19318 — Breast Reduction
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). BREAST REDUCTION (CPT 19318) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/19318?code_type=CPT
MLA (9th ed.)
“BREAST REDUCTION (CPT 19318) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/19318?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“BREAST REDUCTION (CPT 19318) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/19318?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,957–$10,380 (25th–75th percentile) across 2,170 hospitals · 4,341 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 19318 — 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 19318 table above — including hospitals that only publish the bundled version.
2,753 facilities · 907 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
2,732 facilities · 892 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 19318 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
$3,957
$6,908 typical
$10,380
The middle 50% of negotiated facility rates for this procedure, measured across 2,170 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. | $6,908 |
| Surgeon (professional fee) Estimate national typical Medicare $980 × 1.22 commercial. | $1,196 |
| Anesthesia Estimate national typical 00402, ~90 min typical. Medicare $225 × 3.14 commercial. | $708 |
| Likely subtotal | $8,811 |
Surgical episode (typical)
~$8,811
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 $3,957–$10,380.
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)
~$12,596
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 |
|---|---|---|---|---|---|---|---|
| Arkansas Children's Hospital Outpatient | Ambetter, Qualchoice Novasys | All Plans | — | $12,033.62 | $10,830.26 | 2026-07-15 | MRF ↗ |
| Highsmith Rainey Memorial Hospital Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $1.00 | $0.60 | 2026-07-15 | MRF ↗ |
| Highsmith Rainey Memorial Hospital Outpatient | United Healthcare | Commercial | — | $1.00 | $0.60 | 2026-07-15 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Blue Cross | Medicare Advantage | — | — | — | 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 | Managed Medicare | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | United Health Care | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Molina | Mangaged Medicare | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Cigna | Commercial | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | First Choice Select Health | Managed Medicaid | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Aetna | Commercial | — | — | — | 2026-10-03 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $22.53 | $12,515.00 | $6,525.10 | 2024-12-31 | MRF ↗ |
| DECATUR COUNTY MEMORIAL HOSPITAL Outpatient | UHC-ALL OTHER PLANS | UHC-ALL OTHER PLANS | $30.00 | $3,435.00 | $2,576.25 | 2026-03-18 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $31.72 | $5,667.00 | $1,076.73 | 2026-05-20 | 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 | $55.00 | $5,667.00 | $850.05 | 2026-10-05 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | UNIVERSAL HC MCAL PROFEE ONLY | UNIVERSAL HC MCAL PROFEE ONLY | $55.00 | $5,667.00 | $850.05 | 2026-10-05 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | MEDI-CAL | MEDI-CAL | $55.00 | $5,667.00 | $850.05 | 2026-10-05 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | BLUE CROSS NON-MCS | BLUE CROSS NON-MCS | $66.41 | $5,667.00 | $1,133.40 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | BLUE CROSS MCS-ALL OTHER PLANS | BLUE CROSS MCS-ALL OTHER PLANS | $66.41 | $5,667.00 | $1,133.40 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | KERN HEALTH SYSTEMS MCAL | KERN HEALTH SYSTEMS MCAL | $77.55 | $5,667.00 | $850.05 | 2026-10-05 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | AETNA COMM-ALL OTHER PLANS | AETNA COMM-ALL OTHER PLANS | $78.57 | $5,748.75 | $3,736.69 | 2026-08-10 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BC MEDI-CAL | BC MEDI-CAL | $80.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| GLENDALE ADVENTIST MEDICAL CENTER Outpatient | BLUE SHIELD MEDI-CAL | BLUE SHIELD MEDI-CAL | $80.00 | $823.00 | $123.45 | 2026-07-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ALTAMED MEDI-CAL - ALL OTHER PLANS | ALTAMED MEDI-CAL - ALL OTHER PLANS | $80.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PREFERRED MEDI-CAL | PREFERRED MEDI-CAL | $80.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| GLENDALE ADVENTIST MEDICAL CENTER Outpatient | MEDI-CAL | MEDI-CAL | $80.00 | $823.00 | $123.45 | 2026-07-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | CARE FIRST MEDI-CAL | CARE FIRST MEDI-CAL | $80.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| GLENDALE ADVENTIST MEDICAL CENTER Outpatient | BC MEDI-CAL | BC MEDI-CAL | $80.00 | $823.00 | $123.45 | 2026-07-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MEDI-CAL | MEDI-CAL | $80.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | LASALLE MG MEDI-CAL | LASALLE MG MEDI-CAL | $80.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| GLENDALE ADVENTIST MEDICAL CENTER Outpatient | MOLINA MCAL | MOLINA MCAL | $80.00 | $823.00 | $123.45 | 2026-07-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHCARE INC MEDI-CAL | HEALTHCARE INC MEDI-CAL | $80.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC ALLIANCE MEDI-CAL | PACIFIC ALLIANCE MEDI-CAL | $80.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BLUE SHIELD MEDI-CAL | BLUE SHIELD MEDI-CAL | $80.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ACCESS MEDI-CAL | ACCESS MEDI-CAL | $80.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC IPA MEDI-CAL | PACIFIC IPA MEDI-CAL | $80.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| GLENDALE ADVENTIST MEDICAL CENTER Outpatient | HERITAGE MCAL | HERITAGE MCAL | $84.80 | $823.00 | $123.45 | 2026-07-30 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | KAISER MCAL | KAISER MCAL | $85.00 | $5,667.00 | $1,076.73 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | UNIVERSAL HC MCAL PROFEE | UNIVERSAL HC MCAL PROFEE | $85.00 | $5,667.00 | $1,076.73 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE MCAL | CENTRAL CA ALLIANCE MCAL | $85.00 | $5,667.00 | $963.39 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | BC MCAL | BC MCAL | $85.00 | $5,667.00 | $1,076.73 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | BC MCAL | BC MCAL | $85.00 | $5,667.00 | $963.39 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $85.00 | $5,667.00 | $1,076.73 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $85.00 | $5,667.00 | $963.39 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | MEDI-CAL | MEDI-CAL | $85.00 | $5,667.00 | $1,076.73 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CELTIC CA HLTH WELL MCAL - ALL PLANS | CELTIC CA HLTH WELL MCAL - ALL PLANS | $85.00 | $5,667.00 | $963.39 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | MEDI-CAL | MEDI-CAL | $85.00 | $5,667.00 | $963.39 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $95.28 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| GLENDALE ADVENTIST MEDICAL CENTER Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $95.28 | $823.00 | $123.45 | 2026-07-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | FCS IPA MEDI-CAL OP/PROFEE ONLY | FCS IPA MEDI-CAL OP/PROFEE ONLY | $96.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Univera | Medicare Managed Care Plan | $107.65 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $107.65 | — | — | 2026-04-01 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | EL PROYECTO MCAL PROFEE ONLY | EL PROYECTO MCAL PROFEE ONLY | $112.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ASSOC HISPANIC PHYSCNS MCAL | ASSOC HISPANIC PHYSCNS MCAL | $112.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | AHP MEDI-CAL | AHP MEDI-CAL | $112.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | $112.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HCLA MCAL PROFEE ONLY | HCLA MCAL PROFEE ONLY | $112.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | GLOBAL CARE MCAL PROFEE ONLY | GLOBAL CARE MCAL PROFEE ONLY | $112.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE CCS MCAL | CENTRAL CA ALLIANCE CCS MCAL | $127.50 | $5,667.00 | $963.39 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE COMM PROFEE ONLY-ALL OTHER PLA | CENTRAL CA ALLIANCE COMM PROFEE ONLY-ALL OTHER PLA | $127.50 | $5,667.00 | $963.39 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MOLINA MEDI-CAL | MOLINA MEDI-CAL | $128.00 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | VALLEY CHILDRENS - ALL PLANS | VALLEY CHILDRENS - ALL PLANS | $142.80 | $5,667.00 | $1,076.73 | 2026-05-19 | MRF ↗ |
| BLACK HILLS SURGICAL HOSPITAL LLC Both | Umr United Medical Resources | Default | $143.42 | $631.00 | $378.60 | 2026-07-15 | MRF ↗ |
| BLACK HILLS SURGICAL HOSPITAL LLC Both | United Healthcare | Default | $143.42 | $631.00 | $378.60 | 2026-07-15 | MRF ↗ |
| BLACK HILLS SURGICAL HOSPITAL LLC Both | United Healthcare | Medicare Advantage | $143.42 | $631.00 | $378.60 | 2026-07-15 | MRF ↗ |
| BLACK HILLS SURGICAL HOSPITAL LLC Both | Blue Cross Blue Shield Of Sd Wellmark | Medicare Advantage | $144.85 | $631.00 | $378.60 | 2026-07-15 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $149.18 | $1,105.00 | $828.75 | 2026-01-16 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Coventry | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Montana Health CoOp | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Prime Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Pacific Source | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Interwest Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | First Health Network | All | — | — | — | 2026-03-28 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE CHDP MCAL | CENTRAL CA ALLIANCE CHDP MCAL | $170.00 | $5,667.00 | $963.39 | 2026-05-23 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK 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 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 WILLIAMSPORT Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | UNIFIED GROUP SERVICES | 8812_ANTHEM UNIFIED GROUPS VHIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PATHWAY | 9230_ANTHEM PATHWAY VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PATHWAY X | 9231_ANTHEM PATHWAY X VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HMO/POS | 9229_ANTHEM HMO POS VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HEALTHSYNC HMO | 9227_ANTHEM HEALTHSYNC HMO VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $197.32 | $4,626.00 | $4,626.00 | 2025-10-04 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $197.32 | $5,667.00 | $1,530.09 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | UNIVERSAL IPA MCAL OP/PROFEE ONLY | UNIVERSAL IPA MCAL OP/PROFEE ONLY | $197.32 | $5,667.00 | $1,530.09 | 2026-01-31 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $197.32 | $4,626.00 | $4,626.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $197.32 | $4,626.00 | $4,626.00 | 2025-10-04 | MRF ↗ |
| ADVENTIST HEALTH ST HELENA Outpatient | MEDI-CAL | MEDI-CAL | $197.32 | $4,192.00 | $628.80 | 2026-07-15 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $197.32 | $4,626.00 | $4,626.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $201.27 | $4,626.00 | $4,626.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $201.27 | $4,626.00 | $4,626.00 | 2025-10-04 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $204.54 | — | — | 2026-04-01 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Univera | Medicare Managed Care Plan | $204.54 | — | — | 2026-04-01 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Healthfirst | Medicare Advantage PPO | $225.00 | $14,453.02 | $7,717.23 | 2026-09-05 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $229.29 | $1,105.00 | $828.75 | 2026-01-16 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PROSPECT MG COM/POS PROFEE ONLY-ALL OTHER PLAN | PROSPECT MG COM/POS PROFEE ONLY-ALL OTHER PLAN | $246.90 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PROSPECT MG MCAL PROFEE ONLY | PROSPECT MG MCAL PROFEE ONLY | $246.90 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PROSPECT MG MCR ADV PROFEE ONLY | PROSPECT MG MCR ADV PROFEE ONLY | $246.90 | $823.00 | $148.14 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PROSPECT MG MCR ADV PROFEE ONLY | PROSPECT MG MCR ADV PROFEE ONLY | $246.90 | $823.00 | $148.14 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PROSPECT MG MCAL PROFEE ONLY | PROSPECT MG MCAL PROFEE ONLY | $246.90 | $823.00 | $148.14 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PROSPECT MG COM/POS PROFEE ONLY-ALL OTHER PLAN | PROSPECT MG COM/POS PROFEE ONLY-ALL OTHER PLAN | $246.90 | $823.00 | $148.14 | 2026-01-30 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Avmed | Commercial (MMG) | $249.07 | — | — | 2025-10-24 | MRF ↗ |
| GILLETTE CHILDRENS SPECIALTY HOSPITAL Outpatient | Health Partners | Managed Medicaid | $249.08 | — | — | 2026-07-15 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Curative | Commercial | $250.00 | $2,186.00 | $2,186.00 | 2025-07-03 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Blue Cross Oncology | Blue Select | $256.03 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Blue Cross Oncology UPW | Blue Select | $256.03 | — | — | 2026-06-30 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Bcbs | Exchange | $256.04 | — | — | 2026-07-15 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Bcbs | Commercial | $256.04 | — | — | 2026-07-15 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Cigna | Medicare Advantage | $256.50 | — | — | 2025-10-24 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $256.52 | $4,626.00 | $4,626.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $256.52 | $4,626.00 | $4,626.00 | 2025-10-04 | MRF ↗ |
| Shepherd Center Outpatient | Aetna | Commercial | $256.66 | — | — | 2026-09-21 | MRF ↗ |
| Shepherd Center Outpatient | Aetna | Commercial | $256.66 | — | — | 2026-05-06 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $14,453.02 | $7,717.23 | 2026-09-05 | MRF ↗ |
| LINCOLN MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $14,453.02 | — | 2025-09-05 | MRF ↗ |
| QUEENS HOSPITAL CENTER OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $17,632.08 | — | 2025-09-05 | MRF ↗ |
| ELMHURST HOSPITAL CENTER OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $14,453.02 | — | 2025-09-05 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $17,632.08 | — | 2025-09-05 | MRF ↗ |
| KINGS COUNTY HOSPITAL CENTER OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $17,632.08 | — | 2025-09-05 | MRF ↗ |
| BELLEVUE HOSPITAL CENTER OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $17,632.08 | — | 2025-09-05 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $17,632.08 | — | 2025-09-05 | MRF ↗ |
| QUEENS HOSPITAL CENTER OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $17,632.08 | — | 2025-09-05 | MRF ↗ |
| METROPOLITAN HOSPITAL CENTER OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $14,453.02 | — | 2025-09-05 | MRF ↗ |
| KINGS COUNTY HOSPITAL CENTER OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $17,632.08 | — | 2025-09-05 | MRF ↗ |
| METROPOLITAN HOSPITAL CENTER OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $14,453.02 | — | 2025-09-05 | MRF ↗ |
| WOODHULL MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $17,632.08 | — | 2025-09-05 | MRF ↗ |
| WOODHULL MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $17,632.08 | — | 2025-09-05 | MRF ↗ |
| JACOBI MEDICAL CENTER OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $17,632.08 | — | 2025-09-05 | MRF ↗ |
| JACOBI MEDICAL CENTER OutpatientFacility | Aetna | ALL PRODUCTS | $257.00 | $17,632.08 | — | 2025-09-05 | MRF ↗ |
| The Queen's Medical Center Outpatient | Alohacare | Medicaid | $257.71 | $43,779.00 | $30,645.30 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | Alohacare | Medicaid | $257.71 | $1.01 | $0.71 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Alohacare | Medicaid | $257.71 | $1.01 | $0.71 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | Alohacare | Medicaid | $257.71 | $44,177.00 | $30,923.90 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Alohacare | Medicaid | $257.71 | $43,779.00 | $30,645.30 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Alohacare | Medicaid | $257.71 | $44,177.00 | $30,923.90 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Alohacare | Medicaid | $257.71 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | Alohacare | Medicaid | $257.71 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Encore Prime | Commercial | $257.74 | — | — | 2026-07-17 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Blue Cross | Epo/Ppo/Hmo/Indemnity | $258.81 | — | — | 2026-07-18 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | ALBANY COUNTY CORRECTIONAL FACILITY | ALBANY CORRECTIONAL FACILITY | $261.73 | — | $12,983.82 | 2026-03-31 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Cigna Oncology UPW | Commercial | $265.93 | — | — | 2026-06-30 | MRF ↗ |
| CITIZENS BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $266.00 | — | — | 2024-12-11 | MRF ↗ |
| Shepherd Center Outpatient | Coventry | Commercial | $266.11 | — | — | 2026-05-06 | MRF ↗ |
| Shepherd Center Outpatient | Coventry | Commercial | $266.11 | — | — | 2026-09-21 | MRF ↗ |
| Shepherd Center Outpatient | Coventry | Commercial | $266.11 | — | — | 2026-09-21 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Health First | Commercial (MMG) | $266.86 | — | — | 2025-10-24 | MRF ↗ |
| Shepherd Center Outpatient | Cigna | Commercial | $267.55 | — | — | 2026-05-06 | MRF ↗ |
| Shepherd Center Outpatient | Cigna | Commercial | $267.55 | — | — | 2026-09-21 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Blue Cross Oncology | Health Options | $274.93 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Blue Cross Oncology UPW | Health Options | $274.93 | — | — | 2026-06-30 | MRF ↗ |
| SHELBY BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $275.00 | — | — | 2024-12-11 | MRF ↗ |
| PRINCETON BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $275.00 | — | — | 2024-12-11 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Highmark Blue Cross | Ppo/Pos | $275.79 | — | — | 2026-07-15 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Highmark Blue Cross | Ppo/Pos | $275.79 | — | — | 2026-05-06 | MRF ↗ |
| GILLETTE CHILDRENS SPECIALTY HOSPITAL Outpatient | Uhc | Commercial | $276.96 | — | — | 2026-07-15 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Caresource | Marketplace | $277.32 | — | — | 2026-07-18 | MRF ↗ |
| GRADY MEMORIAL HOSPITAL Outpatient | Caresource | Marketplace | $277.32 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | Cigna | Eighth Dist Elect Ben Pln | $277.36 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | Allegiance | Allegiance Group Health | $277.36 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | Allegiance | Allegiance Other | $277.36 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | Allegiance | Cigna - Commercial | $277.36 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | Cigna | Cigna Other | $277.36 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | Allegiance | Cigna Sclhs Employees | $277.36 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | Cigna | Cigna Ppo | $277.36 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | Cigna | Cigna Pos/Qpos | $277.36 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | Allegiance | Silver Bow County Employees | $277.36 | — | — | 2026-07-15 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $277.44 | — | $12,983.82 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $277.44 | — | $12,983.82 | 2026-03-31 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $278.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $278.00 | — | — | 2024-12-08 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | First Choice Health | First Choice Other | $278.92 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | First Choice Health | First Choice Health | $278.92 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | First Choice Health | Boon-Chapman | $278.92 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | Ebms-Employee Benefit Mng | Ebms - Employee Benefit | $278.92 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | First Choice Health | First Choice Health | $278.92 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | Ebms-Employee Benefit Mng | Ebms - Employee Benefit | $278.92 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | First Choice Health | First Choice Other | $278.92 | — | — | 2026-07-15 | MRF ↗ |
| HOLY ROSARY HOSPITAL Outpatient | First Choice Health | Healthcomp Tpa | $278.92 | — | — | 2026-07-15 | MRF ↗ |
| CITIZENS BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $279.00 | — | — | 2024-12-11 | MRF ↗ |
| LOS ANGELES GENERAL MEDICAL CENTER Outpatient | [Medi-Cal Managed Care] | [Kaiser] | $283.04 | — | — | 2026-09-20 | MRF ↗ |
| LAC/OLIVE VIEW-UCLA MEDICAL CENTER Outpatient | [Medi-Cal Managed Care] | [Kaiser] | $283.04 | — | — | 2026-07-15 | MRF ↗ |
| Lac Harbor-ucla Medical Center Outpatient | [Medi-Cal Managed Care] | [Kaiser] | $283.04 | — | — | 2026-09-20 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Blue Cross | All Vermont Plans | $284.43 | $751.50 | $526.05 | 2026-07-15 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Multiplan | PHCS\PPO | $284.65 | — | — | 2025-10-24 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Blue Cross Oncology | Network Blue | $288.68 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Blue Cross Oncology UPW | Network Blue | $288.68 | — | — | 2026-06-30 | MRF ↗ |
| PRINCETON BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $289.00 | — | — | 2024-12-11 | MRF ↗ |
| SHELBY BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $289.00 | — | — | 2024-12-11 | MRF ↗ |
| BASSETT HEALTHCARE Inpatient | Bcbs | Empire Exchange | $291.39 | $1,500.00 | $750.00 | 2026-07-17 | MRF ↗ |
| BASSETT HEALTHCARE Inpatient | Bcbs | Empire Exchange | $291.39 | $1,125.00 | $562.50 | 2026-07-17 | MRF ↗ |
| BASSETT HEALTHCARE Inpatient | Bcbs | Empire Exchange | $291.39 | $4,500.00 | $2,250.00 | 2026-07-17 | MRF ↗ |
| BASSETT HEALTHCARE Inpatient | Bcbs | Empire Exchange | $291.39 | $600.00 | $300.00 | 2026-07-17 | MRF ↗ |
| BASSETT HEALTHCARE Inpatient | Bcbs | Empire Exchange | $291.39 | $3,750.00 | $1,875.00 | 2026-07-17 | MRF ↗ |
| BASSETT HEALTHCARE Inpatient | Bcbs | Empire Exchange | $291.39 | $750.00 | $375.00 | 2026-07-17 | 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.