15430 — Apply Acellular Xenograft
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). APPLY ACELLULAR XENOGRAFT (HCPCS 15430) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/15430?code_type=HCPCS
MLA (9th ed.)
“APPLY ACELLULAR XENOGRAFT (HCPCS 15430) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/15430?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“APPLY ACELLULAR XENOGRAFT (HCPCS 15430) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/15430?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,459–$5,545 (25th–75th percentile) across 375 hospitals · 168 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 15430 — 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 |
|---|---|---|---|---|---|---|---|
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | MRF ↗ |
| LOGAN REGIONAL HOSPITAL OutpatientFacility | None | — | — | — | — | 2026-03-23 | MRF ↗ |
| GROVE CREEK MEDICAL CENTER Outpatient | BLUE CROSS - ALL PLANS | BLUE CROSS - ALL PLANS | $72.10 | $103.00 | $72.10 | 2026-02-02 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Caresource | Wv Marketplace | — | — | — | 2026-05-06 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Healthnet | Commercial | — | $1,060.00 | $742.00 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Healthnet | Commercial | — | $1,060.00 | $742.00 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Great West Other Plans | Commercial | — | $1,060.00 | $742.00 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Nordian Healthcare Solutions | Medicare Advantage | $126.00 | $1,060.00 | $742.00 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Aetna | Commercial | — | $1,060.00 | $742.00 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Blue Cross Blue Shield Of Ca | Commercial | — | $1,060.00 | $742.00 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Innovative Integrated Health | Medicare Advantage | — | $1,060.00 | $742.00 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Blue Cross Blue Shield Of Ca | Medicare Advantage | — | $1,060.00 | $742.00 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Blue Cross Blue Shield Of Ca | Commercial | — | $1,060.00 | $742.00 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Innovative Integrated Health | Medicare Advantage | — | $1,060.00 | $742.00 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Universal Care | Medicare Advantage | — | $1,060.00 | $742.00 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Great West Ppo | Commercial | — | $1,060.00 | $742.00 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Universal Care | Medicare Advantage | — | $1,060.00 | $742.00 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Interplan | Commercial | — | $1,060.00 | $742.00 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Great West Other Plans | Commercial | — | $1,060.00 | $742.00 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Interplan | Commercial | — | $1,060.00 | $742.00 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Coventry | Commercial | — | $1,060.00 | $742.00 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Blue Cross Blue Shield Of Ca | Medicare Advantage | — | $1,060.00 | $742.00 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Aetna | Commercial | — | $1,060.00 | $742.00 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | United Healthcare | Commercial | — | $1,060.00 | $742.00 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Great West Ppo | Commercial | — | $1,060.00 | $742.00 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | United Healthcare | Commercial | — | $1,060.00 | $742.00 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Universal Care | Managed Medicaid | — | $1,060.00 | $742.00 | 2026-05-22 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Universal Care | Managed Medicaid | — | $1,060.00 | $742.00 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Coventry | Commercial | — | $1,060.00 | $742.00 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Nordian Healthcare Solutions | Medicare Advantage | $126.00 | $1,060.00 | $742.00 | 2026-05-18 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicaid Mississippi | 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 | Multiplan Inc. for American Family | 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 | First Choice Health Network | 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 | Magnolia Health Plan MCD Rep | 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 ↗ |
| FIELD HEALTH SYSTEM Both | Connecticut General Cigna | 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 | GEHA Multiplan Network | 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 | UHC Community Plan MS | 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 | Advanced Health | Default | — | $1,908.00 | $1,431.00 | 2025-03-07 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | UHC-ALL PLANS | UHC-ALL PLANS | $184.00 | $1,407.00 | $914.55 | 2025-12-29 | MRF ↗ |
| THE NEBRASKA MEDICAL CENTER Outpatient | UHC-ALL PLANS | UHC-ALL PLANS | $184.00 | $1,407.00 | $914.55 | 2026-01-05 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Superior HealthPlan | Commercial | $213.00 | $887.00 | $887.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Amerigroup | Children's Health Insurance Program | $213.00 | $887.00 | $887.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Amerigroup | Medicare Advantage | $213.00 | $887.00 | $887.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | ChoiceCare Network | Commercial | $213.00 | $887.00 | $887.00 | 2025-07-03 | MRF ↗ |
| GROVE CREEK MEDICAL CENTER Outpatient | REGENCE BLUE SHIELD - ALL PLANS | REGENCE BLUE SHIELD - ALL PLANS | $222.38 | $103.00 | $72.10 | 2026-02-02 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Curative | Commercial | $250.00 | $887.00 | $887.00 | 2025-07-03 | MRF ↗ |
| RUSSELL COUNTY HOSPITAL Outpatient | BCBS MCR ADV | BCBS MCR ADV | $265.54 | $781.00 | $624.80 | 2026-03-18 | MRF ↗ |
| RUSSELL COUNTY HOSPITAL Outpatient | DEVOTED - ALL PLANS | DEVOTED - ALL PLANS | $273.51 | $781.00 | $624.80 | 2026-03-18 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Wellpoint | Commercial | $287.00 | $887.00 | $887.00 | 2025-07-03 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $340.10 | — | — | 2026-05-06 | MRF ↗ |
| HEART HOSPITAL OF AUSTIN Outpatient | Amerigroup | CHIP | $348.57 | — | — | 2026-03-01 | MRF ↗ |
| ST DAVID'S MEDICAL CENTER Outpatient | Amerigroup | CHIP | $348.57 | — | — | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | CHIP | $348.57 | — | — | 2026-03-01 | MRF ↗ |
| ST DAVID'S MEDICAL CENTER Outpatient | Amerigroup | MCD | $348.57 | — | — | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | MCD | $348.57 | — | — | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | Amerigroup | MCD | $348.57 | — | — | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | Amerigroup | CHIP | $348.57 | — | — | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | CHIP | $348.57 | — | — | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Amerigroup | MCD | $348.57 | — | — | 2026-03-01 | MRF ↗ |
| HEART HOSPITAL OF AUSTIN Outpatient | Amerigroup | MCD | $348.57 | — | — | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | MCD | $348.57 | — | — | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Amerigroup | CHIP | $348.57 | — | — | 2026-03-01 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Outpatient | Blue Cross Open Access HMO | HMO | — | $567.00 | $283.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Outpatient | AETNA | Commercial | — | $567.00 | $283.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Outpatient | Blue Cross PAR PPO | PPO | — | $567.00 | $283.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | HUMANA ChoiceCare | Commercial | — | $567.00 | $283.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | CIGNA | Commercial | — | $567.00 | $283.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | Super Med | Commercial | — | $567.00 | $283.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | PHCS | Commercial | — | $567.00 | $283.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | CIGNA Healthgram City Employee | Contract | — | $567.00 | $283.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | First Health | Commercial | — | $567.00 | $283.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | AETNA | Commercial | — | $567.00 | $283.50 | 2025-01-16 | MRF ↗ |
| WAYNE MEMORIAL HOSPITAL Inpatient | United Healthcare | Commercial | — | $567.00 | $283.50 | 2025-01-16 | MRF ↗ |
| LARKIN COMMUNITY HOSPITAL Outpatient | CIGNA PPO-ALL OTHER PLANS | CIGNA PPO-ALL OTHER PLANS | $385.25 | $1,541.00 | $1,078.70 | 2025-12-10 | MRF ↗ |
| RIO GRANDE REGIONAL HOSPITAL Outpatient | USA Managed Care | CHIP | $422.00 | — | — | 2026-03-01 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Outpatient | SEIU1199 | Local 1199 | $426.00 | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Outpatient | Magnacare | Standard | — | — | — | 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 | Multiplan | Multiplan | — | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Outpatient | Magnacare | Preferred | — | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Outpatient | Centivo | Centivo Network | — | — | — | 2026-04-01 | MRF ↗ |
| LARKIN COMMUNITY HOSPITAL Outpatient | MOLINA MEDICAID | MOLINA MEDICAID | $462.30 | $1,541.00 | $1,078.70 | 2025-12-10 | MRF ↗ |
| LARKIN COMMUNITY HOSPITAL Outpatient | HUMANA HMO/PPO/POS-ALL OTHER PLANS | HUMANA HMO/PPO/POS-ALL OTHER PLANS | $462.30 | $1,541.00 | $1,078.70 | 2025-12-10 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Amerigroup | Amerigroup Medicaid | $468.16 | — | — | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Amerigroup | Amerigroup Medicaid | $468.16 | — | — | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Amerigroup | Amerigroup Medicaid | $468.16 | — | — | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Amerigroup | Amerigroup Medicaid | $468.16 | — | — | 2026-02-15 | MRF ↗ |
| NORTHSIDE HOSPITAL Outpatient | Amerigroup | Amerigroup Medicaid | $468.16 | — | — | 2026-02-14 | MRF ↗ |
| WILCOX MEMORIAL HOSPITAL Outpatient | AlohaCare | ABD | $469.71 | — | — | 2026-02-12 | MRF ↗ |
| PALI MOMI MEDICAL CENTER Outpatient | AlohaCare | ABD | $469.71 | — | — | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL Outpatient | AlohaCare | ABD | $469.71 | — | — | 2026-02-12 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Hmo | $477.69 | — | — | 2026-05-06 | 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 ↗ |
| PALI MOMI MEDICAL CENTER Outpatient | Ohana Health Plan | Quest ABD | $483.00 | — | — | 2026-02-12 | MRF ↗ |
| HENRY FORD HEALTH ST JOHN HOSPITAL Outpatient | PPOM | 934_PPOM 20191001 | $489.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION PROVIDENCE HOSPITAL, SOUTHFIELD AND NOVI Outpatient | PPOM | 934_PPOM 20191001 | $489.27 | — | — | 2026-01-01 | MRF ↗ |
| Ascension Macomb-Oakland Hospital Madison Heights Campus Outpatient | PPOM | 934_PPOM 20191001 | $489.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION RIVER DISTRICT HOSPITAL Outpatient | PPOM | 934_PPOM 20191001 | $489.27 | — | — | 2026-01-01 | MRF ↗ |
| Henry Ford Health Warren Hospital Outpatient | PPOM | 934_PPOM 20191001 | $489.27 | — | — | 2026-01-01 | MRF ↗ |
| RUSSELL COUNTY HOSPITAL Outpatient | BCBS PATHWAY | BCBS PATHWAY | $495.54 | $781.00 | $624.80 | 2026-03-18 | MRF ↗ |
| ASCENSION ST JOHN MEDICAL CENTER Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $536.16 | — | — | 2026-01-01 | MRF ↗ |
| ST JOHN OWASSO Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $536.16 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST JOHN JANE PHILLIPS Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $536.16 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST JOHN SAPULPA Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $536.16 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST JOHN BROKEN ARROW Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $536.16 | — | — | 2026-01-01 | MRF ↗ |
| ST JOHN OWASSO Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $536.16 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST JOHN SAPULPA Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $536.16 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST JOHN MEDICAL CENTER Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $536.16 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST JOHN BROKEN ARROW Both | FIRST HEALTH | 2649_BAOK, JPOK, MCOK, OHOK FIRST HEALTH 20241001 | $536.16 | — | — | 2026-01-01 | MRF ↗ |
| RUSSELL COUNTY HOSPITAL Outpatient | HUMANA-ALL PLANS | HUMANA-ALL PLANS | $546.70 | $781.00 | $624.80 | 2026-03-18 | MRF ↗ |
| RUSSELL COUNTY HOSPITAL Outpatient | BCBS PPO/HMO | BCBS PPO/HMO | $550.61 | $781.00 | $624.80 | 2026-03-18 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | BCBS-ALL PLANS | BCBS-ALL PLANS | $565.00 | $1,130.00 | $734.50 | 2025-12-29 | MRF ↗ |
| THE NEBRASKA MEDICAL CENTER Outpatient | BCBS-ALL PLANS | BCBS-ALL PLANS | $565.00 | $1,130.00 | $734.50 | 2026-01-05 | MRF ↗ |
| MOUNT SINAI HOSPITAL OutpatientFacility | Local 1199 | 1199 Seiu - Tmsh | $568.00 | — | — | 2026-04-01 | MRF ↗ |
| NYACK HOSPITAL Outpatient | Cigna | Commercial | — | — | — | 2026-04-01 | MRF ↗ |
| WOODHULL MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| MOUNT SINAI WEST OutpatientFacility | Local 1199 | 1199 Seiu - Bi | $568.00 | — | — | 2026-04-01 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | Local 1199 | 1199 Seiu - Brook | $568.00 | — | — | 2026-04-01 | MRF ↗ |
| NYACK HOSPITAL Outpatient | Magnacare | Standard | — | — | — | 2026-04-01 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | Local 1199 | 1199 Seiu - Msq | $568.00 | — | — | 2026-04-01 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| MOUNT SINAI WEST OutpatientFacility | Local 1199 | 1199 Seiu - Slw | $568.00 | — | — | 2026-04-01 | MRF ↗ |
| NYACK HOSPITAL Outpatient | Emblem | GHI Access Network | — | — | — | 2026-04-01 | MRF ↗ |
| NYACK HOSPITAL Outpatient | SEIU1199 | SEIU1199 | $568.00 | — | — | 2026-04-01 | MRF ↗ |
| ELMHURST HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| JACOBI MEDICAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| NEW YORK COMMUNITY HOSPITAL OF BROOKLYN, INC. OutpatientFacility | Local 1199 | Commercial PPO | $568.00 | — | — | 2026-04-01 | MRF ↗ |
| HARLEM HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| KINGS COUNTY HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| BELLEVUE HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| RICHMOND UNIVERSITY MEDICAL CENTER OutpatientFacility | Local 1199 | Local 1199 | $568.00 | — | — | 2025-08-06 | MRF ↗ |
| NY EYE AND EAR INFIRMARY OF MOUNT SINAI OutpatientFacility | 1199 Seiu | 1199 Seiu - Nyeei | $568.00 | — | — | 2026-04-01 | MRF ↗ |
| METROPOLITAN HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| QUEENS HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| KINGS COUNTY HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| WOODHULL MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| QUEENS HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| JACOBI MEDICAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| METROPOLITAN HOSPITAL CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| LINCOLN MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | Local 1199 | ALL PRODUCTS | $568.00 | — | — | 2025-09-05 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Local 1199 | Commercial PPO | $568.00 | — | — | 2026-04-01 | MRF ↗ |
| RIVERLAND MEDICAL CENTER Both | Medicare A LA JH | Default | $570.48 | $2,772.00 | $1,386.00 | 2024-10-24 | MRF ↗ |
| RIVERLAND MEDICAL CENTER Both | Medicare B LA JH | Default | — | $2,772.00 | $1,386.00 | 2024-10-24 | MRF ↗ |
| RIVERLAND MEDICAL CENTER Both | Aetna | Default | $570.48 | $2,772.00 | $1,386.00 | 2024-10-24 | MRF ↗ |
| RUSSELL COUNTY HOSPITAL Outpatient | UHC-ALL PLANS | UHC-ALL PLANS | $574.04 | $781.00 | $624.80 | 2026-03-18 | MRF ↗ |
| RIVERLAND MEDICAL CENTER Both | Humana Advantage Care Plans Med Advantage | Default | $576.18 | $2,772.00 | $1,386.00 | 2024-10-24 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Aetna | Commercial | $577.00 | $887.00 | $887.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Cigna | Commercial | $577.00 | $887.00 | $887.00 | 2025-07-03 | MRF ↗ |
| RIVERLAND MEDICAL CENTER Both | VA Community Care Network VACCN Region 1-3 Triwest | Default | $582.12 | $2,772.00 | $1,386.00 | 2024-10-24 | MRF ↗ |
| RIVERLAND MEDICAL CENTER Both | Dignity Health Plan DOS lt 01012023 | Default | $599.01 | $2,772.00 | $1,386.00 | 2024-10-24 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Blue Cross Blue Shield | Blue Advantage | $603.00 | $887.00 | $887.00 | 2025-07-03 | MRF ↗ |
| LARKIN COMMUNITY HOSPITAL Outpatient | STAR NETWORK-ALL PLANS | STAR NETWORK-ALL PLANS | $616.40 | $1,541.00 | $1,078.70 | 2025-12-10 | MRF ↗ |
| RUSSELL COUNTY HOSPITAL Outpatient | RCH FIRST HEALTH-ALL PLANS | RCH FIRST HEALTH-ALL PLANS | $624.80 | $781.00 | $624.80 | 2026-03-18 | MRF ↗ |
| RUSSELL COUNTY HOSPITAL Outpatient | BCBS TRAD-ALL OTHER PLANS | BCBS TRAD-ALL OTHER PLANS | $624.80 | $781.00 | $624.80 | 2026-03-18 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Blue Cross Blue Shield | Blue Essentials | $630.00 | $887.00 | $887.00 | 2025-07-03 | MRF ↗ |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER OutpatientFacility | EBS NETWORK | ALL PRODUCTS | $637.02 | — | — | 2025-06-04 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Blue Cross Blue Shield | Commercial | $665.00 | $887.00 | $887.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Blue Cross Blue Shield | PPO | $665.00 | $887.00 | $887.00 | 2025-07-03 | MRF ↗ |
| BERGEN NEW BRIDGE MEDICAL CENTER OutpatientFacility | QUALCARE | HMO | $674.95 | — | — | 2025-12-29 | MRF ↗ |
| BERGEN NEW BRIDGE MEDICAL CENTER OutpatientFacility | QUALCARE | PPO | $674.95 | — | — | 2025-12-29 | 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 ↗ |
| 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 ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Cigna | Medicare Advantage | $689.13 | — | — | 2025-10-24 | 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 ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | AETNA-ALL PLANS | AETNA-ALL PLANS | $700.60 | $1,130.00 | $734.50 | 2025-12-29 | MRF ↗ |
| THE NEBRASKA MEDICAL CENTER Outpatient | AETNA-ALL PLANS | AETNA-ALL PLANS | $700.60 | $1,130.00 | $734.50 | 2026-01-05 | 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 ↗ |
| RIVERLAND MEDICAL CENTER Both | Healthy Blue Community Care of LA MCD | Default | $744.56 | $2,772.00 | $1,386.00 | 2024-10-24 | MRF ↗ |
| ST JAMES PARISH HOSPITAL OutpatientFacility | Bcbs | Ppo | $745.07 | — | — | 2026-04-01 | MRF ↗ |
| ST JAMES PARISH HOSPITAL OutpatientFacility | Bcbs | Hmo | $745.07 | — | — | 2026-04-01 | MRF ↗ |
| RIVERLAND MEDICAL CENTER Both | Medicaid Louisiana IP OP | Default | $747.33 | $2,772.00 | $1,386.00 | 2024-10-24 | MRF ↗ |
| HCA FLORIDA LAKE CITY HOSPITAL Outpatient | Prime Health | WC | $748.80 | — | — | 2024-10-01 | MRF ↗ |
| HCA FLORIDA PUTNAM 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 ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Three Rivers Provider Network | Commercial | $754.00 | $887.00 | $887.00 | 2025-07-03 | MRF ↗ |
| ASCENSION PROVIDENCE Outpatient | FIRSTCARE FOCUS NETWORK | 130_FIRSTCARE FOCUS NETWORK 20131001 | $758.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION PROVIDENCE Outpatient | FIRSTCARE FOCUS NETWORK | 130_FIRSTCARE FOCUS NETWORK 20131001 | $758.25 | — | — | 2026-01-01 | MRF ↗ |
| MARION COMMUNTIY HOSPITAL Outpatient | Prime Health | WC | $758.70 | — | — | 2024-10-01 | MRF ↗ |
| HCA FLORIDA WEST HOSPITAL Outpatient | Prime Health | WC | $765.00 | — | — | 2024-10-01 | MRF ↗ |
| LARKIN COMMUNITY HOSPITAL BEHAVIORAL HEALTH SRVS Outpatient | FCC MEDICAID | FCC MEDICAID | $770.50 | $1,541.00 | $1,078.70 | 2025-12-16 | 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.