19301 — Partial Mastectomy
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PARTIAL MASTECTOMY (CPT 19301) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/19301?code_type=CPT
MLA (9th ed.)
“PARTIAL MASTECTOMY (CPT 19301) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/19301?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“PARTIAL MASTECTOMY (CPT 19301) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/19301?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $2,289–$6,179 (25th–75th percentile) across 2,641 hospitals · 6,195 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 19301 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Also priced as a different code
The same procedure is billed under different code systems depending on the setting. These facilities price it under a code you won’t see in the CPT/HCPCS 19301 table above — including hospitals that only publish the bundled version.
2,687 facilities · 703 not in the CPT/HCPCS table
- ABBEVILLE GENERAL HOSPITAL, ABBEVILLE • only here
- ABBOTT NORTHWESTERN HOSPITAL, MINNEAPOLIS • only here
- ABRAHAM LINCOLN MEMORIAL HOSPITAL, LINCOLN • only here
- ACADIAN MEDICAL CENTER, EUNICE • only here
- Acuity Specialty Hospital Of New Jersey, Atlantic City • only here
- Acuity Specialty Hospital Ohio Valley, BELLAIRE • only here
2,671 facilities · 697 not in the CPT/HCPCS table
- ABBEVILLE GENERAL HOSPITAL, ABBEVILLE • only here
- ABBOTT NORTHWESTERN HOSPITAL, MINNEAPOLIS • only here
- ABRAHAM LINCOLN MEMORIAL HOSPITAL, LINCOLN • only here
- ACADIAN MEDICAL CENTER, EUNICE • only here
- Acuity Specialty Hospital Of New Jersey, Atlantic City • only here
- Acuity Specialty Hospital Ohio Valley, BELLAIRE • only here
An MS-DRG / APR-DRG price is the hospital’s single bundled charge for the entire inpatient stay — operating room, room & board, recovery, imaging, anesthesia (facility), implants and supplies — so it’s a broader, usually higher figure than the CPT/HCPCS 19301 line above, which prices the procedure alone. Neither includes the surgeon’s or anesthesiologist’s professional fees, which are billed separately.
Estimated complete episode
What the whole episode might cost
Your hospital facility price plus the separately-billed professional fees a complete episode adds. The facility figure is an actual negotiated rate from our data; the surgeon and anesthesia fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$2,289
$3,992 typical
$6,179
The middle 50% of negotiated facility rates for this procedure, measured across 2,641 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. | $3,992 |
| Surgeon (professional fee) Estimate national typical Medicare $633 × 1.22 commercial. | $772 |
| Anesthesia Estimate national typical 00400, ~90 min typical. Medicare $184 × 3.14 commercial. | $579 |
| Likely subtotal | $5,343 |
Surgical episode (typical)
~$5,343
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge (see the recovery plan below)
- Complications, revisions, or readmissions
- Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)
The biggest swing: which insurer's rate applies — negotiated prices here run $2,289–$6,179.
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.
Recovery cost modeled
~$3,785
With your recovery plan (typical)
~$9,128
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
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 |
|---|---|---|---|---|---|---|---|
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $7,407.00 | $4,444.20 | 2026-07-15 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $16,019.00 | $1,601.90 | 2026-07-18 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $7.37 | $1,127.00 | $845.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $7.37 | $1,127.00 | $845.25 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $7.37 | $2,326.00 | $1,744.50 | 2026-07-01 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $8.10 | $13.50 | $13.50 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $8.55 | $14.25 | $14.25 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $8.82 | $14.70 | $14.70 | 2026-03-16 | MRF ↗ |
| SPRINGHILL MEDICAL CENTER Outpatient | Unitedhealthcare Insurance Company (Contracting On Behalf Of Itself, Unitedhealthcare Of Alabama, Inc. And United'S Affiliates) | Commercial All Payer | — | $7,424.37 | $6,310.71 | 2026-07-15 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $10.62 | $17.70 | $17.70 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $11.07 | $18.45 | $18.45 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $11.61 | $19.35 | $19.35 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $11.70 | $19.50 | $19.50 | 2026-03-16 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $12.13 | $6,738.00 | $3,774.43 | 2024-12-31 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $13.05 | $21.75 | $21.75 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $13.23 | $22.05 | $22.05 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $13.95 | $23.25 | $23.25 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $14.13 | $23.55 | $23.55 | 2026-03-16 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Phcs/Multiplan | Commercial | — | $1,960.00 | $1,274.00 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Sunflower | Medicaid | — | $1,960.00 | $1,274.00 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Aetna | Commercial | — | $1,960.00 | $1,274.00 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Healthy Blue | Medicaid | — | $1,960.00 | $1,274.00 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | United Healthcare | Commercial | — | $1,960.00 | $1,274.00 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Wppa/Providrscare | Commercial | — | $1,960.00 | $1,274.00 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Hpk (Incl. Cigna) | Commercial | — | $1,960.00 | $1,274.00 | 2026-08-01 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $15.57 | $25.95 | $25.95 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $15.66 | $26.10 | $26.10 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $15.93 | $26.55 | $26.55 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $16.56 | $27.60 | $27.60 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $16.74 | $27.90 | $27.90 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $17.37 | $28.95 | $28.95 | 2026-03-16 | MRF ↗ |
| OTTAWA COUNTY HEALTH CENTER Outpatient | CHOICECARE MCR ADV - ALL PLANS | CHOICECARE MCR ADV - ALL PLANS | $19.06 | $895.00 | $895.00 | 2026-03-09 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $19.06 | $1,633.00 | $310.27 | 2026-01-25 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $19.06 | $304.00 | $57.76 | 2026-05-20 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $19.35 | $32.25 | $32.25 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $19.50 | $32.50 | $32.50 | 2026-03-16 | MRF ↗ |
| WINNMED Outpatient | AETNA/FIRST HEALTH PPO-ALL OTHER PLANS | AETNA/FIRST HEALTH PPO-ALL OTHER PLANS | $19.59 | $2,575.00 | $1,802.50 | 2026-07-14 | MRF ↗ |
| WINNMED Outpatient | AETNA/FIRST HEALTH HMO | AETNA/FIRST HEALTH HMO | $19.59 | $2,575.00 | $1,802.50 | 2026-07-14 | MRF ↗ |
| WINNMED Outpatient | AETNA/FIRST HEALTH PHO | AETNA/FIRST HEALTH PHO | $19.59 | $2,575.00 | $1,802.50 | 2026-07-14 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | TRIWEST WELLMARK-ALL PLANS | TRIWEST WELLMARK-ALL PLANS | $20.47 | $56.85 | $51.17 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | TRICARE- ALL PLANS | TRICARE- ALL PLANS | $20.47 | $56.85 | $51.17 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | VA CCN -ALL PLANS | VA CCN -ALL PLANS | $20.47 | $56.85 | $51.17 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MEDICAL ASSOCIATES-ALL PLANS | MEDICAL ASSOCIATES-ALL PLANS | $20.47 | $56.85 | $51.17 | 2026-01-03 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $20.48 | $34.13 | $34.13 | 2026-03-16 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | WELLMARK MCR ADV- ALL PLANS | WELLMARK MCR ADV- ALL PLANS | $20.67 | $56.85 | $51.17 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | UHC MCR ADV | UHC MCR ADV | $21.08 | $56.85 | $51.17 | 2026-01-03 | MRF ↗ |
| LOURDES COUNSELING CENTER OutpatientFacility | UNITEDHEALTHCARE OF WASHINGTON INC | HMO | $21.91 | $3,785.67 | $1,514.27 | 2026-07-10 | MRF ↗ |
| LOURDES MEDICAL CENTER Outpatient | UNITEDHEALTHCARE OF WASHINGTON INC | HMO | $21.91 | $3,785.67 | $1,514.27 | 2025-09-24 | MRF ↗ |
| LOURDES COUNSELING CENTER OutpatientFacility | UNITEDHEALTHCARE OF WASHINGTON INC | HMO | $21.91 | $3,785.67 | $1,514.27 | 2026-07-10 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $24.39 | $40.65 | $40.65 | 2026-03-16 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | United Health Care | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Blue Cross | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | First Choice Select Health | Managed Medicaid | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | America'S First Choice | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Absolute Total Care | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Aetna | Commercial | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Aetna | Managed Medicare | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Cigna | Commercial | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Molina | Mangaged Medicare | — | — | — | 2026-10-03 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $25.65 | $42.75 | $42.75 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $27.45 | $45.75 | $45.75 | 2026-03-16 | MRF ↗ |
| MOBRIDGE REGIONAL HOSPITAL - CAH Outpatient | SANFORD HEALTHPLAN-ALL PLANS | SANFORD HEALTHPLAN-ALL PLANS | $28.29 | $1,804.00 | $1,804.00 | 2026-07-16 | MRF ↗ |
| ADVENTIST HEALTH CASTLE Outpatient | PACIFIC ADMIN PPO - ALL PLANS | PACIFIC ADMIN PPO - ALL PLANS | $29.27 | $1,628.00 | $520.96 | 2026-05-18 | MRF ↗ |
| DECATUR COUNTY MEMORIAL HOSPITAL Outpatient | UHC-ALL OTHER PLANS | UHC-ALL OTHER PLANS | $30.00 | $2,102.00 | $1,576.50 | 2026-03-18 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | OSCAR-ALL PLANS | OSCAR-ALL PLANS | $30.70 | $56.85 | $51.17 | 2026-01-03 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Humana Healthnet | Tricare | — | $457.65 | $384.43 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Aetna | Medicare Advantage | — | $457.65 | $384.43 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Consumer Life | Commercial | — | $457.65 | $384.43 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Anthem | Ppo Hmo Exchange | — | $457.65 | $384.43 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Coventry | Commercial | — | $457.65 | $384.43 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Care Improvement Plus | Medicare Advantage | — | $457.65 | $384.43 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Encore | Ppo | — | $457.65 | $384.43 | 2026-05-09 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $36.09 | $60.15 | $60.15 | 2026-03-16 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | HEALTH NET | HEALTH NET | $36.87 | $73.73 | $55.30 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | CIGNA-ALL PLANS | CIGNA-ALL PLANS | $36.87 | $73.73 | $55.30 | 2026-04-27 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $38.12 | $4,190.00 | $4,190.00 | 2026-02-13 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $38.12 | $4,190.00 | $4,190.00 | 2026-06-03 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $38.16 | $63.60 | $63.60 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $39.15 | $65.25 | $65.25 | 2026-03-16 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MIDLANDS NEW BUSINESS | MIDLANDS NEW BUSINESS | $39.80 | $56.85 | $51.17 | 2026-01-03 | MRF ↗ |
| ISLAND HOSPITAL Outpatient | MULTIPLAN - ALL PLANS | MULTIPLAN - ALL PLANS | $40.00 | $878.00 | $878.00 | 2025-03-18 | MRF ↗ |
| ISLAND HOSPITAL Outpatient | MULTIPLAN - ALL PLANS | MULTIPLAN - ALL PLANS | $40.00 | $1,317.00 | $1,317.00 | 2025-03-18 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | UNIVERSAL HC MCAL PROFEE ONLY | UNIVERSAL HC MCAL PROFEE ONLY | $40.00 | $304.00 | $45.60 | 2026-10-05 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | MEDI-CAL | MEDI-CAL | $40.00 | $304.00 | $45.60 | 2026-10-05 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | BC MEDI-CAL | BC MEDI-CAL | $40.00 | $304.00 | $45.60 | 2026-10-05 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $40.66 | $67.77 | $67.77 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $41.96 | $69.93 | $69.93 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $43.83 | $73.05 | $73.05 | 2026-03-16 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | UNIVERSAL HC MCAL PROFEE | UNIVERSAL HC MCAL PROFEE | $45.00 | $304.00 | $57.76 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | MEDI-CAL | MEDI-CAL | $45.00 | $304.00 | $57.76 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $45.00 | $304.00 | $57.76 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | KAISER MCAL | KAISER MCAL | $45.00 | $304.00 | $57.76 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | BC MCAL | BC MCAL | $45.00 | $304.00 | $57.76 | 2026-05-19 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA ACA PPO - ALL OTHER PLANS | AVERA ACA PPO - ALL OTHER PLANS | $46.00 | $1,492.70 | $895.62 | 2025-12-20 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA HMO | AVERA HMO | $46.00 | $1,492.70 | $895.62 | 2025-12-20 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA ASO PPO | AVERA ASO PPO | $48.00 | $1,492.70 | $895.62 | 2025-12-20 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $48.15 | $80.25 | $80.25 | 2026-03-16 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $49.00 | $56.85 | $51.17 | 2026-01-03 | MRF ↗ |
| S E LACKEY MEMORIAL HOSPITAL Outpatient | CIGNA COMM - ALL PLANS | CIGNA COMM - ALL PLANS | $50.00 | $1,777.00 | $1,777.00 | 2026-02-10 | MRF ↗ |
| SKYLINE HOSPITAL Outpatient | REGENCE BS PPO/POS - ALL OTHER PLANS | REGENCE BS PPO/POS - ALL OTHER PLANS | $51.00 | $2,577.50 | $1,855.80 | 2026-05-04 | MRF ↗ |
| SKYLINE HOSPITAL Outpatient | REGENCE BS CARE | REGENCE BS CARE | $51.00 | $2,577.50 | $1,855.80 | 2026-05-04 | MRF ↗ |
| SKYLINE HOSPITAL Outpatient | REGENCE BS PAR | REGENCE BS PAR | $51.00 | $2,577.50 | $1,855.80 | 2026-05-04 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $51.27 | $85.45 | $85.45 | 2026-03-16 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | COVENTRY/FIRST HEALTH-ALL PLANS | COVENTRY/FIRST HEALTH-ALL PLANS | $51.61 | $73.73 | $55.30 | 2026-04-27 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA NONACA PPO | AVERA NONACA PPO | $54.00 | $1,492.70 | $895.62 | 2025-12-20 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MULTIPLAN-ALL PLANS | MULTIPLAN-ALL PLANS | $54.01 | $56.85 | $51.17 | 2026-01-03 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $54.18 | $90.30 | $90.30 | 2026-03-16 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MIDLANDS CHOICE - ALL OTHER PLANS | MIDLANDS CHOICE - ALL OTHER PLANS | $55.14 | $56.85 | $51.17 | 2026-01-03 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $55.62 | $92.70 | $92.70 | 2026-03-16 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | KERN HEALTH SYSTEMS MCAL | KERN HEALTH SYSTEMS MCAL | $56.40 | $304.00 | $45.60 | 2026-10-05 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | First Health Network | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Coventry | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Prime Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Interwest Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Montana Health CoOp | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Pacific Source | All | — | — | — | 2026-03-28 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $59.13 | $98.55 | $98.55 | 2026-03-16 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $64.72 | — | — | 2026-04-01 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Univera | Medicare Managed Care Plan | $64.72 | — | — | 2026-04-01 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | BLUE CROSS MCS-ALL OTHER PLANS | BLUE CROSS MCS-ALL OTHER PLANS | $66.41 | $304.00 | $60.80 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | BLUE CROSS NON-MCS | BLUE CROSS NON-MCS | $66.41 | $304.00 | $60.80 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ACCESS MEDI-CAL | ACCESS MEDI-CAL | $66.64 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH ST HELENA Outpatient | MEDI-CAL | MEDI-CAL | $66.64 | $334.00 | $50.10 | 2026-07-15 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | LASALLE MG MEDI-CAL | LASALLE MG MEDI-CAL | $66.64 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MEDI-CAL | MEDI-CAL | $66.64 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ALTAMED MEDI-CAL - ALL OTHER PLANS | ALTAMED MEDI-CAL - ALL OTHER PLANS | $66.64 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $66.64 | $304.00 | $57.76 | 2026-05-22 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | MEDI-CAL | MEDI-CAL | $66.64 | $304.00 | $57.76 | 2026-05-22 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | HEALTHNET MEDI-CAL | HEALTHNET MEDI-CAL | $66.64 | $304.00 | $57.76 | 2026-05-22 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC ALLIANCE MEDI-CAL | PACIFIC ALLIANCE MEDI-CAL | $66.64 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | CCIPA MEDI-CAL - ALL PLANS | CCIPA MEDI-CAL - ALL PLANS | $66.64 | $304.00 | $57.76 | 2026-05-22 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BLUE SHIELD MEDI-CAL | BLUE SHIELD MEDI-CAL | $66.64 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BC MEDI-CAL | BC MEDI-CAL | $66.64 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | $66.64 | $304.00 | $57.76 | 2026-05-22 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | CARE FIRST MEDI-CAL | CARE FIRST MEDI-CAL | $66.64 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PREFERRED MEDI-CAL | PREFERRED MEDI-CAL | $66.64 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHCARE INC MEDI-CAL | HEALTHCARE INC MEDI-CAL | $66.64 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC IPA MEDI-CAL | PACIFIC IPA MEDI-CAL | $66.64 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CELTIC CA HLTH WELL MCAL - ALL PLANS | CELTIC CA HLTH WELL MCAL - ALL PLANS | $70.00 | $304.00 | $51.68 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $70.00 | $304.00 | $51.68 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE MCAL | CENTRAL CA ALLIANCE MCAL | $70.00 | $304.00 | $51.68 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | BC MCAL | BC MCAL | $70.00 | $304.00 | $51.68 | 2026-05-23 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $70.00 | $5,515.00 | $5,515.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $70.00 | $2,757.00 | $2,757.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $70.00 | $5,515.00 | $5,515.00 | 2025-10-04 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | MEDI-CAL | MEDI-CAL | $70.00 | $304.00 | $51.68 | 2026-05-23 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $70.00 | $2,757.00 | $2,757.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $70.00 | $5,515.00 | $5,515.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $70.00 | $2,757.00 | $2,757.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $70.00 | $5,515.00 | $5,515.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $70.00 | $2,757.00 | $2,757.00 | 2025-10-04 | MRF ↗ |
| GRANT REGIONAL HEALTH CENTER Outpatient | DEAN HEALTH PLAN - ALL PLANS | DEAN HEALTH PLAN - ALL PLANS | $71.99 | $2,135.00 | $1,387.75 | 2026-01-15 | MRF ↗ |
| SEARHC WRANGELL MEDICAL CENTER & LTC Outpatient | UHC-ALL PLANS | UHC-ALL PLANS | $72.00 | $3,165.24 | $3,165.24 | 2024-12-09 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| CLAY COUNTY MEDICAL CENTER Outpatient | HEALTH PARTNERS - ALL PLANS | HEALTH PARTNERS - ALL PLANS | $75.00 | $1,015.90 | $1,015.90 | 2026-07-22 | MRF ↗ |
| CLAY COUNTY MEDICAL CENTER Outpatient | HEALTH PARTNERS - ALL PLANS | HEALTH PARTNERS - ALL PLANS | $75.00 | $1,015.90 | $1,015.90 | 2026-04-24 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | VALLEY CHILDRENS - ALL PLANS | VALLEY CHILDRENS - ALL PLANS | $75.60 | $304.00 | $57.76 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | UPN MCAL PROFEE | UPN MCAL PROFEE | $76.00 | $304.00 | $57.76 | 2026-05-19 | MRF ↗ |
| St Anthony Regional Hospital & Nursing Home Outpatient | MIDLANDS CHOICE - ALL PLANS | MIDLANDS CHOICE - ALL PLANS | $76.98 | $1,890.00 | $1,890.00 | 2026-02-09 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | AETNA COMM-ALL OTHER PLANS | AETNA COMM-ALL OTHER PLANS | $78.57 | $2,614.50 | $1,699.43 | 2026-08-10 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $79.37 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | FCS IPA MEDI-CAL OP/PROFEE ONLY | FCS IPA MEDI-CAL OP/PROFEE ONLY | $79.97 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| FISHER-TITUS HOSPITAL Both | Galaxy | Galaxy | — | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Both | Galaxy | Galaxy | — | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Both | Claim Doc | Claimdoc | — | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Both | Claim Doc | Claimdoc | — | — | — | 2026-07-31 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $87.89 | $651.00 | $488.25 | 2026-01-16 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | AHP MEDI-CAL | AHP MEDI-CAL | $93.30 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | EL PROYECTO MCAL PROFEE ONLY | EL PROYECTO MCAL PROFEE ONLY | $93.30 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ASSOC HISPANIC PHYSCNS MCAL | ASSOC HISPANIC PHYSCNS MCAL | $93.30 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | GLOBAL CARE MCAL PROFEE ONLY | GLOBAL CARE MCAL PROFEE ONLY | $93.30 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | $93.30 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HCLA MCAL PROFEE ONLY | HCLA MCAL PROFEE ONLY | $93.30 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Medicare B NY Upstate JK | Default | $93.53 | $1,785.00 | $1,106.70 | 2026-03-16 | MRF ↗ |
| SUBLETTE COUNTY HEALTH Outpatient | TRICARE PROFEE ONLY - ALL PLANS | TRICARE PROFEE ONLY - ALL PLANS | $97.00 | $1,565.00 | $1,408.50 | 2026-10-07 | MRF ↗ |
| RUTLAND REGIONAL MEDICAL CENTER Both | First Health | Hmo | — | $562.00 | $505.80 | 2026-09-20 | MRF ↗ |
| RUTLAND REGIONAL MEDICAL CENTER Both | Mvp Vt Commercial | Hmo | — | $562.00 | $505.80 | 2026-09-20 | MRF ↗ |
| RUTLAND REGIONAL MEDICAL CENTER Both | Mvp Vt Health Connect | Hmo | — | $562.00 | $505.80 | 2026-09-20 | MRF ↗ |
| S E LACKEY MEMORIAL HOSPITAL Outpatient | BCBS AHS | BCBS AHS | $100.00 | $1,777.00 | $1,777.00 | 2026-02-10 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Blue Cross Blue Shield of NY Empire | Medicare Advantage | $100.21 | $1,785.00 | $1,106.70 | 2026-03-16 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE COMM PROFEE ONLY-ALL OTHER PLA | CENTRAL CA ALLIANCE COMM PROFEE ONLY-ALL OTHER PLA | $105.00 | $304.00 | $51.68 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE CCS MCAL | CENTRAL CA ALLIANCE CCS MCAL | $105.00 | $304.00 | $51.68 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MOLINA MEDI-CAL | MOLINA MEDI-CAL | $106.62 | $2,046.00 | $368.28 | 2026-01-30 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $122.96 | — | — | 2026-04-01 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Univera | Medicare Managed Care Plan | $122.96 | — | — | 2026-04-01 | MRF ↗ |
| SAINT LUKE'S SOUTH HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [4000] | BC OUT OF AREA PREF CARE [40010] | — | $31,987.75 | $19,192.65 | 2025-12-31 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - Meridian | Medicaid - Meridian | $128.00 | $1,267.00 | $633.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - United | Medicaid - United | $130.00 | $1,267.00 | $633.00 | 2025-02-03 | MRF ↗ |
| JACKSON COUNTY REGIONAL HEALTH CENTER Outpatient | TRICARE | TRICARE | $131.51 | $281.00 | $281.00 | 2025-07-29 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $135.08 | $651.00 | $488.25 | 2026-01-16 | 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.