19357 — Tiss Xpndr Plmt Brst Rcnstj
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). TISS XPNDR PLMT BRST RCNSTJ (CPT 19357) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/19357?code_type=CPT
MLA (9th ed.)
“TISS XPNDR PLMT BRST RCNSTJ (CPT 19357) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/19357?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“TISS XPNDR PLMT BRST RCNSTJ (CPT 19357) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/19357?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $4,829–$18,842 (25th–75th percentile) across 1,703 hospitals · 3,316 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 19357 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees 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 figures are estimates from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$4,829
$13,731 typical
$18,842
The middle 50% of negotiated facility rates for this procedure, measured across 1,703 hospitals. Surgeon & 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. | $13,731 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $1,073 × 1.22 commercial. | $1,309 |
| Likely subtotal | $15,040 |
Surgical episode (typical)
~$15,040
Your recovery plan — adjust to what your surgeon told you
After surgery, 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)
~$18,825
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
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 | Cigna | Commercial | — | $17,697.00 | $10,618.20 | 2026-05-22 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | United Healthcare | Compass | — | $17,697.00 | $10,618.20 | 2026-05-22 | MRF ↗ |
| CHI HEALTH LAKESIDE Outpatient | United | Commercial|All Plans | — | — | — | 2026-02-28 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $17,697.00 | $10,618.20 | 2026-05-22 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $15,374.33 | $1,537.43 | 2026-05-22 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $15,374.33 | $1,537.43 | 2026-05-14 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $15,374.33 | $1,537.43 | 2026-05-06 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | UNITED HEALTH [40002] | CHA HB MEDICARE MANAGED CARE - UHC | $4.54 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | AARP [40001] | CHA HB MEDICARE MANAGED CARE - UHC | $4.54 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| MERCYONE WATERLOO MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $4.56 | — | $51,541.69 | 2026-03-31 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HPHC [20001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MEDICARE [60001] | CHA HB MEDICARE | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | CIGNA [50005] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | AETNA [50001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS GENERAL BRIGHAM [50021] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | SENIOR WHOLE HEALTH [65003] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BOSTON MEDICAL CENTER - WELLSENSE [50003] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS HEALTH PLAN [30001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BCBS - MA [10001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HEALTH SAFETY NET [80001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER COMMERCIAL PAYOR [50015] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | ELDER SERVICE PLAN [65002] | CHA HB ELDER SERVICE PLAN | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BCBS - OUT OF STATE [10002] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HUMANA [50008] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | RR MEDICARE [60002] | CHA HB MEDICARE | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | COMMONWEALTH CARE ALLIANCE [65001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS HEALTH PLAN [30001] | CHA HB Tufts Health Plan Medicare Preferred | $5.04 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $7.12 | — | $10,594.71 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $7.12 | — | $10,594.71 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $7.12 | — | $10,594.71 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $7.12 | — | $10,594.71 | 2026-03-31 | MRF ↗ |
| UNIVERSITY OF VIRGINIA MEDICAL CENTER Outpatient | VETERANS [99909] | UVA HB VETERANS CHOICE | $8.43 | $94,558.47 | $56,735.08 | 2026-03-24 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB MEDICAID-STANDARD | $8.88 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | UNITED HEALTH [40002] | CHA HB MEDICAID-STANDARD | $8.88 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS TOGETHER W CHA [75001] | CHA HB MEDICAID-STANDARD | $8.88 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BOSTON MEDICAL CENTER - WELLSENSE [50003] | CHA HB MEDICAID-STANDARD | $8.88 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB MEDICAID-STANDARD | $8.88 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OOS MEDICAID [70002] | CHA HB MEDICAID-STANDARD | $8.88 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS GENERAL BRIGHAM [50021] | CHA HB MEDICAID-STANDARD | $8.88 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS HEALTH [70001] | CHA HB MEDICAID-STANDARD | $8.88 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HEALTH SAFETY NET [80001] | CHA HB HEALTH SAFETY NET | $10.08 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB FALLON | $10.08 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB FALLON CAREPLUS | $10.08 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | CHAMPVA [85001] | CHA HB TRICARE | $10.08 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER GOV'T PAYOR [85003] | CHA HB TRICARE | $10.08 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TRICARE [85002] | CHA HB TRICARE | $10.08 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB TUFTS HEALTH PUBLIC PLANS QHP NON-SUBSIDIZED | $16.27 | $17,055.90 | $17,055.90 | 2026-03-20 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | UHC COMMUNITY MEDICAID [2175] | HB XR UHC INDIANA PATHWAYS MEDICAID | $16.63 | $67,798.09 | $42,001.17 | 2025-12-19 | 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 ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Care Improvement Plus | Medicare Advantage | — | $104.75 | $87.99 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Encore | Ppo | — | $104.75 | $87.99 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Consumer Life | Commercial | — | $104.75 | $87.99 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Managed Health Services | Medicaid | $31.20 | $104.75 | $87.99 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Aetna | Medicare Advantage | — | $104.75 | $87.99 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Coventry | Commercial | — | $104.75 | $87.99 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Mdwise | Excel And Hoosier Healthwise | $31.20 | $104.75 | $87.99 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Humana Healthnet | Tricare | — | $104.75 | $87.99 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | Anthem | Ppo Hmo Exchange | — | $104.75 | $87.99 | 2026-05-09 | MRF ↗ |
| MARGARET MARY COMMUNITY HOSPITAL INC Outpatient | United Healthcare | Medicaid | $31.20 | $104.75 | $87.99 | 2026-05-09 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | $9,958.71 | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | $9,958.71 | 2024-12-08 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $41.60 | $23,111.00 | $18,317.44 | 2024-12-31 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | $9,958.71 | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | WELLPOINT [1007] | WELLPOINT CHIP PERINATE POST PARTUM [100704] | $58.36 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | COOK CHILDREN HEALTH PLAN [1380] | COOK CHILDRENS STAR KIDS [138005] | $61.28 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | COOK CHILDREN HEALTH PLAN [1380] | COOK CHILDRENS CHIP [138006] | $61.28 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | COOK CHILDREN HEALTH PLAN [1380] | COOK CHILDREN STAR MEDICAID [138000] | $61.28 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | PARKLAND COMMUNITY HEALTH PLAN [1056] | Parkland CHIP [105606] | $61.30 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | AETNA BETTER HEALTH [1317] | AETNA BETTER HEALTH CHIP [131701] | $61.30 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | AETNA BETTER HEALTH [1317] | BELOW FPIL AETNA CHIP PERINATE [131702] | $61.30 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | AETNA BETTER HEALTH [1317] | ABOVE FPIL AETNA CHIP PERINATE [131703] | $61.30 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | MOLINA [1382] | MOLINA RSA MEDICAID [138203] | $64.19 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | MOLINA [1382] | MOLINA CHIP [138201] | $64.19 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | POINT COMFORT UNDERWRITERS [1801] | POINT COMFORT UNDERWRITERS [180100] | $64.19 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $71.16 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | VA Health | All | $71.16 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $71.16 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Tricare | All | $71.16 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | UHC | Medicare Advantage | $71.16 | — | — | 2026-03-28 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $73.82 | — | — | 2026-04-14 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | CARE IMPROVEMENT PLUS [1104] | CARE IMPROVEMENT PLUS [110400] | $80.67 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | SUPERIOR MEDICARE ADVANTAGE [1319] | SUPERIOR DUAL MEDICARE-MEDICAID PLAN [131901] | $80.67 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | SUPERIOR MEDICARE ADVANTAGE [1319] | ALLWELL SUPERIOR MEDICARE ADVANTAGE [131900] | $80.67 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | SUPERIOR MEDICARE ADVANTAGE [1319] | ALLWELL SUPERIOR MEDICARE ADVANTAGE [131900] | $80.67 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | SUPERIOR MEDICARE ADVANTAGE [1319] | SUPERIOR DUAL MEDICARE-MEDICAID PLAN [131901] | $80.67 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | CARE IMPROVEMENT PLUS [1104] | CARE IMPROVEMENT PLUS [110400] | $80.67 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | CARE IMPROVEMENT PLUS [1104] | CARE IMPROVEMENT PLUS [110400] | $80.67 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | SUPERIOR MEDICARE ADVANTAGE [1319] | ALLWELL SUPERIOR MEDICARE ADVANTAGE [131900] | $80.67 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | SUPERIOR MEDICARE ADVANTAGE [1319] | SUPERIOR DUAL MEDICARE-MEDICAID PLAN [131901] | $80.67 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | WELLPOINT MEDICARE ADVANTAGE [2009] | WELLPOINT DUAL MEDICARE-MEDICAID PLAN [200902] | $81.06 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | UNITED HEALTHCARE MEDICARE ADVANTAGE [1315] | UNITED HEALTHCARE MEDICARE ADVANTAGE [131500] | $81.06 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | WELLCARE OF TEXAS [1330] | WELLCARE MEDICARE ADVANTAGE - UXR [133000] | $81.06 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | WELLCARE OF TEXAS [1330] | WELLCARE MEDICARE ADVANTAGE - UXR [133000] | $81.06 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | WELLPOINT MEDICARE ADVANTAGE [2009] | WELLPOINT MEDICARE ADVANTAGE [200901] | $81.06 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | WELLPOINT MEDICARE ADVANTAGE [2009] | WELLPOINT DUAL MEDICARE-MEDICAID PLAN [200902] | $81.06 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | WELLPOINT MEDICARE ADVANTAGE [2009] | WELLPOINT MEDICARE ADVANTAGE [200901] | $81.06 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | UNITED HEALTHCARE MEDICARE ADVANTAGE [1315] | UNITED HEALTHCARE MEDICARE ADVANTAGE [131500] | $81.06 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | WELLPOINT MEDICARE ADVANTAGE [2009] | WELLPOINT DUAL MEDICARE-MEDICAID PLAN [200902] | $81.06 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | WELLPOINT MEDICARE ADVANTAGE [2009] | WELLPOINT MEDICARE ADVANTAGE [200901] | $81.06 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | UNITED HEALTHCARE MEDICARE ADVANTAGE [1315] | UNITED HEALTHCARE MEDICARE ADVANTAGE [131500] | $81.06 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | WELLCARE OF TEXAS [1330] | WELLCARE MEDICARE ADVANTAGE - UXR [133000] | $81.06 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | PROCARE ADVANTAGE [2104] | PROCARE ADVANTAGE [210400] | $81.83 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | PROCARE ADVANTAGE [2104] | PROCARE ADVANTAGE [210400] | $81.83 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | PROCARE ADVANTAGE [2104] | PROCARE ADVANTAGE [210400] | $81.83 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | MOLINA MEDICARE ADVANTAGE [1333] | MOLINA DUAL MEDICARE-MEDICAID PLAN [133301] | $85.11 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | MOLINA MEDICARE ADVANTAGE [1333] | MOLINA MEDICARE ADVANTAGE [133300] | $85.11 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | MOLINA MEDICARE ADVANTAGE [1333] | MOLINA MEDICARE ADVANTAGE [133300] | $85.11 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | MOLINA MEDICARE ADVANTAGE [1333] | MOLINA DUAL MEDICARE-MEDICAID PLAN [133301] | $85.11 | $386.00 | $154.40 | 2026-03-31 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | MOLINA MEDICARE ADVANTAGE [1333] | MOLINA MEDICARE ADVANTAGE [133300] | $85.11 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| PARKLAND HEALTH & HOSPITAL SYSTEM OutpatientFacility | MOLINA MEDICARE ADVANTAGE [1333] | MOLINA DUAL MEDICARE-MEDICAID PLAN [133301] | $85.11 | $386.00 | $154.40 | 2026-05-29 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | HEALTHNET MEDI-CAL | HEALTHNET MEDI-CAL | $90.00 | $4,064.00 | $772.16 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | CCIPA MEDI-CAL - ALL PLANS | CCIPA MEDI-CAL - ALL PLANS | $90.00 | $4,064.00 | $772.16 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $90.00 | $4,064.00 | $772.16 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | MEDI-CAL | MEDI-CAL | $90.00 | $4,064.00 | $772.16 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | $90.00 | $4,064.00 | $772.16 | 2026-01-31 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $92.80 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $92.80 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $92.80 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $92.80 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $92.80 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $92.80 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $92.80 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $92.80 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $92.80 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $92.80 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $92.80 | — | — | 2026-04-14 | 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 ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $94.17 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Geisinger | Geisinger CHIP | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | United Healthcare | United Healthcare Medicaid | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Geisinger | Geisinger Medicaid HC | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | United Healthcare | United Healthcare Medicaid | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Geisinger | Geisinger CHIP | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Geisinger | Geisinger Medicaid HC | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Geisinger | Geisinger Medicaid HC | $101.94 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $101.94 | — | — | 2026-04-14 | 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.