23450 — Repair Shoulder Capsule
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). REPAIR SHOULDER CAPSULE (CPT 23450) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/23450?code_type=CPT
MLA (9th ed.)
“REPAIR SHOULDER CAPSULE (CPT 23450) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/23450?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“REPAIR SHOULDER CAPSULE (CPT 23450) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/23450?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,413–$9,648 (25th–75th percentile) across 1,547 hospitals · 2,385 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 23450 — 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
$3,413
$7,002 typical
$9,648
The middle 50% of negotiated facility rates for this procedure, measured across 1,547 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. | $7,002 |
| Surgeon (professional fee) Estimate national typical Medicare $872 × 1.22 commercial. | $1,064 |
| 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 | $8,774 |
Surgical episode (typical)
~$8,774
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)
~$12,559
- 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 | Molina | Marketplace | — | $26.25 | $13.13 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Anthem | Ppo Hmo | — | $26.25 | $13.13 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Anthem | Traditional | — | $26.25 | $13.13 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Med Mutual | Ppo Hmo | — | $26.25 | $13.13 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Cigna | Cigna | — | $26.25 | $13.13 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Aetna | Hmo Ppo | — | $26.25 | $13.13 | 2026-05-13 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,675.00 | $588.50 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,675.00 | $722.25 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,675.00 | $588.50 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,675.00 | $642.00 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,675.00 | $615.25 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,675.00 | $508.25 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,675.00 | $481.50 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,675.00 | $588.50 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,675.00 | $642.00 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,675.00 | $615.25 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,675.00 | $695.50 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,675.00 | $588.50 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,675.00 | $508.25 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,675.00 | $588.50 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,675.00 | $722.25 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,675.00 | $615.25 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,675.00 | $588.50 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,675.00 | $481.50 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,675.00 | $588.50 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,675.00 | $615.25 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,675.00 | $588.50 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,675.00 | $695.50 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $28.05 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $28.05 | — | — | 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 ↗ |
| 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 ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $35.95 | $19,974.00 | $7,262.33 | 2024-12-31 | 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 ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $70.00 | $4,277.00 | $4,277.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $70.00 | $4,277.00 | $4,277.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $75.00 | $4,277.00 | $4,277.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $75.00 | $4,277.00 | $4,277.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $76.50 | $4,277.00 | $4,277.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $76.50 | $4,277.00 | $4,277.00 | 2025-10-04 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $77.07 | — | — | 2026-04-14 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Martins Point | MCR Advantage | $83.70 | $186.00 | $167.40 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Wellcare | MCR Advantage | $83.70 | $186.00 | $167.40 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Aetna | MCR Advantage | $83.70 | $186.00 | $167.40 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | United Healthcare | MCR Advantage | $83.70 | $186.00 | $167.40 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Cigna | MCR Advantage | $83.70 | $186.00 | $167.40 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Anthem | MCR Advantage | $83.70 | $186.00 | $167.40 | 2026-04-05 | 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 ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $97.50 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Aetna | Aetna Better Health CHIP | $97.50 | — | — | 2026-04-14 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $97.50 | $4,277.00 | $4,277.00 | 2025-10-04 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $97.50 | — | — | 2026-04-14 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $97.50 | $4,277.00 | $4,277.00 | 2025-10-04 | MRF ↗ |
| ONECORE HEALTH Outpatient | Employer Direct/Surgery Plus | PPO | $100.00 | $44,242.24 | — | 2026-02-27 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $100.93 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $100.93 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $100.93 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $100.93 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $100.93 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $100.93 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $100.93 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $100.93 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $100.93 | — | — | 2026-04-14 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $101.11 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $101.11 | — | — | 2026-04-01 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $102.38 | — | — | 2026-04-14 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $107.25 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $107.25 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $107.25 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $107.25 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | GEISINGER | MANAGED MEDICAID | $107.25 | — | — | 2025-08-01 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $107.25 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $107.25 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | GEISINGER | MANAGED MEDICAID | $107.25 | — | — | 2025-08-01 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | United Healthcare | Commercial | $111.60 | $186.00 | $167.40 | 2026-04-05 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $112.13 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $112.13 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $112.13 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $112.13 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $112.13 | — | — | 2025-08-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $112.13 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $112.13 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $112.13 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $112.13 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | CHIP | $112.13 | — | — | 2025-08-01 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $112.13 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | CHIP | $112.13 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $112.13 | — | — | 2025-08-01 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $112.13 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | CHIP | $112.13 | — | — | 2025-08-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $113.34 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $113.34 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $113.34 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $113.34 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $113.34 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $113.34 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $113.34 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $113.34 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $113.34 | — | — | 2026-04-14 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Both | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $113.44 | $10,908.15 | $10,908.15 | 2026-04-24 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | GEISINGER | MANAGED MEDICAID | $116.03 | — | — | 2025-08-01 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $117.00 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $117.00 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $117.00 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $117.00 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $118.80 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $118.80 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $118.80 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | GEISINGER | MANAGED MEDICAID | $118.80 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | GEISINGER | MANAGED MEDICAID | $118.80 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $119.93 | — | — | 2025-08-01 | MRF ↗ |
| HOSPITAL FOR SPECIAL SURGERY OutpatientFacility | BLUE CROSS BLUE SHIELD NY [1022] | BCBS INDIVIDUAL NETWORK [102218] | $119.96 | — | $23,694.95 | 2026-04-01 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | HealthNet | Commercial | $120.90 | $186.00 | $167.40 | 2026-04-05 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MANAGED MEDICAID | $121.88 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | GEISINGER | MANAGED MEDICAID | $121.88 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MANAGED MEDICAID | $121.88 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Healthy Kids | $123.71 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Sunshine State Oncology | Medicaid HMO | $123.71 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Medicaid HMO | $123.71 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $123.83 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $123.83 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $123.83 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $123.83 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $123.83 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $123.83 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | CHIP | $124.20 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $124.20 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | CHIP | $124.20 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | CHIP | $124.20 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $124.20 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $124.20 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $124.20 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AETNA | MANAGED MEDICAID | $126.75 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AETNA | MANAGED MEDICAID | $126.75 | — | — | 2025-08-01 | 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.