local 1199 | $300.75 | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Outpatient | Magnacare | Standard | — | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Outpatient | Magnacare | Preferred | — | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Outpatient | Magnacare | JIB | — | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Outpatient | Emblem | GHI Access Network | — | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Outpatient | Centivo | Centivo Network | — | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Outpatient | Multiplan | Multiplan | — | — | — | 2026-04-01 | MRF ↗ |
| ARBUCKLE MEMORIAL HOSPITAL Outpatient | Health Choice Network | Commercial | $307.00 | $307.00 | $246.00 | 2026-05-22 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Hmo | $330.84 | — | — | 2026-05-06 | MRF ↗ |
| ASCENSION ST JOHN BROKEN ARROW Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $379.39 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST JOHN SAPULPA Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $379.39 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST JOHN BROKEN ARROW Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $379.39 | — | — | 2026-01-01 | MRF ↗ |
| ST JOHN OWASSO Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $379.39 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST JOHN SAPULPA Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $379.39 | — | — | 2026-01-01 | MRF ↗ |
| ST JOHN OWASSO Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $379.39 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST JOHN JANE PHILLIPS Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $379.39 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST JOHN MEDICAL CENTER Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $379.39 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST JOHN MEDICAL CENTER Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $379.39 | — | — | 2026-01-01 | MRF ↗ |
| HENRY FORD HEALTH ST JOHN HOSPITAL Outpatient | PPOM | 934_PPOM 20191001 | $397.34 | — | — | 2026-01-01 | MRF ↗ |
| Henry Ford Health Warren Hospital Outpatient | PPOM | 934_PPOM 20191001 | $397.34 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION RIVER DISTRICT HOSPITAL Outpatient | PPOM | 934_PPOM 20191001 | $397.34 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION PROVIDENCE HOSPITAL, SOUTHFIELD AND NOVI Outpatient | PPOM | 934_PPOM 20191001 | $397.34 | — | — | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | PPOM | 934_PPOM 20191001 | $397.34 | — | — | 2026-01-01 | MRF ↗ |
| JACOBI MEDICAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| KINGS COUNTY HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| NYACK HOSPITAL Outpatient | Cigna | Commercial | — | — | — | 2026-04-01 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| MOUNT SINAI WEST OutpatientFacility | Local 1199 | 1199 Seiu - Slw | $401.00 | — | — | 2026-04-01 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | Local 1199 | 1199 Seiu - Msq | $401.00 | — | — | 2026-04-01 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | Local 1199 | 1199 Seiu - Brook | $401.00 | — | — | 2026-04-01 | MRF ↗ |
| QUEENS HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| WOODHULL MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Local 1199 | Commercial PPO | $401.00 | — | — | 2026-04-01 | MRF ↗ |
| RICHMOND UNIVERSITY MEDICAL CENTER OutpatientFacility | Local 1199 | Local 1199 | $401.00 | — | — | 2025-08-06 | MRF ↗ |
| MOUNT SINAI HOSPITAL OutpatientFacility | Local 1199 | 1199 Seiu - Tmsh | $401.00 | — | — | 2026-04-01 | MRF ↗ |
| METROPOLITAN HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| NEW YORK COMMUNITY HOSPITAL OF BROOKLYN, INC. OutpatientFacility | Local 1199 | Commercial PPO | $401.00 | — | — | 2026-04-01 | MRF ↗ |
| NYACK HOSPITAL Outpatient | Emblem | GHI Access Network | — | — | — | 2026-04-01 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| MOUNT SINAI WEST OutpatientFacility | Local 1199 | 1199 Seiu - Bi | $401.00 | — | — | 2026-04-01 | MRF ↗ |
| QUEENS HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| KINGS COUNTY HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| HARLEM HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| BELLEVUE HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| METROPOLITAN HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| NY EYE AND EAR INFIRMARY OF MOUNT SINAI OutpatientFacility | 1199 Seiu | 1199 Seiu - Nyeei | $401.00 | — | — | 2026-04-01 | MRF ↗ |
| ELMHURST HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| WOODHULL MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| LINCOLN MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| NYACK HOSPITAL Outpatient | SEIU1199 | SEIU1199 | $401.00 | — | — | 2026-04-01 | MRF ↗ |
| NYACK HOSPITAL Outpatient | Magnacare | Standard | — | — | — | 2026-04-01 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| JACOBI MEDICAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $401.00 | — | — | 2025-09-05 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Outpatient | Blue Cross PAR PPO | PPO | — | $667.00 | $333.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Outpatient | AETNA | Commercial | — | $667.00 | $333.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Outpatient | Blue Cross Open Access HMO | HMO | — | $667.00 | $333.50 | 2025-01-16 | MRF ↗ |
| RIO GRANDE REGIONAL HOSPITAL Outpatient | USA Managed Care | CHIP | $422.00 | — | — | 2026-03-01 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Aetna | Commercial | $434.00 | $667.00 | $667.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Cigna | Commercial | $434.00 | $667.00 | $667.00 | 2025-07-03 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER OutpatientFacility | EBS NETWORK | ALL PRODUCTS | $442.26 | — | — | 2025-06-04 | MRF ↗ |
| MILLER COUNTY HOSPITAL OutpatientFacility | Amerigroup | Managed Care | $446.00 | — | — | 2025-07-08 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | First Health | Commercial | — | $667.00 | $333.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | AETNA | Commercial | — | $667.00 | $333.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | United Healthcare | Commercial | — | $667.00 | $333.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | PHCS | Commercial | — | $667.00 | $333.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | Super Med | Commercial | — | $667.00 | $333.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | CIGNA | Commercial | — | $667.00 | $333.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | CIGNA Healthgram City Employee | Contract | — | $667.00 | $333.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | HUMANA ChoiceCare | Commercial | — | $667.00 | $333.50 | 2025-01-16 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Blue Cross Blue Shield | Blue Advantage | $454.00 | $667.00 | $667.00 | 2025-07-03 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Cigna | Medicare Advantage | $465.62 | — | — | 2025-10-24 | MRF ↗ |
| PALI MOMI MEDICAL CENTER Outpatient | AlohaCare | ABD | $469.71 | — | — | 2026-02-12 | MRF ↗ |
| WILCOX MEMORIAL HOSPITAL Outpatient | AlohaCare | ABD | $469.71 | — | — | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL Outpatient | AlohaCare | ABD | $469.71 | — | — | 2026-02-12 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Blue Cross Blue Shield | Blue Essentials | $474.00 | $667.00 | $667.00 | 2025-07-03 | MRF ↗ |
| PALI MOMI MEDICAL CENTER Outpatient | Ohana Health Plan | Quest ABD | $483.00 | — | — | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL Outpatient | Ohana Health Plan | Quest ABD | $483.00 | — | — | 2026-02-12 | MRF ↗ |
| WILCOX MEMORIAL HOSPITAL Outpatient | Ohana Health Plan | Quest ABD | $483.00 | — | — | 2026-02-12 | MRF ↗ |
| BERGEN NEW BRIDGE MEDICAL CENTER OutpatientFacility | QUALCARE | PPO | $483.80 | — | — | 2025-12-29 | MRF ↗ |
| BERGEN NEW BRIDGE MEDICAL CENTER OutpatientFacility | QUALCARE | HMO | $483.80 | — | — | 2025-12-29 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Blue Cross Blue Shield | Commercial | $500.00 | $667.00 | $667.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Blue Cross Blue Shield | PPO | $500.00 | $667.00 | $667.00 | 2025-07-03 | MRF ↗ |
| THE NEBRASKA MEDICAL CENTER Outpatient | BCBS-ALL PLANS | BCBS-ALL PLANS | $520.80 | $1,041.60 | $677.04 | 2026-01-05 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | BCBS-ALL PLANS | BCBS-ALL PLANS | $520.80 | $1,041.60 | $677.04 | 2025-12-29 | MRF ↗ |
| RENOWN SOUTH MEADOWS MEDICAL CENTER OutpatientFacility | Anthem Blue Cross and Blue Shield | PPO_HMO_EPO | $541.20 | — | — | 2026-03-27 | MRF ↗ |
| RENOWN REGIONAL MEDICAL CENTER OutpatientFacility | Anthem Blue Cross and Blue Shield | PPO_HMO_EPO | $541.20 | — | — | 2026-03-27 | MRF ↗ |
| ASCENSION SETON HAYS Outpatient | TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | $548.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION SETON NORTHWEST Outpatient | TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | $548.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION SETON EDGAR B DAVIS Outpatient | TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | $548.00 | — | — | 2026-01-01 | MRF ↗ |
| DELL SETON MED CENTER AT THE UNIVERSITY OF TX Outpatient | TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | $548.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION SETON SMITHVILLE Outpatient | TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | $548.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION SETON MEDICAL CENTER AUSTIN Outpatient | TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | $548.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION SETON HIGHLAND LAKES Outpatient | TRICARE | 1229_TRICARE CAH OUTPATIENT 20170101 | $548.00 | — | — | 2026-01-01 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Three Rivers Provider Network | Commercial | $567.00 | $667.00 | $667.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | HealthSmart Preferred Care | Commercial | $600.00 | $667.00 | $667.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Health Advantage Network | Commercial | $600.00 | $667.00 | $667.00 | 2025-07-03 | MRF ↗ |
| THE NEBRASKA MEDICAL CENTER Outpatient | AETNA-ALL PLANS | AETNA-ALL PLANS | $645.79 | $1,041.60 | $677.04 | 2026-01-05 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | AETNA-ALL PLANS | AETNA-ALL PLANS | $645.79 | $1,041.60 | $677.04 | 2025-12-29 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Cofinity Group Health | ALL PRODUCTS | $658.48 | — | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Cofinity Group Health | ALL PRODUCTS | $658.48 | — | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Cofinity Group Health | ALL PRODUCTS | $658.48 | — | — | 2025-06-28 | MRF ↗ |
| CORPUS CHRISTI MEDICAL CENTER,THE Outpatient | MultiPlan PHCS | PPO | $677.00 | — | — | 2026-03-01 | MRF ↗ |
| CORPUS CHRISTI MEDICAL CENTER,THE Outpatient | MultiPlan PHCS | PPO | $677.00 | — | — | 2026-03-01 | MRF ↗ |
| CORPUS CHRISTI MEDICAL CENTER,THE Outpatient | MultiPlan PHCS | PPO | $677.00 | — | — | 2026-03-01 | MRF ↗ |
| CORPUS CHRISTI MEDICAL CENTER,THE Outpatient | MultiPlan PHCS | PPO | $677.00 | — | — | 2024-10-01 | MRF ↗ |
| PERRY COUNTY GENERAL HOSPITAL OutpatientFacility | Hattiesburg Clinic | Commercial | $690.00 | — | — | 2026-01-30 | MRF ↗ |
| WALTHALL COUNTY GENERAL HOSPITAL CAH OutpatientFacility | Hattiesburg Clinic | Commercial | $690.00 | — | — | 2026-01-30 | MRF ↗ |
| PERRY COUNTY GENERAL HOSPITAL OutpatientFacility | Hattiesburg Clinic | Commercial | $690.00 | — | — | 2026-01-30 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | USA Managed Care | COMM | $711.00 | — | — | 2026-03-01 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | Prime Health | WORKERSCOMP | $729.90 | — | — | 2024-10-01 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | Prime Health | WORKERSCOMP | $729.90 | — | — | 2024-10-01 | MRF ↗ |
| HCA FLORIDA CAPITAL HOSPITAL Outpatient | Prime Health | WC | $739.80 | — | — | 2024-10-01 | MRF ↗ |
| HCA FLORIDA GULF COAST HOSPITAL Outpatient | Prime Health | WC | $740.70 | — | — | 2024-10-01 | MRF ↗ |
| ST JAMES PARISH HOSPITAL OutpatientFacility | Bcbs | Hmo | $745.07 | — | — | 2026-04-01 | MRF ↗ |
| ST JAMES PARISH HOSPITAL OutpatientFacility | Bcbs | Ppo | $745.07 | — | — | 2026-04-01 | MRF ↗ |
| HCA FLORIDA PUTNAM HOSPITAL Outpatient | Prime Health | WC | $748.80 | — | — | 2024-10-01 | MRF ↗ |
| HCA FLORIDA LAKE CITY HOSPITAL Outpatient | Prime Health | WC | $748.80 | — | — | 2024-10-01 | MRF ↗ |
| HCA FLORIDA RAULERSON HOSPITAL Outpatient | Prime Health | WORKERSCOMP | $748.80 | — | — | 2024-10-01 | 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.