21337 — Closed Tx Septal&nose Fx
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). CLOSED TX SEPTAL&NOSE FX (HCPCS 21337) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/21337?code_type=HCPCS
MLA (9th ed.)
“CLOSED TX SEPTAL&NOSE FX (HCPCS 21337) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/21337?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“CLOSED TX SEPTAL&NOSE FX (HCPCS 21337) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/21337?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,328–$4,389 (25th–75th percentile) across 1,826 hospitals · 5,025 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 21337 — 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 fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$1,328
$3,215 typical
$4,389
The middle 50% of negotiated facility rates for this procedure, measured across 1,826 hospitals. The surgeon and anesthesia fees are modeled estimates added on top.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $3,215 |
| Surgeon (professional fee) Estimate national typical Medicare $282 × 1.22 commercial. | $344 |
| 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 | $4,267 |
Surgical episode (typical)
~$4,267
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)
~$8,052
- 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 |
|---|---|---|---|---|---|---|---|
| WILSON MEMORIAL HOSPITAL Both | Anthem | Traditional | — | $9.45 | $4.73 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Anthem | Ppo Hmo | — | $9.45 | $4.73 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Cigna | Cigna | — | $9.45 | $4.73 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Med Mutual | Ppo Hmo | — | $9.45 | $4.73 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Aetna | Hmo Ppo | — | $9.45 | $4.73 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Molina | Marketplace | — | $9.45 | $4.73 | 2026-05-13 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Aetna | Commercial | — | $1,124.00 | $843.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Sunflower | Medicaid | — | $1,124.00 | $843.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | United Healthcare | Commercial | — | $1,124.00 | $843.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Wppa/Providrscare | Commercial | — | $1,124.00 | $843.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Hpk (Incl. Cigna) | Commercial | — | $1,124.00 | $843.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Ks | Commercial | $4.57 | $1,124.00 | $843.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Phcs/Multiplan | Commercial | — | $1,124.00 | $843.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Healthy Blue | Medicaid | — | $1,124.00 | $843.00 | 2026-05-18 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $6.31 | $7,317.19 | $4,390.31 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $6.31 | $7,317.19 | $4,390.31 | 2025-08-11 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $8.00 | $1,363.00 | $1,363.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $8.00 | $1,363.00 | $1,363.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $8.00 | $1,363.00 | $1,363.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $8.00 | $1,363.00 | $1,363.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $8.16 | $1,363.00 | $1,363.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $8.16 | $1,363.00 | $1,363.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $10.40 | $1,363.00 | $1,363.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $10.40 | $1,363.00 | $1,363.00 | 2025-10-04 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Inland Empire Health Plan | MGMCD | $15.95 | — | — | 2024-10-01 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $16.82 | $6,466.00 | $6,466.00 | 2026-02-13 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.50 | $850.00 | $161.50 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.50 | $850.00 | $161.50 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.50 | $850.00 | $187.00 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.50 | $850.00 | $187.00 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.50 | $850.00 | $187.00 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.50 | $850.00 | $229.50 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.50 | $850.00 | $195.50 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.50 | $850.00 | $187.00 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.50 | $850.00 | $153.00 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.50 | $850.00 | $221.00 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.50 | $850.00 | $153.00 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.50 | $850.00 | $195.50 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.50 | $850.00 | $229.50 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.50 | $850.00 | $187.00 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.50 | $850.00 | $187.00 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.50 | $850.00 | $195.50 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.50 | $850.00 | $195.50 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.50 | $850.00 | $187.00 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.50 | $850.00 | $187.00 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $17.50 | $850.00 | $204.00 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.50 | $850.00 | $221.00 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $17.50 | $850.00 | $204.00 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.71 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $24.71 | — | — | 2026-04-14 | 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 ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $32.32 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $32.32 | — | — | 2026-04-01 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $32.36 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $32.36 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $32.36 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $32.36 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $32.36 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $32.36 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $32.36 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $32.36 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $32.36 | — | — | 2026-04-14 | 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 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $36.34 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $36.34 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $36.34 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $36.34 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $36.34 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $36.34 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $36.34 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $36.34 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $36.34 | — | — | 2026-04-14 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $38.00 | $1,080.00 | $291.60 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | UNIVERSAL IPA MCAL OP/PROFEE ONLY | UNIVERSAL IPA MCAL OP/PROFEE ONLY | $38.00 | $1,080.00 | $291.60 | 2026-01-31 | MRF ↗ |
| Southwest Healthcare System-wildomar Both | Anthem Blue Cross Blue Shield | Medicaid | $38.00 | $6,597.00 | $2,638.80 | 2026-05-06 | MRF ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | CCIPA MEDI-CAL - ALL PLANS | CCIPA MEDI-CAL - ALL PLANS | $43.00 | $1,080.00 | $205.20 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | HEALTHNET MEDI-CAL | HEALTHNET MEDI-CAL | $43.00 | $1,080.00 | $205.20 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $43.00 | $1,080.00 | $205.20 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | $43.00 | $1,080.00 | $205.20 | 2026-01-31 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $43.00 | $850.00 | $195.50 | 2026-04-14 | MRF ↗ |
| ROXBOROUGH MEMORIAL HOSPITAL Outpatient | Health Partners Plan | Health Partners Plan Medicaid | $43.00 | $10,868.50 | $3,389.00 | 2026-03-17 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | MEDI-CAL | MEDI-CAL | $43.00 | $1,080.00 | $205.20 | 2026-01-31 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Geisinger Health Plan | F8109_Geisinger Health Plan - Medicaid Chip | $43.00 | — | — | 2026-04-01 | MRF ↗ |
| LOWER BUCKS HOSPITAL Outpatient | Health Partners Plan | Health Partners Plan Medicaid | $43.00 | $10,868.50 | $3,261.00 | 2026-03-17 | MRF ↗ |
| ROXBOROUGH MEMORIAL HOSPITAL Outpatient | Health Partners Plan | Health Partners Plan Medicaid | $43.00 | $10,868.50 | $3,389.00 | 2026-03-17 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Amerihealth | F8102_Amerihealth | $43.00 | — | — | 2026-04-01 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $43.00 | $850.00 | $187.00 | 2026-04-14 | MRF ↗ |
| SUBURBAN COMMUNITY HOSPITAL Outpatient | Health Partners | Health Partners Plan Medicaid | $43.00 | $10,868.50 | $3,990.00 | 2024-12-19 | MRF ↗ |
| LOWER BUCKS HOSPITAL Outpatient | Health Partners Plan | Health Partners Plan Medicaid | $43.00 | $10,868.50 | $3,261.00 | 2026-03-17 | MRF ↗ |
| SURGICAL INSTITUTE OF READING BothFacility | Unison | Med Plus | $43.00 | $3,473.00 | $4,783.07 | 2026-04-08 | MRF ↗ |
| SUBURBAN COMMUNITY HOSPITAL Outpatient | Traditional Medicaid | Traditional Medicaid | $43.00 | $10,868.50 | $3,990.00 | 2024-12-19 | MRF ↗ |
| ARNOT OGDEN MEDICAL CENTER OutpatientFacility | AmeriHealth | All Products | $43.00 | — | — | 2026-03-27 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Upmc | F8120_Upmc Health Plan - Medicaid | $43.00 | — | — | 2026-04-01 | MRF ↗ |
| LOWER BUCKS HOSPITAL Outpatient | Health Partners Plan | Health Partners Plan Medicaid | $43.00 | $10,868.50 | $4,103.00 | 2024-12-19 | MRF ↗ |
| ROXBOROUGH MEMORIAL HOSPITAL Outpatient | Health Partners Plan | Health Partners Plan Medicaid | $43.00 | $10,868.50 | $4,132.00 | 2024-12-19 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Amerihealth | F8102_Amerihealth | $43.00 | — | — | 2026-04-01 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Upmc | F8120_Upmc Health Plan - Medicaid | $43.00 | — | — | 2026-04-01 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Geisinger Health Plan | F8109_Geisinger Health Plan - Medicaid Chip | $43.00 | — | — | 2026-04-01 | MRF ↗ |
| GEISINGER SOUTH WILKES-BARRE Outpatient | Medicaid | Medicaid | $43.00 | $7,977.00 | $4,945.74 | 2026-04-01 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Aetna | Aetna Better Health CHIP | $43.00 | $850.00 | $195.50 | 2026-04-14 | MRF ↗ |
| TRINITAS REGIONAL MEDICAL CENTER OutpatientFacility | Wellpoint | NJ Family Care | $43.53 | — | — | 2026-03-04 | MRF ↗ |
| GEISINGER SOUTH WILKES-BARRE Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $44.29 | $7,977.00 | $4,945.74 | 2026-04-01 | MRF ↗ |
| NEWARK BETH ISRAEL MEDICAL CENTER OutpatientFacility | United Healthcare | Community Plan | $44.81 | — | — | 2026-03-04 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $45.15 | $850.00 | $187.00 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $45.15 | $850.00 | $187.00 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $45.15 | $850.00 | $187.00 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $45.15 | $850.00 | $187.00 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $45.15 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | UHC MCR ADV | UHC MCR ADV | $45.56 | $134.00 | $80.40 | 2025-11-18 | MRF ↗ |
| SUBURBAN COMMUNITY HOSPITAL Outpatient | Keystone First | Keystone First Medicaid | $45.58 | $10,868.50 | $3,990.00 | 2024-12-19 | MRF ↗ |
| ROXBOROUGH MEMORIAL HOSPITAL Outpatient | Keystone | Keystone First Medicaid | $45.58 | $10,868.50 | $4,132.00 | 2024-12-19 | MRF ↗ |
| LOWER BUCKS HOSPITAL Outpatient | Keystone | Keystone First Medicaid | $45.58 | $10,868.50 | $4,103.00 | 2024-12-19 | MRF ↗ |
| ROXBOROUGH MEMORIAL HOSPITAL Outpatient | Keystone | Keystone First Medicaid | $45.60 | $10,868.50 | $3,389.00 | 2026-03-17 | MRF ↗ |
| LOWER BUCKS HOSPITAL Outpatient | Keystone | Keystone First Medicaid | $45.60 | $10,868.50 | $3,261.00 | 2026-03-17 | MRF ↗ |
| LOWER BUCKS HOSPITAL Outpatient | Keystone | Keystone First Medicaid | $45.60 | $10,868.50 | $3,261.00 | 2026-03-17 | MRF ↗ |
| ROXBOROUGH MEMORIAL HOSPITAL Outpatient | Keystone | Keystone First Medicaid | $45.60 | $10,868.50 | $3,389.00 | 2026-03-17 | MRF ↗ |
| ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL - SOMERSET OutpatientFacility | Wellpoint | NJ Family Care | $46.09 | — | — | 2026-03-04 | MRF ↗ |
| UPMC MERCY OutpatientFacility | UPMC Health Plan | Managed Medicaid | $47.30 | — | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | UPMC Health Plan | Managed Medicaid | $47.30 | — | — | 2026-03-06 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | GEISINGER | MANAGED MEDICAID | $47.30 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $47.30 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $47.30 | — | — | 2025-08-01 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $47.30 | $850.00 | $229.50 | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | GEISINGER | MANAGED MEDICAID | $47.30 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $47.30 | — | — | 2025-08-01 | MRF ↗ |
| UPMC SOMERSET OutpatientFacility | UPMC Health Plan | Managed Medicaid | $47.30 | $6,619.00 | $3,971.40 | 2026-03-06 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $47.30 | $850.00 | $153.00 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $47.30 | $850.00 | $229.50 | 2026-04-14 | MRF ↗ |
| UPMC SOMERSET OutpatientFacility | AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $49.36 | $6,619.00 | $3,971.40 | 2026-03-06 | MRF ↗ |
| St. Luke's Allentown Hospital OutpatientFacility | Keystone First | Medicaid | $49.45 | — | — | 2026-02-26 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $49.45 | — | — | 2025-08-01 | MRF ↗ |
| ST LUKE'S HOSPITAL - ANDERSON CAMPUS OutpatientFacility | Keystone First | Medicaid | $49.45 | — | — | 2026-02-26 | MRF ↗ |
| ST LUKES HOSPITAL BETHLEHEM OutpatientFacility | Keystone First | Medicaid | $49.45 | — | — | 2026-02-26 | MRF ↗ |
| UPMC MERCY OutpatientFacility | United Healthcare Community Plan for Families | PA Medicaid | $49.45 | — | — | 2026-03-06 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | CHIP | $49.45 | — | — | 2025-08-01 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $49.45 | $850.00 | $195.50 | 2026-04-14 | MRF ↗ |
| ST LUKE'S HOSPITAL - GRAND VIEW CAMPUS OutpatientFacility | United Healthcare Community | Managed Medicaid | $49.45 | — | — | 2024-12-31 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $49.45 | $850.00 | $153.00 | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $49.45 | — | — | 2025-08-01 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $49.45 | $850.00 | $195.50 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $49.45 | $850.00 | $161.50 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $49.45 | $850.00 | $161.50 | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | CHIP | $49.45 | — | — | 2025-08-01 | MRF ↗ |
| ST LUKE'S HOSPITAL - UPPER BUCKS CAMPUS OutpatientFacility | Keystone First | Medicaid | $49.45 | — | — | 2026-02-26 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $49.45 | — | — | 2025-08-01 | MRF ↗ |
| GEISINGER SOUTH WILKES-BARRE Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $49.45 | $7,977.00 | $4,945.74 | 2026-04-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $49.45 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | CHIP | $49.45 | — | — | 2025-08-01 | MRF ↗ |
| UPMC MERCY OutpatientFacility | United Healthcare Community Plan for Families | PA Medicaid | $49.45 | — | — | 2026-03-06 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $49.45 | $850.00 | $161.50 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $49.45 | $850.00 | $195.50 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $49.45 | $850.00 | $153.00 | 2026-04-14 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| GEISINGER SOUTH WILKES-BARRE Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $50.52 | $7,977.00 | $4,945.74 | 2026-04-01 | MRF ↗ |
| ST LUKES HOSPITAL BETHLEHEM OutpatientFacility | Geisinger | Medicaid/CHIP | $50.74 | — | — | 2026-02-26 | MRF ↗ |
| ST LUKE'S HOSPITAL - UPPER BUCKS CAMPUS OutpatientFacility | Geisinger | Medicaid/CHIP | $50.74 | — | — | 2026-02-26 | MRF ↗ |
| ST LUKE'S HOSPITAL - ANDERSON CAMPUS OutpatientFacility | Geisinger | Medicaid/CHIP | $50.74 | — | — | 2026-02-26 | MRF ↗ |
| St. Luke's Allentown Hospital OutpatientFacility | Geisinger | Medicaid/CHIP | $50.74 | — | — | 2026-02-26 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | GEISINGER | MANAGED MEDICAID | $51.17 | — | — | 2025-08-01 | MRF ↗ |
| ST LUKES HOSPITAL BETHLEHEM OutpatientFacility | UPMC Health Plan | Medicaid | $51.60 | — | — | 2026-02-26 | 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.