15877 — Suction Lipectomy Trunk
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). SUCTION LIPECTOMY TRUNK (HCPCS 15877) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/15877?code_type=HCPCS
MLA (9th ed.)
“SUCTION LIPECTOMY TRUNK (HCPCS 15877) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/15877?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“SUCTION LIPECTOMY TRUNK (HCPCS 15877) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/15877?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,418–$6,689 (25th–75th percentile) across 1,588 hospitals · 2,981 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 15877 — 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 |
|---|---|---|---|---|---|---|---|
| Highsmith Rainey Memorial Hospital Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $1.00 | $0.60 | 2026-05-17 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | GRANTS [20507] | All TB GETCHELL [226] Plans | $6.52 | $50,610.00 | $50,610.00 | 2025-12-08 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $7.30 | — | $5,184.35 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $7.30 | — | $5,184.35 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $7.30 | — | $5,184.35 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $7.30 | — | $5,184.35 | 2026-03-31 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP OPTION|MVP CHILD HEALTH PLUS | $7.58 | $11,419.15 | $9,135.32 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 1&2|MVP ESSENTIAL 3&4 | $7.58 | $11,419.15 | $9,135.32 | 2024-12-30 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | FALLON MEDICAID [10904] | All FALLON MCO MH [225] Plans | $7.59 | $50,610.00 | $50,609.96 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | INSTITUTION [10406] | All WORCESTER RECOVERY MH [234] Plans | $7.59 | $50,610.00 | $50,609.96 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER MH [123] Plans | $7.59 | $50,610.00 | $50,609.96 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) MH [8] Plans | $7.59 | $50,610.00 | $50,609.96 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | MASSHEALTH [20302] | All MASSHEALTH MH [90] Plans | $7.59 | $50,610.00 | $50,609.96 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | HNE MEDICAID [10905] | All HEALTH NEW ENGLAND/MINUTEMAN MCO MH [221] Plans | $7.59 | $50,610.00 | $50,609.96 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | MGB MEDICAID [10906] | All MGB (FORMERLY AHP) ACO MH [202] Plans | $7.59 | $50,610.00 | $50,609.96 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | FALLON MEDICAID [10904] | All FALLON ACO MH [80] Plans | $7.59 | $50,610.00 | $50,609.96 | 2025-12-08 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP EXCHANGE-INDIVIDUAL | $8.09 | $11,419.15 | $9,135.32 | 2024-12-30 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE SPECIAL KIDS (FORMERLY BMC) MH [256] Plans | $9.49 | $50,610.00 | $50,609.96 | 2025-12-08 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $12.87 | $7,150.00 | $3,571.58 | 2024-12-31 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Consumer Life | Commercial | — | $68.80 | $57.79 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Anthem | Ppo Hmo Exchange | — | $68.80 | $57.79 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Care Improvement Plus | Medicare Advantage | — | $68.80 | $57.79 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Humana Healthnet | Tricare | — | $68.80 | $57.79 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Aetna | Medicare Advantage | — | $68.80 | $57.79 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Coventry | Commercial | — | $68.80 | $57.79 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Encore | Ppo | — | $68.80 | $57.79 | 2026-05-09 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $22.12 | — | $9,638.95 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $22.12 | — | $9,638.95 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $22.12 | — | $9,638.95 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $22.12 | — | $9,638.95 | 2026-03-31 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MOLINA [1071] | MOLINA MICHILD [107101] | $37.50 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MOLINA HEALTH CARE [9008] | MOLINA HEALTH CARE [900801] | $37.50 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | FALLON CONNECTORCARE [10503] | All FALLON HMO MH [107] Plans | $47.00 | $50,610.00 | $50,609.96 | 2025-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Health Options Inc | Bcbs Health Options Medicare | $56.93 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Medicare Ppo | $56.93 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| MERCYONE CLINTON MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $65.31 | — | $54,263.33 | 2026-03-31 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Careplus | Careplus | $71.91 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| TOMAH MEMORIAL HOSPITAL Outpatient | BCBS COMM - ALL OTHER PLANS | BCBS COMM - ALL OTHER PLANS | $77.00 | $4,925.00 | $2,831.88 | 2026-03-03 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | MIDLANDS CHOICE-ALL PLANS | MIDLANDS CHOICE-ALL PLANS | $80.09 | $1,968.80 | $1,279.72 | 2025-12-29 | MRF ↗ |
| THE NEBRASKA MEDICAL CENTER Outpatient | MIDLANDS CHOICE-ALL PLANS | MIDLANDS CHOICE-ALL PLANS | $80.09 | $1,968.80 | $1,279.72 | 2026-01-05 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Aetna Health | Aetna Medicare | $89.89 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | PRIORITY HEALTH PLAN [1051] | PRIORITY HEALTH HMA [105104] | $92.38 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | PRIORITY HEALTH PLAN [1051] | PRIORITY HEALTH PLAN [105101] | $92.38 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | PRIORITY HEALTH PLAN [1051] | PRIORITY HEALTH 853923 [105103] | $92.38 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | PRIORITY HEALTH PLAN [1051] | PRIORITY HEALTH [105102] | $92.38 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | CIGNA [1013] | CIGNA 55270 [101303] | $92.38 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | CIGNA [1013] | CIGNA 188017 [101305] | $92.38 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | CIGNA [1013] | CIGNA PRIORITY HEALTH [101308] | $92.38 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | CIGNA [1013] | CIGNA [101307] | $92.38 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | CIGNA [1013] | CIGNA TOTAL CHOICE MEDICARE SUPPLEMENTAL [101310] | $92.38 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | CIGNA [1013] | CIGNA EXPATRIOT BENEFITS [101304] | $92.38 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | CIGNA [1013] | CIGNA MEDICARE SUPPLEMENTAL [101309] | $92.38 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | CIGNA [1013] | CIGNA 182223 [101302] | $92.38 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| SOUTH PENINSULA HOSPITAL Outpatient | PREMERA FIRST - ALL PLANS | PREMERA FIRST - ALL PLANS | $95.00 | $2,200.00 | $1,650.00 | 2026-05-11 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Aetna Better Health Ky | Managed Care Medicaid Plan | $108.64 | $5,830.00 | $2,973.30 | 2026-05-09 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | CIGNA [1013] | CIGNA EXPATRIOT BENEFITS [101304] | $108.68 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | PRIORITY HEALTH PLAN [1051] | PRIORITY HEALTH [105102] | $108.68 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | PRIORITY HEALTH PLAN [1051] | PRIORITY HEALTH PLAN [105101] | $108.68 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | PRIORITY HEALTH PLAN [1051] | PRIORITY HEALTH 853923 [105103] | $108.68 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | CIGNA [1013] | CIGNA MEDICARE SUPPLEMENTAL [101309] | $108.68 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | PRIORITY HEALTH PLAN [1051] | PRIORITY HEALTH HMA [105104] | $108.68 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | CIGNA [1013] | CIGNA PRIORITY HEALTH [101308] | $108.68 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | CIGNA [1013] | CIGNA 182223 [101302] | $108.68 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | CIGNA [1013] | CIGNA 188017 [101305] | $108.68 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | CIGNA [1013] | CIGNA TOTAL CHOICE MEDICARE SUPPLEMENTAL [101310] | $108.68 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | CIGNA [1013] | CIGNA [101307] | $108.68 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | CIGNA [1013] | CIGNA 55270 [101303] | $108.68 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Wellcare Ky | Managed Care Medicaid Plan | $114.07 | $5,830.00 | $2,973.30 | 2026-05-09 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Humana Ky | Managed Care Medicaid Plan | $114.07 | $5,830.00 | $2,973.30 | 2026-05-09 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | United Health Care Ky | Managed Care Medicaid Plan | $114.62 | $5,830.00 | $2,973.30 | 2026-05-09 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS BH PARTNERSHIP [70098] | CHA HB MBHP SOMERVILLE | $117.90 | $7,201.00 | $7,201.00 | 2026-03-20 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Aetna | All Non-Gatekeeper Plans | $121.99 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Aetna | All Gatekeeper Plans | $121.99 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Aetna | All Gatekeeper Plans | $121.99 | — | — | 2026-03-18 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Aetna | All Non-Gatekeeper Plans | $121.99 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Aetna | All Non-Gatekeeper Plans | $121.99 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Aetna | All Non-Gatekeeper Plans | $121.99 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Aetna | All Gatekeeper Plans | $121.99 | — | — | 2026-03-18 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Aetna | All Gatekeeper Plans | $121.99 | — | — | 2026-03-18 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Msmc | Cigna | $125.85 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Humana | Humana Humx | $128.85 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Medicaid Hmo Apr Drg | Medicaid Hmo Apr Drg | $129.72 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Oscar Health (Hie) | Oscar Health (Hie) | $134.84 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Dimension Health | Dimension Plus | $134.84 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan – Hmo | $136.00 | — | — | 2026-03-01 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan | $136.00 | — | — | 2026-03-01 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Magellan Complete Care | Magellan Complete Care | $138.80 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Aetna Health | Aetna Workers Comp | $140.83 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| ST CLAIRE REGIONAL MEDICAL CENTER Outpatient | AETNA BETTER HEALTH-ALL PLANS | AETNA BETTER HEALTH-ALL PLANS | $144.85 | $2,566.00 | $1,924.50 | 2026-02-02 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Aetna Better Health Ky | Managed Care Medicaid Plan | $144.85 | $5,830.00 | $2,973.30 | 2026-05-09 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Passport Ky | Managed Care Medicaid Plan | $150.64 | $5,830.00 | $2,973.30 | 2026-05-09 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Humana Ky | Managed Care Medicaid Plan | $152.09 | $5,830.00 | $2,973.30 | 2026-05-09 | MRF ↗ |
| ST CLAIRE REGIONAL MEDICAL CENTER Outpatient | BEACON BH - ALL PLANS | BEACON BH - ALL PLANS | $152.09 | $2,566.00 | $1,924.50 | 2026-02-02 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Wellcare Ky | Managed Care Medicaid Plan | $152.09 | $5,830.00 | $2,973.30 | 2026-05-09 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | United Health Care Ky | Managed Care Medicaid Plan | $152.82 | $5,830.00 | $2,973.30 | 2026-05-09 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS CARE NEW YORK [112] | FIDELIS CARE NEW YORK|FIDELIS FHP|FIDELIS CHP | — | $13,788.76 | $8,962.69 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS(INCLUDING GOLD,SILVER,BRONZE AND PLATINUM) | — | $13,788.76 | $8,962.69 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN|UHC COMMUNITY MEDICAID DENTAL|UHC ESSENTIAL 1&2|UHC CHPS|UHC ESSENTIAL 3&4 | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MH OPTUM [170] | MH OPTUM COMMUNITY | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS ESSENTIAL 1&2|FIDELIS ESSENTIAL 3&4 | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC MEDICARE COMPLETE | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK MEDICARE | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | AETNA [100] | AETNA MEDICARE ADVANTAGE | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC MEDICARE COMPLETE | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | EMBLEM GHI [113] | EMBLEM GHI | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS MEDICARE [176] | FIDELIS MEDICARE|FIDELIS DUAL ADVANTAGE | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | EXCELLUS INDEMNITY [127] | BLUE CHOICE|RGHS EMPLOYEE MEDICAL PLAN|EXCELLUS UNITY EMPLOYEE PLAN|RRH CDHP|EMPIRE BLUE CROSS (NYC)|BLUE CROSS & BLUE SHIELD|UNIVERA|EMPIRE PLAN B/C (KINGSTON)|EXCELLUS BCBS RIT|FEDERAL BLUE CROSS & BLUE SHIELD | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | VETERANS ADMINISTRATION [178] | VA VETERAN'S CHOICE VACAA [17803] | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | INDEPENDENT HEALTH ASSOC|NOVA HEALTHCARE-IHA | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UNITED HEALTHCARE|UHC - GENERIC|UHC EMPIRE PLAN (KINGSTON)|UNITEDHEALTHCARE OXFORD|UNITED MEDICAL RESOURCES (UMR)|UHC STUDENT RESOURCES|UHC SUREST|UNITED HEALTHCARE SHARED SERVICES | — | $13,788.76 | $8,962.69 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | EXCELLUS INDEMNITY [127] | BLUE CHOICE|RGHS EMPLOYEE MEDICAL PLAN|EXCELLUS UNITY EMPLOYEE PLAN|RRH CDHP|BLUE CROSS & BLUE SHIELD|UNIVERA|EMPIRE PLAN B/C (KINGSTON)|EXCELLUS BCBS RIT|FEDERAL BLUE CROSS & BLUE SHIELD | — | $13,788.76 | $8,962.69 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE|TRICARE FOR LIFE|MARTINS POINT/US FAMILY | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE MEDICARE HMO | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | EXCELLUS HMO [104] | MEDICARE BLUE CHOICE|MEDICARE BLUE DUAL|UNIVERA SENIOR|MEDICARE BLUE PPO | — | $13,788.76 | $8,962.69 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC DUAL COMPLETE | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | GENERIC CARRIER [107] | COMMERCIAL|HUMANA|CDPHP COMMERCIAL | — | $13,788.76 | $8,962.69 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | GENERIC CARRIER [107] | COMMERCIAL|HUMANA|CDPHP COMMERCIAL | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | FIDELIS CARE NEW YORK [112] | FIDELIS CARE NEW YORK|FIDELIS FHP|FIDELIS CHP | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK|HIGHMARK INDEMNITY- OUT OF AREA|HIGHMARK HMO BLUE | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE DUAL | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | EXCELLUS HMO [104] | MEDICARE BLUE CHOICE|MEDICARE BLUE DUAL|UNIVERA SENIOR|MEDICARE BLUE PPO | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE MEDICARE HMO | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE DUAL | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | EXCELLUS HMO [104] | BLUE CHOICE OPTION|CHILD HEALTH PLUS|UNIVERA MYHEALTH PLUS|EXCELLUS ESSENTIAL 1&2|EXCELLUS ESSENTIAL 3&4|UNIVERA MYHEALTH|UNIVERA ESSENTIAL 1&2|HEALTHY NY|UNIVERA ESSENTIAL 1&2 | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP GOLD HMO | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP DUAL ACCESS|MVP DUAL ACCESS COMPLETE | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP GOLD PPO | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN|UHC COMMUNITY MEDICAID DENTAL|UHC ESSENTIAL 1&2|UHC CHPS|UHC ESSENTIAL 3&4 | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | HUMANA MEDICARE HMO|GENERIC MEDICARE HMO|ELDERPLAN|CDPHP MEDICARE HMO | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP|CIGNA|GWH CIGNA|NALC CIGNA | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC DUAL COMPLETE | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS(INCLUDING GOLD,SILVER,BRONZE AND PLATINUM) | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS ESSENTIAL 1&2|FIDELIS ESSENTIAL 3&4 | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | FIDELIS MEDICARE [176] | FIDELIS MEDICARE|FIDELIS DUAL ADVANTAGE | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UNITED HEALTHCARE|UHC - GENERIC|UHC EMPIRE PLAN (KINGSTON)|UNITEDHEALTHCARE OXFORD|UNITED MEDICAL RESOURCES (UMR)|UHC CHPS|UHC STUDENT RESOURCES|UHC SUREST|UNITED HEALTHCARE SHARED SERVICES | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | MEDICARE HMO INDEPENDENT HLTH|NOVA HEALTHCARE MEDICARE | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MVP [109] | MVP DUAL ACCESS|MVP DUAL ACCESS COMPLETE | — | $13,788.76 | $8,962.69 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MULTIPLAN [141] | MULTIPLAN | — | $13,788.76 | $8,962.69 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED BEHAVORIAL HEALTH [120] | UNITED BEHAVORIAL HEALTH|MH OPTUM COMMERCIAL | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK MEDICARE | — | $13,788.76 | $8,962.69 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA MEDICAID MANAGED CARE|MOLINA CHILD HEALTH PLUS | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | INDEPENDENT HEALTH ASSOC|NOVA HEALTHCARE-IHA | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 3&4 | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK|HIGHMARK INDEMNITY- OUT OF AREA|HIGHMARK HMO BLUE | — | $13,788.76 | $8,962.69 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 1&2 | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | AETNA [100] | AETNA MEDICARE ADVANTAGE | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE|TRICARE FOR LIFE|MARTINS POINT/US FAMILY | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | YOURCARE BEACON MEDICAID|MOLINA MEDICAID MANAGED CARE|MOLINA CHILD HEALTH PLUS | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | EMBLEM GHI [113] | EMBLEM GHI | — | $13,788.76 | $8,962.69 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK ESSENTIALS | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MVP [109] | MVP ROCHESTER|MVP|CIGNA|GWH CIGNA|NALC CIGNA | — | $13,788.76 | $8,962.69 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | HUMANA MEDICARE HMO|GENERIC MEDICARE HMO|ELDERPLAN|CDPHP MEDICARE HMO | — | $13,788.76 | $8,962.69 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 3&4 | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | MEDICARE HMO INDEPENDENT HLTH|NOVA HEALTHCARE MEDICARE | — | $12,150.53 | $7,897.84 | 2024-12-30 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Health Options Inc | Bcbs Health Options Hmo | $164.80 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Network Blue | $164.80 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Ppo | $164.80 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Traditional | $164.80 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| DRISCOLL CHILDREN'S HOSPITAL RIO GRANDE VALLEY Outpatient | TEXAS REHABILITATION COMM [50038] | TEXAS REHABILITATION COMM [5003801] | $165.82 | $15,107.40 | $3,021.48 | 2025-10-06 | MRF ↗ |
| DRISCOLL CHILDRENS HOSPITAL Outpatient | TEXAS REHABILITATION COMM [50038] | TEXAS REHABILITATION COMM [5003801] | $165.82 | $13,137.30 | $2,627.46 | 2025-10-06 | MRF ↗ |
| Driscoll Children's Hospital Transplant Center Both | TEXAS REHABILITATION COMM [50038] | TEXAS REHABILITATION COMM [5003801] | $165.82 | $13,137.30 | $2,627.46 | 2026-03-31 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | BCBS - TN | Commercial|Network S | $167.00 | — | — | 2026-02-28 | MRF ↗ |
| BAPTIST HOSPITAL Both | VISTA | COVENTRY MEDICAID | $173.17 | $18,569.00 | $12,069.85 | 2026-03-30 | MRF ↗ |
| ALTUS BAYTOWN HOSPITAL Outpatient | Blue Cross Blue Shield of Texas | PPO | $176.00 | $220.00 | $220.00 | 2026-04-01 | MRF ↗ |
| ALTUS BAYTOWN HOSPITAL Outpatient | Blue Cross Blue Shield of Texas | Blue Advantage | $176.00 | $220.00 | $220.00 | 2026-04-01 | MRF ↗ |
| ALTUS BAYTOWN HOSPITAL Outpatient | Blue Cross Blue Shield of Texas | HMO | $176.00 | $220.00 | $220.00 | 2026-04-01 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | MOLINA MEDICARE [7006] | MOLINA MEDICARE COMPLETE CARE [700602] | $176.25 | $1,175.00 | $1,175.00 | 2026-03-23 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Dimension Health | Dimension International | $179.78 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Corvel Healthcare | Corvel Healthcare | $181.13 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $182.55 | — | — | 2026-03-18 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Aetna Health | Aetna | $194.77 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Care Management Network | Care Management Network | $194.77 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Workmans Compensation | Workmans Compensation | $194.77 | $299.64 | $299.64 | 2026-05-22 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM TRADITIONAL | 9408_ANTHEM TRADITIONAL VEIN 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM PATHWAY | 9404_ANTHEM PATHWAY VEIN 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | PATOKA VALLEY TIER 2 | 9415_PAKOTA VALLEY TIER 2 VEIN 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM HEALTHSYNC HMO | 9399_ANTHEM HEALTHSYNC HMO VEIN 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM SHORT TERM LIMITED DURATION | 9407_ANTHEM SHORT TERM LIMITED DURATION VEIN 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | PATOKA VALLEY TIER 2 | 9413_PAKOTA VALLEY TIER 2 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ENCORE EXCLUSIVE | 9409_ENCORE EXCUSIVE VEIN 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM HMO/POS | 9403_ANTHEM HMO POS VEIN 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM HEALTHSYNC POS | 9401_ANTHEM HEALTHSYNC POS VEIN 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM PATHWAY X | 9405_ANTHEM PATHWAY X VEIN 20250101 | $200.00 | — | — | 2026-01-01 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.