19318 — Breast Reduction
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). BREAST REDUCTION (HCPCS 19318) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/19318?code_type=HCPCS
MLA (9th ed.)
“BREAST REDUCTION (HCPCS 19318) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/19318?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“BREAST REDUCTION (HCPCS 19318) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/19318?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $4,197–$10,469 (25th–75th percentile) across 1,800 hospitals · 4,239 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.
2,200 facilities · 613 not in the CPT/HCPCS table
- ACADIAN MEDICAL CENTER, EUNICE • only here
- AdventHealth Carrollwood, TAMPA • only here
- ADVENTHEALTH CENTRAL TEXAS, KILLEEN • only here
- Adventhealth Connerton, Land O' Lakes • only here
- ADVENTHEALTH DADE CITY, DADE CITY • only here
- ADVENTHEALTH DAYTONA BEACH, DAYTONA BEACH • only here
2,190 facilities · 606 not in the CPT/HCPCS table
- ACADIAN MEDICAL CENTER, EUNICE • only here
- AdventHealth Carrollwood, TAMPA • only here
- ADVENTHEALTH CENTRAL TEXAS, KILLEEN • only here
- Adventhealth Connerton, Land O' Lakes • only here
- ADVENTHEALTH DADE CITY, DADE CITY • only here
- ADVENTHEALTH DAYTONA BEACH, DAYTONA BEACH • 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
$4,197
$7,007 typical
$10,469
The middle 50% of negotiated facility rates for this procedure, measured across 1,800 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. | $7,007 |
| Surgeon (professional fee) Estimate national typical Medicare $980 × 1.22 commercial. | $1,196 |
| 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 | $8,911 |
Surgical episode (typical)
~$8,911
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)
~$12,696
- The anesthesia component is a generic, approximate estimate — no procedure-specific anesthesia mapping exists for this code, so a typical anesthesia for this procedure type is shown.
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 |
|---|---|---|---|---|---|---|---|
| Highsmith Rainey Memorial Hospital Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $1.00 | $0.60 | 2026-05-17 | MRF ↗ |
| Highsmith Rainey Memorial Hospital Outpatient | United Healthcare | Commercial | — | $1.00 | $0.60 | 2026-05-17 | MRF ↗ |
| UNIVERSITY OF VIRGINIA MEDICAL CENTER Outpatient | VETERANS [99909] | UVA HB VETERANS CHOICE | $5.99 | $42,974.81 | $25,784.89 | 2026-03-24 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $22.53 | $12,515.00 | $6,525.10 | 2024-12-31 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL AETNA CARE [700912] | $26.30 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| PRATT REGIONAL MEDICAL CENTER Outpatient | Christian Health Aid | Commercial | $41.00 | $55.00 | $39.00 | 2025-10-24 | MRF ↗ |
| PRATT REGIONAL MEDICAL CENTER Outpatient | United Healthcare | Commercial | $46.00 | $55.00 | $39.00 | 2025-10-24 | MRF ↗ |
| PRATT REGIONAL MEDICAL CENTER Outpatient | Health Partners of Kansas | Commercial | $47.00 | $55.00 | $39.00 | 2025-10-24 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| PRATT REGIONAL MEDICAL CENTER Outpatient | Aetna | Commercial | $50.00 | $55.00 | $39.00 | 2025-10-24 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL WELLCARE CARE [700920] | $50.59 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL MED PLUS BLUE CARE [700903] | $50.59 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL AETNA BETTER HEALTH MEDICAID [300612] | $50.99 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| PRATT REGIONAL MEDICAL CENTER Outpatient | ChoiceCare | Commercial | $55.00 | $55.00 | $39.00 | 2025-10-24 | MRF ↗ |
| PRATT REGIONAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | $56.00 | $55.00 | $39.00 | 2025-10-24 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL UNITED HEALTHCARE CARE [300609] | $60.02 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL UNITED HEALTHCARE CARE [700909] | $60.02 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL UNITED HEALTHCARE LABS [106809] | $60.02 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $62.90 | — | $41,850.50 | 2026-03-31 | MRF ↗ |
| MERCYONE WATERLOO MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $62.90 | — | $65,474.66 | 2026-03-31 | MRF ↗ |
| MERCYONE NORTH IOWA MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $62.90 | — | $64,470.72 | 2026-03-31 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL MIDWEST HEALTHCARE CARE [700907] | $63.24 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL VACCN [106827] | $63.24 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL PRIORITY HEALTH CARE [700911] | $63.24 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL HAP CARE [700904] | $63.24 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | OMNICARE CARE [700906] | $63.24 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL GENERIC MEDICARE [700914] | $63.24 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL AMERIHEALTH CARITAS VIP [700921] | $63.24 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | WELLCARE HEALTH PLAN [250516] | MEDICARE REPLACEMENT [25051601] | $63.66 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | WELLCARE HEALTH PLAN [250516] | MEDICARE REPLACEMENT [25051601] | $63.66 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | BCBS MEDICARE [250503] | BCBS MEDICARE REPLACEMENT [25050301] | $63.66 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | CIGNA MCR HMO/PPO [250525] | MEDICARE REPLACEMENT [25052501] | $63.66 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | BCBS MEDICARE [250503] | BCBS MEDICARE REPLACEMENT [25050301] | $63.66 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | CIGNA MCR HMO/PPO [250525] | MEDICARE REPLACEMENT [25052501] | $63.66 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | AETNA COVENTRY MCR REPLACEMENT [250518] | AETNA MEDICARE [25051801] | $64.78 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | HUMANA GOLD [250508] | PFFS MEDICARE REPLACEMENT [25050801] | $64.78 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | UNITED HEALTH MCR HMO/PPO [250515] | UHC MEDICARE REPLACEMENT [25051501] | $64.78 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | UNITED HEALTH MCR HMO/PPO [250515] | UHC MEDICARE REPLACEMENT [25051501] | $64.78 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | AETNA COVENTRY MCR REPLACEMENT [250518] | AETNA MEDICARE [25051801] | $64.78 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | HUMANA GOLD [250508] | PFFS MEDICARE REPLACEMENT [25050801] | $64.78 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | ALIGN SENIOR CARE [250524] | ALIGN MEDICARE REPLACEMENT [25052401] | $64.87 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | FREEDOM HEALTH [250505] | FREEDOM HLTH MEDICARE REPLACEMENT [25050501] | $64.87 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | FREEDOM HEALTH [250505] | FREEDOM HLTH MEDICARE REPLACEMENT [25050501] | $64.87 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | ALIGN SENIOR CARE [250524] | ALIGN MEDICARE REPLACEMENT [25052401] | $64.87 | $92,864.41 | $18,572.88 | 2026-03-26 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL MERIDIAN CAID [300605] | $70.67 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| MIDDLESEX HOSPITAL Outpatient | AETNA | MIDDLESEX HOSP EMP AETNA | $75.00 | — | — | 2025-01-01 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $79.42 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $79.92 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $79.92 | — | — | 2026-03-18 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER OutpatientFacility | Cigna | PPO | $82.00 | $8,049.00 | $8,049.00 | 2026-04-15 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL BLUE CROSS COMPLETE [300610] | $84.99 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL HAP EMPOWERED [300613] | $86.78 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL MIDWEST HEALTH CAID [300607] | $86.78 | $58,700.01 | $58,700.01 | 2026-03-23 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $88.62 | — | — | 2026-04-14 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $91.02 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $91.59 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $91.59 | — | — | 2026-03-18 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $94.35 | — | $51,374.62 | 2026-03-31 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $99.10 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $99.72 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $99.72 | — | — | 2026-03-18 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $107.61 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $107.61 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $107.61 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $107.61 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $107.61 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $107.61 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $107.61 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $107.61 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $107.61 | — | — | 2026-04-14 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $107.65 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $107.65 | — | — | 2026-04-01 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $116.91 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $116.91 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $116.91 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $116.91 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $116.91 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $116.91 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $116.91 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $116.91 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $116.91 | — | — | 2026-04-14 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $131.99 | — | — | 2026-05-06 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | United Healthcare | Medicaid | $134.40 | $3,036.75 | $2,550.87 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Mdwise | Excel And Hoosier Healthwise | $134.40 | $3,036.75 | $2,550.87 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Managed Health Services | Medicaid | $134.40 | $3,036.75 | $2,550.87 | 2026-05-09 | MRF ↗ |
| ALTUS BAYTOWN HOSPITAL Outpatient | Blue Cross Blue Shield of Texas | HMO | $138.00 | $172.00 | $172.00 | 2026-04-01 | MRF ↗ |
| ALTUS BAYTOWN HOSPITAL Outpatient | Blue Cross Blue Shield of Texas | PPO | $138.00 | $172.00 | $172.00 | 2026-04-01 | MRF ↗ |
| ALTUS BAYTOWN HOSPITAL Outpatient | Blue Cross Blue Shield of Texas | Blue Advantage | $138.00 | $172.00 | $172.00 | 2026-04-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Sunshine State Oncology | Medicaid HMO | $142.20 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Medicaid HMO | $142.20 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Healthy Kids | $142.20 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Molina Oncology | Medicaid HMO | $146.26 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Molina Oncology | Healthy Kids | $146.26 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Amerihealth Caritas Oncology | Medicaid HMO | $148.97 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Community Care Plan Oncology | Medicaid HMO | $148.97 | — | — | 2025-08-01 | 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 | Interwest Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | UHC | Medicare Advantage | $149.76 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | First Health Network | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $149.76 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Coventry | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $149.76 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Tricare | All | $149.76 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Prime Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | VA Health | All | $149.76 | — | — | 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 ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 1&2|MVP ESSENTIAL 3&4 | $157.00 | $15,089.03 | $12,071.22 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP OPTION|MVP CHILD HEALTH PLUS | $157.00 | $15,089.03 | $12,071.22 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP EXCHANGE-INDIVIDUAL | $157.00 | $15,089.03 | $12,071.22 | 2024-12-30 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $157.29 | — | — | 2026-04-14 | MRF ↗ |
| DRISCOLL CHILDREN'S HOSPITAL RIO GRANDE VALLEY Outpatient | TEXAS REHABILITATION COMM [50038] | TEXAS REHABILITATION COMM [5003801] | $165.82 | $16,508.80 | $3,301.76 | 2025-10-06 | MRF ↗ |
| Driscoll Children's Hospital Transplant Center Both | TEXAS REHABILITATION COMM [50038] | TEXAS REHABILITATION COMM [5003801] | $165.82 | $14,356.10 | $2,871.22 | 2026-03-31 | MRF ↗ |
| DRISCOLL CHILDRENS HOSPITAL Outpatient | TEXAS REHABILITATION COMM [50038] | TEXAS REHABILITATION COMM [5003801] | $165.82 | $14,356.10 | $2,871.22 | 2025-10-06 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | BCBS - TN | Commercial|Network S | $167.00 | — | — | 2026-02-28 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $168.39 | — | — | 2026-04-14 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Peia | Other Governmental | $169.64 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Peak Health | Medicare | $169.64 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | United Healthcare | Medicare | $169.64 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Aetna | Medicare | $169.64 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Highmark Blue Cross | Medicare | $169.64 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Humana | Medicare | $169.64 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Highmark Blue Cross | Ppo/Pos | $169.64 | — | — | 2026-05-06 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Blue Cross Oncology | Medicare Advantage | $171.83 | — | — | 2025-08-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $172.71 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $172.71 | — | — | 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 WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $172.71 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $172.71 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $172.71 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $172.71 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $172.71 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $172.71 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $172.71 | — | — | 2026-01-01 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.