Price Transparency Hospital negotiated rates

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

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20561 — Ndl Insj Without Njx 3+ Musc

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

Typical negotiated price $50

Usually $28–$86 (25th–75th percentile) across 2,075 hospitals · 5,386 payers.

“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 20561 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.

What the whole episode might cost

Your hospital facility price plus the separately-billed professional fees a complete episode adds. The facility figure is an actual negotiated rate from our data; the surgeon and anesthesia figures are estimates from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.

Pick your insurer to anchor on your plan’s negotiated rate.
Measured
$28 $50 typical $86

The middle 50% of negotiated facility rates for this procedure, measured across 2,075 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. $50
Surgeon (professional fee) Estimate national typical Medicare PFS $20 × 1.22 commercial. $24
Likely subtotal $74
Surgical episode (typical) ~$74

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.

After discharge
Recovery cost ~$3,785
With your recovery plan (typical) ~$3,858
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
SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH OutpatientFacility Anthem Medicaid $64.00 $53.12 2025-01-01 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Humana Dual (D-SNP) 2026-05-11 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Gilsbar 360 Alliance PPO 2026-05-11 MRF ↗
SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH OutpatientFacility Mdwise Medicaid $64.00 $53.12 2025-01-01 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Wellcare Dual Managed MedicareMedicaid 2026-05-11 MRF ↗
SAINT JOSEPH REGIONAL MEDICAL CENTER OutpatientFacility Caresource Medicaid $64.00 $53.12 2025-01-01 MRF ↗
SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH OutpatientFacility Caresource Medicaid $64.00 $53.12 2025-01-01 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility BCBS of Louisiana Blue Advantage HMO 2026-05-11 MRF ↗
SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH OutpatientFacility Managed Health Services Medicaid $64.00 $53.12 2025-01-01 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Humana PPO 2026-05-11 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility United Healthcare HMOPPOPOS 2026-05-11 MRF ↗
SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH OutpatientFacility Caresource Medicaid $64.00 $53.12 2025-01-01 MRF ↗
SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH OutpatientFacility Mdwise Medicaid $64.00 $53.12 2025-01-01 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Aetna Better Health 2026-05-11 MRF ↗
SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH OutpatientFacility UHC Medicaid $64.00 $53.12 2025-01-01 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Amerihealth Caritas 2026-05-11 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Aetna POS 2026-05-11 MRF ↗
SAINT JOSEPH REGIONAL MEDICAL CENTER OutpatientFacility UHC Medicaid $64.00 $53.12 2025-01-01 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Aetna Dual (D-SNP) 2026-05-11 MRF ↗
SAINT JOSEPH REGIONAL MEDICAL CENTER OutpatientFacility Mdwise Medicaid $64.00 $53.12 2025-01-01 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Humana Military Tricare West 2026-05-11 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Cigna HMO 2026-05-11 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Aetna Medicare Advantage 2026-05-11 MRF ↗
SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH OutpatientFacility Managed Health Services Medicaid $64.00 $53.12 2025-01-01 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Humana Gold Medicare 2026-05-11 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Louisiana Health Care Connections Managed Medicaid 2026-05-11 MRF ↗
SAINT JOSEPH REGIONAL MEDICAL CENTER OutpatientFacility Managed Health Services Medicaid $64.00 $53.12 2025-01-01 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Wellcare HMO 2026-05-11 MRF ↗
SAINT JOSEPH REGIONAL MEDICAL CENTER OutpatientFacility Anthem Medicaid $64.00 $53.12 2025-01-01 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility United Healthcare VA CCN Optum 2026-05-11 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Humana Healthy Horizons Medicaid 2026-05-11 MRF ↗
SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH OutpatientFacility Anthem Medicaid $64.00 $53.12 2025-01-01 MRF ↗
SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH OutpatientFacility UHC Medicaid $64.00 $53.12 2025-01-01 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Cigna PPO 2026-05-11 MRF ↗
WEST FELICIANA PARISH HOSPITAL OutpatientFacility Healthy Blue Managed Medicaid 2026-05-11 MRF ↗
FLAMBEAU HOSPITAL OutpatientFacility Security Health Plan (SHP) Medicare Advantage $0.23 $61.20 $58.14 2026-02-20 MRF ↗
FLAMBEAU HOSPITAL OutpatientFacility Security Health Plan (SHP) Medicare Advantage $0.23 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility Security Health Plan (SHP) Medicare Advantage $0.29 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility Security Health Plan (SHP) Medicare Advantage $0.29 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility Veteran's Administration (VA CCN) VA Network $0.29 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility Veteran's Administration (VA CCN) VA Network $0.29 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility Veteran's Administration (VA CCN) VA Network $0.30 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility Security Health Plan (SHP) Medicare Advantage $0.30 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility Point Comfort Underwriters Organizational $0.30 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility Anthem BCBS of WI Medicare Advantage $0.30 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility Anthem BCBS of WI Medicare Advantage $0.30 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility Point Comfort Underwriters Organizational $0.30 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility Security Health Plan (SHP) Medicare Advantage $0.30 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility Veteran's Administration (VA CCN) VA Network $0.30 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility Group Health Cooperative of Eau Claire Medicare Advantage $0.31 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility Group Health Cooperative of Eau Claire Medicare Advantage $0.31 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility Group Health Cooperative of Eau Claire Medicare Advantage $0.32 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility Group Health Cooperative of Eau Claire Medicare Advantage $0.32 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility Point Comfort Underwriters Organizational $0.33 $61.20 $58.14 2026-02-20 MRF ↗
MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility Point Comfort Underwriters Organizational $0.33 $61.20 $58.14 2026-02-20 MRF ↗
CHI Memorial Hospital - Hixson Outpatient Alliant Health Commercial|All Plans $0.65 2026-02-28 MRF ↗
OTTAWA COUNTY HEALTH CENTER Outpatient CHOICECARE MCR ADV - ALL PLANS CHOICECARE MCR ADV - ALL PLANS $0.71 $60.00 $60.00 2026-03-09 MRF ↗
CHERRY COUNTY HOSPITAL Outpatient AMBETTER COMM - ALL PLANS AMBETTER COMM - ALL PLANS $0.95 $91.55 $91.55 2026-04-24 MRF ↗
LAKEVIEW HOSPITAL BothFacility HP MEDICAID REPLACEMENT [950307] HP CARE PMAP [50327] $1.12 $70.00 $25.90 2026-03-31 MRF ↗
NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient HEALTH ALLIANCE MEDICAID [1310] DCH ILLINOIS MEDICAID $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient BLUE CROSS MEDICAID [1612] DCH ILLINOIS MEDICAID $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient COUNTYCARE IL COOK CO [1607] DCH ILLINOIS MEDICAID $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient MERIDIAN HEALTH PLAN HMO [1604] KH ILLINOIS MEDICAID $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient CENPATICO BEHAVIORAL HEALTH [1603] KH ILLINOIS MEDICAID $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient COUNTYCARE IL COOK CO [1607] KH ILLINOIS MEDICAID $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient FAMILY HEALTH NETWORK HMO [1610] KH ILLINOIS MEDICAID $36.00 $25.20 2026-04-01 MRF ↗
VALLEY WEST COMMUNITY HOSPITAL Outpatient HEALTH ALLIANCE MEDICAID [1310] VWH ILLINOIS MEDICAID $2.48 $36.00 $25.20 2026-04-01 MRF ↗
VALLEY WEST COMMUNITY HOSPITAL Outpatient COUNTYCARE IL COOK CO [1607] VWH ILLINOIS MEDICAID $2.48 $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient HEALTH ALLIANCE MEDICAID [1310] KH ILLINOIS MEDICAID $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient COUNTYCARE IL COOK CO [1607] CDH ILLINOIS MEDICAID $2.48 $36.00 $25.20 2026-04-01 MRF ↗
VALLEY WEST COMMUNITY HOSPITAL Outpatient BLUE CROSS MEDICAID [1612] VWH ILLINOIS MEDICAID $2.48 $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient HEALTH ALLIANCE MEDICAID [1310] CDH ILLINOIS MEDICAID $2.48 $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient BLUE CROSS MEDICAID [1612] KH ILLINOIS MEDICAID $36.00 $25.20 2026-04-01 MRF ↗
VALLEY WEST COMMUNITY HOSPITAL Outpatient MERIDIAN HEALTH PLAN HMO [1604] VWH ILLINOIS MEDICAID $2.48 $36.00 $25.20 2026-04-01 MRF ↗
VALLEY WEST COMMUNITY HOSPITAL Outpatient FAMILY HEALTH NETWORK HMO [1610] VWH ILLINOIS MEDICAID $2.48 $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient CIGNA HEALTHSPRING SPECIALCARE OF IL [1608] KH ILLINOIS MEDICAID $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient BLUE CROSS MEDICAID [1612] CDH ILLINOIS MEDICAID $2.48 $36.00 $25.20 2026-04-01 MRF ↗
VALLEY WEST COMMUNITY HOSPITAL Outpatient CIGNA HEALTHSPRING SPECIALCARE OF IL [1608] VWH ILLINOIS MEDICAID $2.48 $36.00 $25.20 2026-04-01 MRF ↗
ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility MagnaCare All Products $2.50 2025-12-31 MRF ↗
RICHLAND HOSPITAL OutpatientFacility Dean Health Plan DHI/DHP Products and ASO Managed Care $2.74 $20.00 $16.00 2026-04-24 MRF ↗
JONES REGIONAL MEDICAL CENTER InpatientFacility Aetna Medicare Advantage $25.00 $20.00 2026-01-28 MRF ↗
CAMERON MEMORIAL COMMUNITY HOSPITAL INC OutpatientFacility Anthem Blue Cross of IN Medicare $3.16 $10.20 $6.12 2026-02-18 MRF ↗
CAMERON MEMORIAL COMMUNITY HOSPITAL INC OutpatientFacility United Healthcare Medicare $3.26 $10.20 $6.12 2026-02-18 MRF ↗
CAMERON MEMORIAL COMMUNITY HOSPITAL INC OutpatientFacility Humana Medicare $3.26 $10.20 $6.12 2026-02-18 MRF ↗
CAMERON MEMORIAL COMMUNITY HOSPITAL INC OutpatientFacility Aetna Medicare $3.26 $10.20 $6.12 2026-02-18 MRF ↗
CAMERON MEMORIAL COMMUNITY HOSPITAL INC OutpatientFacility CareSource Indiana of IN Medicare $3.59 $10.20 $6.12 2026-02-18 MRF ↗
CAMERON MEMORIAL COMMUNITY HOSPITAL INC OutpatientFacility CareSource Indiana of IN Just 4 Me $3.75 $10.20 $6.12 2026-02-18 MRF ↗
OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC Outpatient MAGELLAN BEHAV MCAID - ALL PLANS MAGELLAN BEHAV MCAID - ALL PLANS $3.91 $28.00 $14.00 2026-01-17 MRF ↗
OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC Outpatient HUMANA HLTHY HORIZ MCAID HUMANA HLTHY HORIZ MCAID $3.91 $28.00 $14.00 2026-01-17 MRF ↗
OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC Outpatient AETNA BETTER HLTH MCAID AETNA BETTER HLTH MCAID $3.91 $28.00 $14.00 2026-01-17 MRF ↗
OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC Outpatient AMERIHEALTH CARITAS MCAID - ALL PLANS AMERIHEALTH CARITAS MCAID - ALL PLANS $3.91 $28.00 $14.00 2026-01-17 MRF ↗
OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC Outpatient UHC COMMUNITY MCAID UHC COMMUNITY MCAID $3.91 $28.00 $14.00 2026-01-17 MRF ↗
OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC Outpatient LHC MEDICAID LHC MEDICAID $3.91 $28.00 $14.00 2026-01-17 MRF ↗
OUR LADY OF LOURDES REGIONAL MEDICAL CENTER, INC Outpatient HEALTHY BLUE MCAID - ALL OTHER PLANS HEALTHY BLUE MCAID - ALL OTHER PLANS $3.91 $28.00 $14.00 2026-01-17 MRF ↗
CAMERON MEMORIAL COMMUNITY HOSPITAL INC OutpatientFacility Plain Church Group Ministry All Commercial $3.98 $10.20 $6.12 2026-02-18 MRF ↗
OSCEOLA COMMUNITY HOSPITAL Inpatient None $40.00 $32.00 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient BLUE CROSS BLUE SHIELD [1401] CDH BCBS BLUECHOICE SELECT $4.00 $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient ALTERNATE BLUE CROSS [1402] CDH BCBS BLUECHOICE PREFERRED $4.00 $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient ALTERNATE BLUE CROSS [1402] CDH BCBS BLUECHOICE SELECT $4.00 $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient ALTERNATE BLUE CROSS [1402] CDH BCBS BLUECHOICE OPTIONS $4.00 $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient BLUE CROSS BLUE SHIELD [1401] CDH BCBS BLUECHOICE OPTIONS $4.00 $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient BLUE CROSS BLUE SHIELD [1401] CDH BCBS BLUECHOICE PREFERRED $4.00 $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient GLOBAL EXCEL [1712] KH MEDICARE $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient ALTERNATE BLUE CROSS MEDICARE ADV [2304] KH MEDICARE $36.00 $25.20 2026-04-01 MRF ↗
ELY - BLOOMENSON COMMUNITY HOSPITAL BothFacility Blue Cross Blue Shield of MN Minnesota Health Care Program (MHCP) $4.15 $10.00 2024-07-01 MRF ↗
MERCY HOSPITAL LINCOLN OutpatientFacility MOLINA HEALTHCARE MEDICAID [20265] HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.16 $64.00 $41.60 2026-03-12 MRF ↗
MERCY HOSPITAL LINCOLN OutpatientFacility MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.16 $64.00 $41.60 2026-03-12 MRF ↗
MERCY HOSPITAL LINCOLN OutpatientFacility MERIDIAN MEDICAID CONTRACTED [320430] HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% $4.16 $64.00 $41.60 2026-03-12 MRF ↗
MERCY HOSPITAL LINCOLN OutpatientFacility MOLINA HEALTHCARE MEDICAID [20265] HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.16 $64.00 $41.60 2026-03-12 MRF ↗
MERCY HOSPITAL LINCOLN OutpatientFacility MERIDIAN MEDICAID CONTRACTED [320430] HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% $4.16 $64.00 $41.60 2026-03-12 MRF ↗
MERCY HOSPITAL LINCOLN OutpatientFacility MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.16 $64.00 $41.60 2026-03-12 MRF ↗
ELY - BLOOMENSON COMMUNITY HOSPITAL OutpatientFacility Medica Minnesota Health care Program (MHCP) $4.29 $10.00 2024-07-01 MRF ↗
MACNEAL HOSPITAL OutpatientFacility BCBS IL PPO $4.39 $51.00 2026-03-31 MRF ↗
MERCY HOSPITAL ST LOUIS OutpatientFacility AETNA MEDICAID CONTRACTED [320009] HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 $4.42 $68.00 $44.20 2026-03-12 MRF ↗
MERCY HOSPITAL SOUTH OutpatientFacility MOLINA HEALTHCARE MEDICAID [20265] HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.42 $68.00 $44.20 2026-03-12 MRF ↗
MERCY HOSPITAL SOUTH OutpatientFacility MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.42 $68.00 $44.20 2026-03-12 MRF ↗
MERCY HOSPITAL WASHINGTON OutpatientFacility MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.42 $68.00 $44.20 2026-03-12 MRF ↗
MERCY HOSPITAL WASHINGTON OutpatientFacility MERIDIAN MEDICAID CONTRACTED [320430] HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% $4.42 $68.00 $44.20 2026-03-12 MRF ↗
MERCY HOSPITAL SOUTH OutpatientFacility MERIDIAN MEDICAID CONTRACTED [320430] HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% $4.42 $68.00 $44.20 2026-03-12 MRF ↗
MERCY HOSPITAL WASHINGTON OutpatientFacility MOLINA HEALTHCARE MEDICAID [20265] HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.42 $68.00 $44.20 2026-03-12 MRF ↗
MERCY HOSPITAL ST LOUIS OutpatientFacility MOLINA HEALTHCARE MEDICAID [20265] HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.42 $68.00 $44.20 2026-03-12 MRF ↗
MERCY HOSPITAL ST LOUIS OutpatientFacility MERIDIAN MEDICAID CONTRACTED [320430] HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% $4.42 $68.00 $44.20 2026-03-12 MRF ↗
MERCY HOSPITAL ST LOUIS OutpatientFacility MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.42 $68.00 $44.20 2026-03-12 MRF ↗
Marianjoy Rehabilitation Hospital Outpatient ALTERNATE HUMANA MEDICARE ADV [2409] MRH MEDICARE $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient GLOBAL EXCEL [1712] DCH MEDICARE $36.00 $25.20 2026-04-01 MRF ↗
Marianjoy Rehabilitation Hospital Outpatient GLOBAL EXCEL [1712] MRH MEDICARE $36.00 $25.20 2026-04-01 MRF ↗
Marianjoy Rehabilitation Hospital Outpatient ALTERNATE BLUE CROSS MEDICARE ADV [2304] MRH MEDICARE $36.00 $25.20 2026-04-01 MRF ↗
NORTHWESTERN LAKE FOREST HOSPITAL Outpatient GLOBAL EXCEL [1712] NLFH MEDICARE $36.00 $25.20 2026-04-01 MRF ↗
MERCY HOSPITAL SOUTHEAST OutpatientFacility MERIDIAN MEDICAID CONTRACTED [320430] HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% $4.62 $71.00 $46.15 2026-03-18 MRF ↗
MERCY HOSPITAL SOUTHEAST OutpatientFacility MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.62 $71.00 $46.15 2026-03-18 MRF ↗
MERCY HOSPITAL SOUTHEAST OutpatientFacility AETNA MEDICAID CONTRACTED [320009] HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 $4.62 $71.00 $46.15 2026-03-18 MRF ↗
MERCY HOSPITAL SOUTHEAST OutpatientFacility MOLINA HEALTHCARE MEDICAID [20265] HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.62 $71.00 $46.15 2026-03-18 MRF ↗
DOCTORS HOSPITAL OF MANTECA Outpatient United OptionsPPO $4.72 $30.25 $30.25 2026-03-01 MRF ↗
ELY - BLOOMENSON COMMUNITY HOSPITAL BothFacility Health Partners Health Partners Care Plans $4.80 $10.00 2024-07-01 MRF ↗
ELY - BLOOMENSON COMMUNITY HOSPITAL BothFacility Health Partners Minnesota Care Programs $4.80 $10.00 2024-07-01 MRF ↗
MERCY HOSPITAL SOUTH OutpatientFacility MULTIPLAN CONTRACTED [320270] HB SAMC PHCS PRIMARY $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL SOUTH OutpatientFacility MERCY MGD BEHAVIORAL HEALTH CONTRACTED [320259] HB SAMC PHCS PRIMARY $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL SOUTH OutpatientFacility PRIVATE HEALTH CARE SYSTEMS CONTRACTED [320320] HB SAMC PHCS PRIMARY $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL SOUTH OutpatientFacility FIRST HEALTH CONTRACTED [320128] HB SAMC PHCS PRIMARY $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL SOUTH OutpatientFacility MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.81 $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL ST LOUIS OutpatientFacility MOLINA HEALTHCARE MEDICAID [20265] HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.81 $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL WASHINGTON OutpatientFacility PRIVATE HEALTH CARE SYSTEMS CONTRACTED [320320] HB STLO WASH JEFN PHCS PRIMARY $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL ST LOUIS OutpatientFacility AETNA MEDICAID CONTRACTED [320009] HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 $4.81 $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL ST LOUIS OutpatientFacility MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.81 $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL WASHINGTON OutpatientFacility MOLINA HEALTHCARE MEDICAID [20265] HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.81 $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL WASHINGTON OutpatientFacility FIRST HEALTH CONTRACTED [320128] HB STLO WASH JEFN PHCS PRIMARY $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL ST LOUIS OutpatientFacility FIRST HEALTH CONTRACTED [320128] HB STLO WASH JEFN PHCS PRIMARY $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL ST LOUIS OutpatientFacility MERIDIAN MEDICAID CONTRACTED [320430] HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% $4.81 $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL ST LOUIS OutpatientFacility MERCY MGD BEHAVIORAL HEALTH CONTRACTED [320259] HB STLO WASH JEFN PHCS PRIMARY $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL WASHINGTON OutpatientFacility MULTIPLAN CONTRACTED [320270] HB STLO WASH JEFN PHCS PRIMARY $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL SOUTH OutpatientFacility MERIDIAN MEDICAID CONTRACTED [320430] HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% $4.81 $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL WASHINGTON OutpatientFacility MERIDIAN MEDICAID CONTRACTED [320430] HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% $4.81 $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL SOUTH OutpatientFacility MOLINA HEALTHCARE MEDICAID [20265] HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.81 $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL ST LOUIS OutpatientFacility MULTIPLAN CONTRACTED [320270] HB STLO WASH JEFN PHCS PRIMARY $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL WASHINGTON OutpatientFacility MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 $4.81 $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL WASHINGTON OutpatientFacility MERCY MGD BEHAVIORAL HEALTH CONTRACTED [320259] HB STLO WASH JEFN PHCS PRIMARY $74.00 $48.10 2026-03-12 MRF ↗
MERCY HOSPITAL ST LOUIS OutpatientFacility PRIVATE HEALTH CARE SYSTEMS CONTRACTED [320320] HB STLO WASH JEFN PHCS PRIMARY $74.00 $48.10 2026-03-12 MRF ↗
ELY - BLOOMENSON COMMUNITY HOSPITAL OutpatientFacility United Healthcare All Medicare advantage plans $4.90 $10.00 2024-07-01 MRF ↗
ELY - BLOOMENSON COMMUNITY HOSPITAL OutpatientFacility Health Partners All Medicare plans $4.90 $10.00 2024-07-01 MRF ↗
ELY - BLOOMENSON COMMUNITY HOSPITAL OutpatientFacility Blue Cross Blue Shield of MN All Medicare plans $4.90 $10.00 2024-07-01 MRF ↗
ASCENSION ST VINCENT RANDOLPH Outpatient UNIFIED GROUP SERVICES 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 2026-01-01 MRF ↗
ASCENSION ST VINCENT WARRICK Inpatient UHC BEHAVIORAL HEALTH 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 $4.94 $87.00 $52.20 2026-01-01 MRF ↗
ASCENSION ST VINCENT RANDOLPH Both UHC 9395_UNITED HEALTHCARE VRIN 20250101 $4.94 2026-01-01 MRF ↗
ASCENSION ST VINCENT HOSPITAL Outpatient UHC SELF 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 $4.94 2026-01-01 MRF ↗
ASCENSION ST VINCENT WILLIAMSPORT Both UHC 9397_UNITED HEALTHCARE VWIN 20250101 $4.94 2026-01-01 MRF ↗
ASCENSION ST VINCENT HOSPITAL Inpatient SMARTHEALTH PPO 8842_SMARTHEALTH PPO 20241001 2026-01-01 MRF ↗
ASCENSION ST VINCENT HOSPITAL Outpatient UHC NEW 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 $4.94 2026-01-01 MRF ↗
ASCENSION ST VINCENT KOKOMO 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 WILLIAMSPORT Outpatient UNIFIED GROUP SERVICES 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 2026-01-01 MRF ↗
ASCENSION ST VINCENT CARMEL Outpatient UHC NEW 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 $4.94 2026-01-01 MRF ↗
ASCENSION ST VINCENT WARRICK Inpatient UHC 8493_UNITED HEALTHCARE SWIN 20240701 $4.94 $87.00 $52.20 2026-01-01 MRF ↗
ASCENSION ST VINCENT KOKOMO Both UHC 9393_UNITED HEALTHCARE VKIN 20250101 $4.94 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 KOKOMO Outpatient UNIFIED GROUP SERVICES 8813_ANTHEM UNIFIED GROUPS VKIN 20241001 2026-01-01 MRF ↗
ASCENSION ST VINCENT ANDERSON Both UHC 9390_UNITED HEALTHCARE VAIN 20250101 $4.94 2026-01-01 MRF ↗
ASCENSION ST VINCENT RANDOLPH Both UHC 9395_UNITED HEALTHCARE VRIN 20250101 $4.94 2026-01-01 MRF ↗
ASCENSION ST VINCENT ANDERSON Outpatient UNIFIED GROUP SERVICES 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 2026-01-01 MRF ↗
ASCENSION ST VINCENT HOSPITAL Outpatient UNIFIED GROUP SERVICES 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 2026-01-01 MRF ↗
ASCENSION ST VINCENT CLAY Both UHC 9384_UNITED HEALTHCARE CLIN 20250101 $4.94 $70.00 $42.00 2026-01-01 MRF ↗
ELY - BLOOMENSON COMMUNITY HOSPITAL OutpatientFacility Humana Choice Care All Medicare plans $4.95 $10.00 2024-07-01 MRF ↗
CARLE FOUNDATION HOSPITAL InpatientFacility Meridian Managed Medicaid $5.00 $50.00 $50.00 2026-04-15 MRF ↗
CARLE FOUNDATION HOSPITAL InpatientFacility Meridian Medicare-Medicaid (MMAI/Dual) $5.00 $50.00 $50.00 2026-04-15 MRF ↗
CARLE BROMENN MEDICAL CENTER InpatientFacility United Healthcare (UHC) Medicare Advantage $50.00 $50.00 2026-04-15 MRF ↗
CARLE EUREKA HOSPITAL InpatientFacility Meridian Medicare-Medicaid (D-SNP) $5.00 $50.00 $50.00 2026-04-15 MRF ↗
CARLE BROMENN MEDICAL CENTER InpatientFacility United Healthcare (UHC) PPO $50.00 $50.00 2026-04-15 MRF ↗
CARLE BROMENN MEDICAL CENTER InpatientFacility United Healthcare (UHC) VA CCN/Optum $50.00 $50.00 2026-04-15 MRF ↗
CARLE BROMENN MEDICAL CENTER InpatientFacility Community Partners Health Plan (CPHP) PPO $50.00 $50.00 2026-04-15 MRF ↗
CARLE EUREKA HOSPITAL InpatientFacility Cigna PPO $50.00 $50.00 2026-04-15 MRF ↗
CARLE EUREKA HOSPITAL InpatientFacility Humana Medicare Advantage $50.00 $50.00 2026-04-15 MRF ↗
CARLE BROMENN MEDICAL CENTER InpatientFacility Wellcare Medicare Advantage HMO $50.00 $50.00 2026-04-15 MRF ↗
CARLE EUREKA HOSPITAL InpatientFacility Community Partners Health Plan (CPHP) PPO $50.00 $50.00 2026-04-15 MRF ↗
CARLE EUREKA HOSPITAL InpatientFacility Wellcare Medicare Advantage HMO $50.00 $50.00 2026-04-15 MRF ↗
CARLE BROMENN MEDICAL CENTER InpatientFacility Blue Cross Blue Shield Medicare Advantage $50.00 $50.00 2026-04-15 MRF ↗
CARLE BROMENN MEDICAL CENTER InpatientFacility Aetna Better Health Managed Medicaid $50.00 $50.00 2026-04-15 MRF ↗
CARLE EUREKA HOSPITAL InpatientFacility United Healthcare (UHC) VA CCN/Optum $50.00 $50.00 2026-04-15 MRF ↗
CARLE EUREKA HOSPITAL InpatientFacility Blue Cross Blue Shield Blue Choice/Options/PPO $50.00 $50.00 2026-04-15 MRF ↗
CARLE EUREKA HOSPITAL InpatientFacility Aetna Medicare Advantage $50.00 $50.00 2026-04-15 MRF ↗
CARLE EUREKA HOSPITAL InpatientFacility Blue Cross Blue Shield HMO $50.00 $50.00 2026-04-15 MRF ↗
CARLE EUREKA HOSPITAL InpatientFacility Aetna Commercial $50.00 $50.00 2026-04-15 MRF ↗

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