23470 — Reconstruct Shoulder Joint
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). RECONSTRUCT SHOULDER JOINT (HCPCS 23470) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/23470?code_type=HCPCS
MLA (9th ed.)
“RECONSTRUCT SHOULDER JOINT (HCPCS 23470) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/23470?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“RECONSTRUCT SHOULDER JOINT (HCPCS 23470) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/23470?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $5,772–$17,002 (25th–75th percentile) across 1,745 hospitals · 3,777 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 23470 — 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
$5,772
$12,607 typical
$17,002
The middle 50% of negotiated facility rates for this procedure, measured across 1,745 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. | $12,607 |
| Surgeon (professional fee) Estimate national typical Medicare $1,088 × 1.22 commercial. | $1,327 |
| 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 | $14,642 |
Surgical episode (typical)
~$14,642
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)
~$18,427
- 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 |
|---|---|---|---|---|---|---|---|
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Molina | Marketplace | — | $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 | Anthem | 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 | Anthem | Traditional | — | $9.45 | $4.73 | 2026-05-13 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Ks | Commercial | $11.30 | $3,940.00 | $2,955.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Aetna | Commercial | — | $3,940.00 | $2,955.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Wppa/Providrscare | Commercial | — | $3,940.00 | $2,955.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Sunflower | Medicaid | — | $3,940.00 | $2,955.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | United Healthcare | Commercial | — | $3,940.00 | $2,955.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Phcs/Multiplan | Commercial | — | $3,940.00 | $2,955.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Healthy Blue | Medicaid | — | $3,940.00 | $2,955.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Hpk (Incl. Cigna) | Commercial | — | $3,940.00 | $2,955.00 | 2026-05-18 | 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 | 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 | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $35.40 | $19,668.00 | $14,325.75 | 2024-12-31 | MRF ↗ |
| EAST COOPER 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 ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC ALLIANCE MEDI-CAL | PACIFIC ALLIANCE MEDI-CAL | $75.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | LASALLE MG MEDI-CAL | LASALLE MG MEDI-CAL | $75.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ACCESS MEDI-CAL | ACCESS MEDI-CAL | $75.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BLUE SHIELD MEDI-CAL | BLUE SHIELD MEDI-CAL | $75.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC IPA MEDI-CAL | PACIFIC IPA MEDI-CAL | $75.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | CARE FIRST MEDI-CAL | CARE FIRST MEDI-CAL | $75.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $75.00 | $4,930.00 | $4,930.00 | 2025-10-04 | MRF ↗ |
| CLAY COUNTY MEDICAL CENTER Outpatient | HEALTH PARTNERS - ALL PLANS | HEALTH PARTNERS - ALL PLANS | $75.00 | $2,245.37 | $2,245.37 | 2026-04-24 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PREFERRED MEDI-CAL | PREFERRED MEDI-CAL | $75.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $75.00 | $4,930.00 | $4,930.00 | 2025-10-04 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ALTAMED MEDI-CAL - ALL OTHER PLANS | ALTAMED MEDI-CAL - ALL OTHER PLANS | $75.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MEDI-CAL | MEDI-CAL | $75.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BC MEDI-CAL | BC MEDI-CAL | $75.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHCARE INC MEDI-CAL | HEALTHCARE INC MEDI-CAL | $75.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 1&2|MVP ESSENTIAL 3&4 | $75.20 | $30,359.70 | $19,733.81 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP OPTION|MVP CHILD HEALTH PLUS | $75.20 | $30,359.70 | $19,733.81 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 3&4 | $75.20 | $30,359.70 | $19,733.81 | 2024-12-30 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $76.50 | $4,930.00 | $4,930.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $76.50 | $4,930.00 | $4,930.00 | 2025-10-04 | MRF ↗ |
| St Anthony Regional Hospital & Nursing Home Outpatient | MIDLANDS CHOICE - ALL PLANS | MIDLANDS CHOICE - ALL PLANS | $76.98 | $3,290.00 | $3,290.00 | 2026-02-09 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $89.33 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | FCS IPA MEDI-CAL OP/PROFEE ONLY | FCS IPA MEDI-CAL OP/PROFEE ONLY | $90.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP EXCHANGE-INDIVIDUAL | $92.01 | $30,359.70 | $19,733.81 | 2024-12-30 | MRF ↗ |
| Harper University Hospital Outpatient | Priority Health | PriorityHealthSBDHMOPPO | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Mclaren Health Plan | McLarenMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | United Healthcare | UnitedCommunityPlanMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Humana | HumanaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Employers Choice Network | EmployersChoiceNetworkWC | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Amerihealth | BlueCrossCompleteMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Priority Health | PriorityHealthMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Mclaren Health Plan | McLarenCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Mclaren Health Plan | McLarenMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Humana | HumanaCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Aetna | AetnaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Aetna | AetnaExistingBusiness | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Zing Health | ZingHealthMedicareNonNarrow | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaHIX | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Americas Choice Provider Network | AmericasChoiceProviderNetworkWC | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | BCBS-MI | BCBSMIMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | American Health Plan | AmericanHealthPlanMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Enlyte/Genex/Coventry | CoventryAKAGenexWC | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHPICigna | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | BCBS-MI | BCBSMIBCNMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Priority Health | PriorityHealthCigna | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Aetna | AetnaMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Community Care | CommunityCareComm | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Priority Health | PriorityHealthSEMIPartnersNet | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | AllyAlign Health | AllyAlignHealthMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | United Healthcare | UnitedMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Priority Health | PriorityHealthMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Point Comfort Underwriters | PointComfortUnderwriters | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Provider Partners Health Plan | ProviderPartnersHealthPlanMedicareAdvantage | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Naphcare Inc. | NaphCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Mclaren Health Plan | McLarenAdvantagePPO | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Commonwealth Care Alliance | CommonwealthCareAllianceMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Wellcare | CenteneHNWellcareMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Corvel | CorvelWC | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Longevity Health Plan | LongevityHealthPlan | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Wellcare | MeridianMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Priority Health | PriorityHealthCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Prime Health Services | PrimeHealthServicesWC | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Multiplan | MultiplanWC | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Centene | AmbetterHIX | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Amerihealth | AmerihealthCaritasMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Centene | CenteneHNWellcareMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | MidwestMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Prime Health Services | PrimeHealthServicesMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | BCBS-MI | BCBSMICommercial | — | — | — | 2025-01-31 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $97.34 | — | — | 2026-04-14 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $97.50 | $4,930.00 | $4,930.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $97.50 | $4,930.00 | $4,930.00 | 2025-10-04 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | GENERIC CARRIER [107] | ST REGIS MOHAWK [10724] | — | $30,359.70 | $19,733.81 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | FIDELIS CARE NEW YORK [112] | FIDELIS CARE NEW YORK|FIDELIS FHP|FIDELIS CHP | — | $30,359.70 | $19,733.81 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | AETNA [100] | AETNA MEDICARE ADVANTAGE | — | $30,359.70 | $19,733.81 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | EXCELLUS HMO [104] | BLUE CHOICE OPTION|CHILD HEALTH PLUS|UNIVERA MYHEALTH PLUS|EXCELLUS ESSENTIAL 1&2|EXCELLUS ESSENTIAL 3&4|UNIVERA MYHEALTH|UNIVERA ESSENTIAL 1&2|HEALTHY NY | — | $30,359.70 | $19,733.81 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN|UHC COMMUNITY MEDICAID DENTAL|UHC ESSENTIAL 1&2|UHC CHPS|UHC ESSENTIAL 3&4 | — | $30,359.70 | $19,733.81 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | WELLCARE TODAY'S OPTIONS [12503] | — | $30,359.70 | $19,733.81 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS(INCLUDING GOLD,SILVER,BRONZE AND PLATINUM) | — | $30,359.70 | $19,733.81 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | HUMANA MEDICARE HMO | — | $30,359.70 | $19,733.81 | 2024-12-30 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Naphcare Inc. | NaphCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Aetna | AetnaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Aetna | AetnaExistingBusiness | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Contigo Health | ContigoHealthWCfkaThreeRiversWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | BCBS-MI | BCBSMICommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Mclaren Health Plan | McLarenAdvantagePPO | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Mclaren Health Plan | McLarenCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Mclaren Health Plan | McLarenMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Employers Choice Network | EmployersChoiceNetworkWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Commonwealth Care Alliance | CommonwealthCareAllianceMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHPICigna | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Prime Health Services | PrimeHealthServicesMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaHIX | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | BCBS-MI | BCBSMIMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Amerihealth | BlueCrossCompleteMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Centene | AmbetterHIX | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthSBDHMOPPO | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | American Health Plan | AmericanHealthPlanMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Longevity Health Plan | LongevityHealthPlan | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | AllyAlign Health | AllyAlignHealthMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | BCBS-MI | BCBSMIBCNMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | United Healthcare | HealthSmartMgdWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Zing Health | ZingHealthMedicareNonNarrow | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | United Healthcare | UnitedMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | MidwestMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Humana | HumanaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Humana | HumanaCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Multiplan | MultiplanWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | United Healthcare | UnitedCommunityPlanMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Wellcare | CenteneHNWellcareMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthCigna | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Community Care | CommunityCareComm | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Prime Health Services | PrimeHealthServicesWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Enlyte/Genex/Coventry | CoventryAKAGenexWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Wellcare | MeridianMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Mclaren Health Plan | McLarenMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Aetna | AetnaMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Centene | CenteneHNWellcareMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Amerihealth | AmerihealthCaritasMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthSEMIPartnersNet | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | GLOBAL CARE MCAL PROFEE ONLY | GLOBAL CARE MCAL PROFEE ONLY | $105.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | $105.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HCLA MCAL PROFEE ONLY | HCLA MCAL PROFEE ONLY | $105.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ASSOC HISPANIC PHYSCNS MCAL | ASSOC HISPANIC PHYSCNS MCAL | $105.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | EL PROYECTO MCAL PROFEE ONLY | EL PROYECTO MCAL PROFEE ONLY | $105.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | AHP MEDI-CAL | AHP MEDI-CAL | $105.00 | $705.00 | $126.90 | 2026-01-30 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER INC OutpatientFacility | UCARE [91180041] | UCARE ESSENTIA CARE MEDICARE ADVANTAGE PLAN [777] | $111.89 | — | — | 2026-03-31 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $117.60 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $117.60 | — | — | 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.