Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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19120 — Removal Of Breast Lesion

Per-row negotiated rates, exactly as filed by each hospital. Aggregated views below summarize across hospitals; the bottom table shows the underlying rows.

Typical negotiated price $3,650

Usually $1,603–$5,036 (25th–75th percentile) across 2,400 hospitals · 7,557 payers.

“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 19120 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.

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 fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.

Pick your insurer to anchor on your plan’s negotiated rate.
Measured
$1,603 $3,650 typical $5,036

The middle 50% of negotiated facility rates for this procedure, measured across 2,400 hospitals. The surgeon and 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. $3,650
Surgeon (professional fee) Estimate national typical Medicare $408 × 1.22 commercial. $498
Anesthesia Estimate national typical Generic anesthesia (~90 min typical, median CMS base units). Medicare $225 × 3.14 commercial. Approximate — no procedure-specific anesthesia mapping for this code. $708
Likely subtotal $4,855
Surgical episode (typical) ~$4,855

Your recovery plan — adjust to what your doctor told you

After your procedure, recovery care is billed separately. We pre-fill the typical plan; change it to your situation.

After discharge
Recovery cost ~$3,785
With your recovery plan (typical) ~$8,640
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
Anesthesia (estimate)
base_units_version: CY2022 file (base units unchanged for CY2026 per CMS) · anesthesia_cf: $20.49754 (National) · cf_rule: CMS-1832-F · multiplier_source: AJMC/Duffy 2016-2017 (PMID 34156223) national · basis: generic surgical anesthesia — 5 base units (typical CMS value) × ~90 min; approximate, NOT a procedure-specific crosswalk

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
GROVE HILL MEMORIAL HOSPITAL BothFacility Aetna All Other Plans $0.03 $0.04 $0.02 2026-05-05 MRF ↗
GROVE HILL MEMORIAL HOSPITAL BothFacility Cigna All Plans $0.03 $0.04 $0.02 2026-05-05 MRF ↗
Highsmith Rainey Memorial Hospital Outpatient Cigna Commercial $1,149.00 $689.40 2026-05-17 MRF ↗
Highsmith Rainey Memorial Hospital Outpatient Blue Cross Blue Shield Of Nc Commercial $1.00 $0.60 2026-05-17 MRF ↗
CITIZENS MEDICAL CENTER Outpatient Blue Cross Blue Shield Of Ks Commercial $1.00 $1.00 $0.75 2026-05-18 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - IN (ANTHEM) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - ID WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - WV (HIGHMARK) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - PA (CAPITAL) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - AL WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE SHIELD - WA (REGENCE) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - TX WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - MN WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CARE NETWORK WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - NY (ANTHEM) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - AR WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - GA (ANTHEM) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - WY WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - NM WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility KAISER DOMESTIC WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - MI WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE SHIELD - PA (HIGHMARK) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - KS WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - VT WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - MS WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - TN WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE SHIELD - NY HIGHMARK WESTERN WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - IL ALTERNATE WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE SHIELD - ID (REGENCE) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - NH (ANTHEM) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - MD (CAREFIRST) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - OK WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - MO (ANTHEM) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility PRE-EMPLOYMENT WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE SHIELD - CA WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - CO (ANTHEM) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - DE (HIGHMARK) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - FEDERAL WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS DOMESTIC WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - PA (INDEPENDENCE) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - WA (PREMERA) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BCN DOMESTIC WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - UT (REGENCE) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - AZ WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BCBS GENERIC WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - IL WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - RI WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - MT WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - MA WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - HI WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - KY (ANTHEM) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - IA (WELLMARK) WELLMARK HMO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - SC WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE SHIELD - NY HIGHMARK NORTHEASTERN WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - ME (ANTHEM) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - NC WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - IA (WELLMARK) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - NY (EXCELLUS) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE DISTINCTION TRANSPLANT WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - NJ (HORIZON) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - VA (CAREFIRST) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - FL WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - LA WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - SD (WELLMARK) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - WI (ANTHEM) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - CT (ANTHEM) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - ND WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - VA (ANTHEM) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility WC DOMESTIC WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - OR (REGENCE) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - CA (ANTHEM) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - NV (ANTHEM) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - OH (ANTHEM) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - DC (CAREFIRST) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - NE WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility BLUE CROSS - AK (PREMERA) WELLMARK PPO $3.36 $13,421.54 2026-03-31 MRF ↗
FLAMBEAU HOSPITAL OutpatientFacility Security Health Plan (SHP) Medicare Advantage $3.38 $914.00 $868.30 2026-02-20 MRF ↗
FLAMBEAU HOSPITAL OutpatientFacility UnitedHealth Group of WI Medicare Advantage $3.38 $914.00 $868.30 2026-02-20 MRF ↗
FLAMBEAU HOSPITAL OutpatientFacility Veteran's Administration (VA CCN) VA Network $3.38 $914.00 $868.30 2026-02-20 MRF ↗
FLAMBEAU HOSPITAL OutpatientFacility Anthem BCBS of WI Medicare Advantage $3.47 $914.00 $868.30 2026-02-20 MRF ↗
UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient WELLSENSE MEDICAID [10901] All WELLSENSE MEDICAID (FORMERLY BMC) HR [40] Plans $3.47 $27,116.78 $27,116.78 2026-04-03 MRF ↗
FLAMBEAU HOSPITAL OutpatientFacility Group Health Cooperative of Eau Claire Medicare Advantage $3.56 $914.00 $868.30 2026-02-20 MRF ↗
FLAMBEAU HOSPITAL OutpatientFacility Point Comfort Underwriters Organizational $3.66 $914.00 $868.30 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility Security Health Plan (SHP) Medicare Advantage $4.39 $914.00 $868.30 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility Veteran's Administration (VA CCN) VA Network $4.39 $914.00 $868.30 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility Security Health Plan (SHP) Medicare Advantage $4.48 $914.00 $868.30 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility Point Comfort Underwriters Organizational $4.48 $914.00 $868.30 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility Anthem BCBS of WI Medicare Advantage $4.48 $914.00 $868.30 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility Veteran's Administration (VA CCN) VA Network $4.48 $914.00 $868.30 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility Anthem BCBS of WI Medicare Advantage $4.57 $914.00 $868.30 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility Group Health Cooperative of Eau Claire Medicare Advantage $4.66 $914.00 $868.30 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility Group Health Cooperative of Eau Claire Medicare Advantage $4.75 $914.00 $868.30 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility Point Comfort Underwriters Organizational $4.94 $914.00 $868.30 2026-02-20 MRF ↗
FIELD HEALTH SYSTEM Both United Healthcare Default $5.38 $2,999.00 $2,249.25 2025-03-07 MRF ↗
UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient MASSHEALTH [20302] All MASSHEALTH HR [91] Plans $5.60 $27,116.78 $27,116.78 2026-04-03 MRF ↗
UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient FALLON MEDICAID [10904] All FALLON MCO HR [305] Plans $5.60 $27,116.78 $27,116.78 2026-04-03 MRF ↗
UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient MGB MEDICAID [10906] All MGB (FORMERLY AHP) ACO HR [307] Plans $5.60 $27,116.78 $27,116.78 2026-04-03 MRF ↗
UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient FALLON MEDICAID [10904] All FALLON ACO HR [304] Plans $5.60 $27,116.78 $27,116.78 2026-04-03 MRF ↗
UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient HNE MEDICAID [10905] All HEALTH NEW ENGLAND/MINUTEMAN MCO HR [303] Plans $5.60 $27,116.78 $27,116.78 2026-04-03 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient GRANTS [20507] All TB GETCHELL [226] Plans $6.52 $17,251.00 $17,251.00 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient GRANTS [20507] All TB GETCHELL [226] Plans $6.52 $18,977.00 $18,977.00 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient GRANTS [20507] All TB GETCHELL [226] Plans $6.52 $14,634.30 $14,634.30 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient HNE MEDICAID [10905] All HEALTH NEW ENGLAND/MINUTEMAN MCO HA [223] Plans $7.59 $12,810.32 $12,810.32 2026-03-26 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient MGB MEDICAID [10906] All MGB (FORMERLY AHP) ACO MH [202] Plans $7.59 $18,977.00 $18,977.03 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient TUFTS MEDICAID [10908] All TUFTS TOGETHER MH [123] Plans $7.59 $18,977.00 $18,977.03 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient MASSHEALTH [20302] All MASSHEALTH HA [93] Plans $7.59 $12,810.32 $12,810.32 2026-03-26 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient MASSHEALTH [20302] All MASSHEALTH MH [90] Plans $7.59 $17,251.00 $17,251.04 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient INSTITUTION [10406] All WORCESTER RECOVERY MH [234] Plans $7.59 $18,977.00 $18,977.03 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient MGB MEDICAID [10906] All MGB (FORMERLY AHP) ACO MH [202] Plans $7.59 $17,251.00 $17,251.04 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient FALLON MEDICAID [10904] All FALLON MCO HA [55] Plans $7.59 $15,691.91 $15,691.91 2026-03-26 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient WELLSENSE MEDICAID [10901] All WELLSENSE MEDICAID (FORMERLY BMC) MH [8] Plans $7.59 $18,977.00 $18,977.03 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient FALLON MEDICAID [10904] All FALLON ACO MH [80] Plans $7.59 $18,977.00 $18,977.03 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient WELLSENSE MEDICAID [10901] All WELLSENSE MEDICAID (FORMERLY BMC) MH [8] Plans $7.59 $17,251.00 $17,251.04 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient FALLON MEDICAID [10904] All FALLON MCO MH [225] Plans $7.59 $17,251.00 $17,251.04 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient TUFTS MEDICAID [10908] All TUFTS TOGETHER MH [123] Plans $7.59 $17,251.00 $17,251.04 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient HNE MEDICAID [10905] All HEALTH NEW ENGLAND/MINUTEMAN MCO MH [221] Plans $7.59 $18,977.00 $18,977.03 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient INSTITUTION [10406] All WORCESTER RECOVERY MH [234] Plans $7.59 $17,251.00 $17,251.04 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient FALLON MEDICAID [10904] All FALLON MCO MH [225] Plans $7.59 $18,977.00 $18,977.03 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient MASSHEALTH [20302] All MASSHEALTH HA [93] Plans $7.59 $15,691.91 $15,691.91 2026-03-26 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient FALLON MEDICAID [10904] All FALLON ACO MH [80] Plans $7.59 $17,251.00 $17,251.04 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient HNE MEDICAID [10905] All HEALTH NEW ENGLAND/MINUTEMAN MCO MH [221] Plans $7.59 $17,251.00 $17,251.04 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient MASSHEALTH [20302] All MASSHEALTH MH [90] Plans $7.59 $18,977.00 $18,977.03 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient HNE MEDICAID [10905] All HEALTH NEW ENGLAND/MINUTEMAN MCO HA [223] Plans $7.59 $15,691.91 $15,691.91 2026-03-26 MRF ↗
UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient MGB MEDICAID [10906] All MGB (FORMERLY AHP) ACO HA [197] Plans $7.59 $12,810.32 $12,810.32 2026-03-26 MRF ↗
UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient FALLON MEDICAID [10904] All FALLON MCO HA [55] Plans $7.59 $12,810.32 $12,810.32 2026-03-26 MRF ↗
UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient MGB MEDICAID [10906] All MGB (FORMERLY AHP) ACO HA [197] Plans $7.59 $15,691.91 $15,691.91 2026-03-26 MRF ↗
UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient FALLON MEDICAID [10904] All FALLON ACO HA [79] Plans $7.59 $15,691.91 $15,691.91 2026-03-26 MRF ↗
UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient INSTITUTION [10406] All WORCESTER RECOVERY HA [235] Plans $7.59 $12,810.32 $12,810.32 2026-03-26 MRF ↗
UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient INSTITUTION [10406] All WORCESTER RECOVERY HA [235] Plans $7.59 $15,691.91 $15,691.91 2026-03-26 MRF ↗
UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient FALLON MEDICAID [10904] All FALLON ACO HA [79] Plans $7.59 $12,810.32 $12,810.32 2026-03-26 MRF ↗
CANTON-POTSDAM 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 $8.61 $6,445.79 $4,189.76 2024-12-30 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient WELLSENSE MEDICAID [10901] All WELLSENSE SPECIAL KIDS (FORMERLY BMC) MH [256] Plans $9.49 $18,977.00 $18,977.03 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient WELLSENSE MEDICAID [10901] All WELLSENSE SPECIAL KIDS (FORMERLY BMC) MH [256] Plans $9.49 $17,251.00 $17,251.04 2025-12-08 MRF ↗
ATLANTIC GENERAL HOSPITAL Outpatient All Payors All Payors $10.19 $10.19 $10.19 2026-04-10 MRF ↗
WESTFIELD MEMORIAL HOSPITAL, INC Outpatient Amerihealth Amerihealth Medicaid CHC $11.00 $1,183.00 $260.26 2026-04-14 MRF ↗
WESTFIELD MEMORIAL HOSPITAL, INC Outpatient Amerihealth Amerihealth Medicaid HC $11.00 $1,183.00 $260.26 2026-04-14 MRF ↗
WESTFIELD MEMORIAL HOSPITAL, INC Outpatient Amerihealth Amerihealth Medicaid CHC $11.00 $1,183.00 $260.26 2026-04-14 MRF ↗
ALLEGHENY VALLEY HOSPITAL Outpatient Amerihealth Amerihealth Medicaid HC $11.00 $1,183.00 $272.09 2026-04-14 MRF ↗
JEFFERSON HOSPITAL Outpatient Amerihealth Amerihealth Medicaid CHC $11.00 $1,183.00 $224.77 2026-04-14 MRF ↗
JEFFERSON HOSPITAL Outpatient Amerihealth Amerihealth Medicaid HC $11.00 $1,183.00 $224.77 2026-04-14 MRF ↗
CANONSBURG GENERAL HOSPITAL Outpatient Amerihealth Amerihealth Medicaid CHC $11.00 $1,183.00 $260.26 2026-04-14 MRF ↗
WEST PENN HOSPITAL Outpatient Amerihealth Amerihealth Medicaid CHC $11.00 $1,183.00 $319.41 2026-04-14 MRF ↗
AHN WEXFORD HOSPITAL Outpatient Amerihealth Amerihealth Medicaid CHC $11.00 $1,183.00 $307.58 2026-04-14 MRF ↗
GROVE CITY MEDICAL CENTER Outpatient Amerihealth Amerihealth Medicaid HC $11.00 $1,183.00 $272.09 2026-04-14 MRF ↗
GROVE CITY MEDICAL CENTER Outpatient Amerihealth Amerihealth Medicaid CHC $11.00 $1,183.00 $272.09 2026-04-14 MRF ↗
ALLEGHENY VALLEY HOSPITAL Outpatient Amerihealth Amerihealth Medicaid CHC $11.00 $1,183.00 $272.09 2026-04-14 MRF ↗
ALLEGHENY GENERAL HOSPITAL Outpatient Amerihealth Amerihealth Medicaid HC $11.00 $1,183.00 $283.92 2026-04-14 MRF ↗
FORBES HOSPITAL Outpatient Amerihealth Amerihealth Medicaid CHC $11.00 $1,183.00 $260.26 2026-04-14 MRF ↗
FORBES HOSPITAL Outpatient Amerihealth Amerihealth Medicaid HC $11.00 $1,183.00 $260.26 2026-04-14 MRF ↗
SAINT VINCENT HOSPITAL Outpatient Amerihealth Amerihealth Medicaid CHC $11.00 $1,183.00 $212.94 2026-04-14 MRF ↗
ALLEGHENY GENERAL HOSPITAL Outpatient Amerihealth Amerihealth Medicaid CHC $11.00 $1,183.00 $283.92 2026-04-14 MRF ↗
WEST PENN HOSPITAL Outpatient Amerihealth Amerihealth Medicaid HC $11.00 $1,183.00 $319.41 2026-04-14 MRF ↗
WESTFIELD MEMORIAL HOSPITAL, INC Outpatient Amerihealth Amerihealth Medicaid HC $11.00 $1,183.00 $260.26 2026-04-14 MRF ↗
SAINT VINCENT HOSPITAL Outpatient Amerihealth Amerihealth Medicaid HC $11.00 $1,183.00 $212.94 2026-04-14 MRF ↗
AHN WEXFORD HOSPITAL Outpatient Amerihealth Amerihealth Medicaid HC $11.00 $1,183.00 $307.58 2026-04-14 MRF ↗
CANONSBURG GENERAL HOSPITAL Outpatient Amerihealth Amerihealth Medicaid HC $11.00 $1,183.00 $260.26 2026-04-14 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient DIGNITY MCR ADV OP/PROFEE ONLY DIGNITY MCR ADV OP/PROFEE ONLY $12.00 $1,047.00 $198.93 2026-01-25 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient DIGNITY MCR ADV OP/PROFEE ONLY DIGNITY MCR ADV OP/PROFEE ONLY $12.00 $1,047.00 $198.93 2026-01-25 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient DIGNITY MCR ADV OP/PROFEE ONLY DIGNITY MCR ADV OP/PROFEE ONLY $12.00 $1,047.00 $198.93 2026-01-25 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient DIGNITY MCR ADV OP/PROFEE ONLY DIGNITY MCR ADV OP/PROFEE ONLY $12.00 $1,047.00 $198.93 2026-01-25 MRF ↗
OTTAWA COUNTY HEALTH CENTER Outpatient CHOICECARE MCR ADV - ALL PLANS CHOICECARE MCR ADV - ALL PLANS $12.00 $710.00 $710.00 2026-03-09 MRF ↗
OAKDALE COMMUNITY HOSPITAL Both HUMANA HUMANA COMM OP $12.10 $22.00 $4.40 2026-04-30 MRF ↗
OAKDALE COMMUNITY HOSPITAL Both HUMANA HUMANA COMM IP $12.10 $22.00 $4.40 2026-04-30 MRF ↗
MONMOUTH MEDICAL CENTER OutpatientFacility Clover Managed Medicare $12.63 $7,014.00 $3,774.43 2024-12-31 MRF ↗
CITIZENS MEDICAL CENTER Outpatient Wppa/Providrscare Commercial $1,178.00 $883.50 2026-05-18 MRF ↗
CITIZENS MEDICAL CENTER Outpatient Hpk (Incl. Cigna) Commercial $1,178.00 $883.50 2026-05-18 MRF ↗
CITIZENS MEDICAL CENTER Outpatient Phcs/Multiplan Commercial $1,178.00 $883.50 2026-05-18 MRF ↗
CITIZENS MEDICAL CENTER Outpatient Aetna Commercial $1,178.00 $883.50 2026-05-18 MRF ↗
CITIZENS MEDICAL CENTER Outpatient Sunflower Medicaid $1,178.00 $883.50 2026-05-18 MRF ↗
CITIZENS MEDICAL CENTER Outpatient Blue Cross Blue Shield Of Ks Commercial $13.26 $1,178.00 $883.50 2026-05-18 MRF ↗
CITIZENS MEDICAL CENTER Outpatient Healthy Blue Medicaid $1,178.00 $883.50 2026-05-18 MRF ↗
CITIZENS MEDICAL CENTER Outpatient United Healthcare Commercial $1,178.00 $883.50 2026-05-18 MRF ↗
UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient MASSHEALTH [20302] All MASSHEALTH UM [10] Plans $14.82 $41,481.72 $41,481.72 2026-03-26 MRF ↗
UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient WELLSENSE MEDICAID [10901] All WELLSENSE MEDICAID (FORMERLY BMC) UM [75] Plans $14.82 $41,481.72 $41,481.72 2026-03-26 MRF ↗
UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient MGB MEDICAID [10906] All MGB (FORMERLY AHP) ACO UM [212] Plans $14.82 $41,481.72 $41,481.72 2026-03-26 MRF ↗
UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient HNE MEDICAID [10905] All HEALTH NEW ENGLAND/MINUTEMAN MCO UM [222] Plans $14.82 $41,481.72 $41,481.72 2026-03-26 MRF ↗
UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient FALLON MEDICAID [10904] All FALLON MCO UM [104] Plans $14.82 $41,481.72 $41,481.72 2026-03-26 MRF ↗
UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient FALLON MEDICAID [10904] All FALLON ACO UM [130] Plans $14.82 $41,481.72 $41,481.72 2026-03-26 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient INSTITUTION [10406] All WORCESTER RECOVERY MH [234] Plans $15.20 $14,634.30 $14,634.30 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient FALLON MEDICAID [10904] All FALLON ACO MH [80] Plans $15.20 $14,634.30 $14,634.30 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient FALLON MEDICAID [10904] All FALLON MCO MH [225] Plans $15.20 $14,634.30 $14,634.30 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient MGB MEDICAID [10906] All MGB (FORMERLY AHP) ACO MH [202] Plans $15.20 $14,634.30 $14,634.30 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient MASSHEALTH [20302] All MASSHEALTH MH [90] Plans $15.20 $14,634.30 $14,634.30 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient TUFTS MEDICAID [10908] All TUFTS TOGETHER MH [123] Plans $15.20 $14,634.30 $14,634.30 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient HNE MEDICAID [10905] All HEALTH NEW ENGLAND/MINUTEMAN MCO MH [221] Plans $15.20 $14,634.30 $14,634.30 2025-12-08 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient WELLSENSE MEDICAID [10901] All WELLSENSE MEDICAID (FORMERLY BMC) MH [8] Plans $15.20 $14,634.30 $14,634.30 2025-12-08 MRF ↗
HOSPITAL FOR SPECIAL SURGERY OutpatientFacility BLUE CROSS BLUE SHIELD NY [1022] BCBS NY EXCHANGE [102200] $18.72 $12,750.32 2026-04-01 MRF ↗
UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient WELLSENSE MEDICAID [10901] All WELLSENSE SPECIAL KIDS (FORMERLY BMC) MH [256] Plans $19.00 $14,634.30 $14,634.30 2025-12-08 MRF ↗
HOSPITAL PAVIA YAUCO Outpatient VA VA Veterans Affairs Program $20.03 $342.00 $342.00 2025-03-27 MRF ↗
HOSPITAL PAVIA YAUCO Outpatient Hospicio Hospicio Medicare Advantage $20.24 $342.00 $342.00 2025-03-27 MRF ↗
HOSPITAL PAVIA YAUCO Outpatient Medicare Medicare Medicare Advantage $22.16 $342.00 $342.00 2025-03-27 MRF ↗
HOSPITAL PAVIA YAUCO Outpatient Humana Humana Medicare Advantage $22.28 $342.00 $342.00 2025-03-27 MRF ↗
HOSPITAL PAVIA YAUCO Outpatient MSO MSO Medicare Advantage $22.28 $342.00 $342.00 2025-03-27 MRF ↗
HOSPITAL PAVIA YAUCO Outpatient MCS MCS Medicare Advantage $22.28 $342.00 $342.00 2025-03-27 MRF ↗
HOSPITAL PAVIA YAUCO Outpatient Triple S Triple S Medicare Advantage $22.28 $342.00 $342.00 2025-03-27 MRF ↗
SARAH BUSH LINCOLN HEALTH CENTER Outpatient HLTH ALLIANCE-ALL OTHER PLANS HLTH ALLIANCE-ALL OTHER PLANS $24.00 $1,644.00 $1,644.00 2026-02-13 MRF ↗
UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient TUFTS MEDICAID [10908] All TUFTS TOGETHER HA [122] Plans $25.11 $10,273.31 $10,273.31 2026-03-26 MRF ↗
LEE MEMORIAL HOSPITAL OutpatientFacility WELLCARE HEALTH PLAN [250516] MEDICARE REPLACEMENT [25051601] $25.45 $25,988.47 $5,197.69 2026-03-26 MRF ↗
LEE MEMORIAL HOSPITAL OutpatientFacility CIGNA MCR HMO/PPO [250525] MEDICARE REPLACEMENT [25052501] $25.45 $25,988.47 $5,197.69 2026-03-26 MRF ↗

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