23472 — Reconstruct Shoulder Joint
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). RECONSTRUCT SHOULDER JOINT (HCPCS 23472) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/23472?code_type=HCPCS
MLA (9th ed.)
“RECONSTRUCT SHOULDER JOINT (HCPCS 23472) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/23472?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“RECONSTRUCT SHOULDER JOINT (HCPCS 23472) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/23472?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $5,774–$21,762 (25th–75th percentile) across 2,462 hospitals · 4,691 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 23472 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Also priced as a different code
The same procedure is billed under different code systems depending on the setting. These facilities price it under a code you won’t see in the CPT/HCPCS 23472 table above — including hospitals that only publish the bundled version.
2,860 facilities · 832 not in the CPT/HCPCS table
- ABBOTT NORTHWESTERN HOSPITAL, MINNEAPOLIS • only here
- ABRAHAM LINCOLN MEMORIAL HOSPITAL, LINCOLN • only here
- ACADIAN MEDICAL CENTER, EUNICE • only here
- Adventhealth Connerton, Land O' Lakes • only here
- ADVENTHEALTH FISH MEMORIAL, ORANGE CITY • only here
- ADVENTHEALTH LAKE WALES, LAKE WALES • only here
689 facilities · 191 not in the CPT/HCPCS table
- Adventhealth Connerton, Land O' Lakes • only here
- ADVENTHEALTH FISH MEMORIAL, ORANGE CITY • only here
- ADVENTHEALTH LAKE WALES, LAKE WALES • only here
- ADVENTHEALTH OCALA, OCALA • only here
- ADVENTHEALTH ORLANDO, ORLANDO • only here
- ADVENTHEALTH PALM COAST PARKWAY, PALM COAST • only here
An MS-DRG / APR-DRG price is the hospital’s single bundled charge for the entire inpatient stay — operating room, room & board, recovery, imaging, anesthesia (facility), implants and supplies — so it’s a broader, usually higher figure than the CPT/HCPCS 23472 line above, which prices the procedure alone. Neither includes the surgeon’s or anesthesiologist’s professional fees, which 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
$5,774
$16,730 typical
$21,762
The middle 50% of negotiated facility rates for this procedure, measured across 2,462 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. | $16,730 |
| Surgeon (professional fee) Estimate national typical Medicare $1,300 × 1.22 commercial. | $1,586 |
| Anesthesia Estimate national typical 01638, ~145 min typical. Medicare $403 × 3.14 commercial. | $1,266 |
| Likely subtotal | $19,582 |
Surgical episode (typical)
~$19,582
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge (see the recovery plan below)
- Complications, revisions, or readmissions
- Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)
The biggest swing: which insurer's rate applies — negotiated prices here run $5,774–$21,762.
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)
~$23,367
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
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 |
|---|---|---|---|---|---|---|---|
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $54,860.00 | $5,486.00 | 2026-07-18 | MRF ↗ |
| CHI Health Richard Young Behavioral Health Outpatient | United | Commercial|All Plans | — | — | — | 2026-02-28 | MRF ↗ |
| CHI Health Richard Young Behavioral Health Outpatient | United | Commercial|All Plans | — | — | — | 2026-02-28 | MRF ↗ |
| CHI HEALTH GOOD SAMARITAN Outpatient | United | Commercial|All Plans | — | — | — | 2026-02-28 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Anthem | Ppo Hmo | — | $8.40 | $4.20 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Aetna | Hmo Ppo | — | $8.40 | $4.20 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Anthem | Traditional | — | $8.40 | $4.20 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Med Mutual | Ppo Hmo | — | $8.40 | $4.20 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Molina | Marketplace | — | $8.40 | $4.20 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Cigna | Cigna | — | $8.40 | $4.20 | 2026-05-13 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $6.39 | $10.65 | $10.65 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $7.02 | $11.70 | $11.70 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $7.29 | $12.15 | $12.15 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $8.10 | $13.50 | $13.50 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $8.46 | $14.10 | $14.10 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $8.55 | $14.25 | $14.25 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $8.91 | $14.85 | $14.85 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $9.27 | $15.45 | $15.45 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $10.62 | $17.70 | $17.70 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $11.61 | $19.35 | $19.35 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $12.96 | $21.60 | $21.60 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $13.05 | $21.75 | $21.75 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $13.50 | $22.50 | $22.50 | 2026-03-16 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Sunflower | Medicaid | — | $4,914.00 | $3,194.10 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | United Healthcare | Commercial | — | $4,914.00 | $3,194.10 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Phcs/Multiplan | Commercial | — | $4,914.00 | $3,194.10 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Wppa/Providrscare | Commercial | — | $4,914.00 | $3,194.10 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Hpk (Incl. Cigna) | Commercial | — | $4,914.00 | $3,194.10 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Aetna | Commercial | — | $4,914.00 | $3,194.10 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Healthy Blue | Medicaid | — | $4,914.00 | $3,194.10 | 2026-08-01 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $13.95 | $23.25 | $23.25 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $14.13 | $23.55 | $23.55 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $15.66 | $26.10 | $26.10 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $15.93 | $26.55 | $26.55 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $17.37 | $28.95 | $28.95 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $18.09 | $30.15 | $30.15 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $18.54 | $30.90 | $30.90 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $19.50 | $32.50 | $32.50 | 2026-03-16 | MRF ↗ |
| WINNMED Outpatient | AETNA/FIRST HEALTH PPO-ALL OTHER PLANS | AETNA/FIRST HEALTH PPO-ALL OTHER PLANS | $19.59 | $5,708.00 | $3,995.60 | 2026-07-14 | MRF ↗ |
| WINNMED Outpatient | AETNA/FIRST HEALTH PHO | AETNA/FIRST HEALTH PHO | $19.59 | $5,708.00 | $3,995.60 | 2026-07-14 | MRF ↗ |
| WINNMED Outpatient | AETNA/FIRST HEALTH HMO | AETNA/FIRST HEALTH HMO | $19.59 | $5,708.00 | $3,995.60 | 2026-07-14 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $19.98 | $33.30 | $33.30 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $20.48 | $34.13 | $34.13 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $21.69 | $36.15 | $36.15 | 2026-03-16 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MEDICAL ASSOCIATES-ALL PLANS | MEDICAL ASSOCIATES-ALL PLANS | $22.16 | $61.55 | $55.40 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | TRIWEST WELLMARK-ALL PLANS | TRIWEST WELLMARK-ALL PLANS | $22.16 | $61.55 | $55.40 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | TRICARE- ALL PLANS | TRICARE- ALL PLANS | $22.16 | $61.55 | $55.40 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | VA CCN -ALL PLANS | VA CCN -ALL PLANS | $22.16 | $61.55 | $55.40 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | WELLMARK MCR ADV- ALL PLANS | WELLMARK MCR ADV- ALL PLANS | $22.38 | $61.55 | $55.40 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | UHC MCR ADV | UHC MCR ADV | $22.82 | $61.55 | $55.40 | 2026-01-03 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $24.12 | $40.20 | $40.20 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $24.39 | $40.65 | $40.65 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $25.29 | $42.15 | $42.15 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $25.65 | $42.75 | $42.75 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $25.74 | $42.90 | $42.90 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $27.18 | $45.30 | $45.30 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $27.45 | $45.75 | $45.75 | 2026-03-16 | MRF ↗ |
| ADVENTIST HEALTH CASTLE Outpatient | PACIFIC ADMIN PPO - ALL PLANS | PACIFIC ADMIN PPO - ALL PLANS | $29.27 | $3,604.00 | $1,153.28 | 2026-05-18 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $30.96 | $51.60 | $51.60 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $31.59 | $52.65 | $52.65 | 2026-03-16 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | OSCAR-ALL PLANS | OSCAR-ALL PLANS | $33.24 | $61.55 | $55.40 | 2026-01-03 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $33.57 | $55.95 | $55.95 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $35.55 | $59.25 | $59.25 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $36.09 | $60.15 | $60.15 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $38.07 | $63.45 | $63.45 | 2026-03-16 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MEDI-CAL | MEDI-CAL | $40.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC IPA MEDI-CAL | PACIFIC IPA MEDI-CAL | $40.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | CARE FIRST MEDI-CAL | CARE FIRST MEDI-CAL | $40.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ALTAMED MEDI-CAL - ALL OTHER PLANS | ALTAMED MEDI-CAL - ALL OTHER PLANS | $40.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BC MEDI-CAL | BC MEDI-CAL | $40.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PREFERRED MEDI-CAL | PREFERRED MEDI-CAL | $40.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHCARE INC MEDI-CAL | HEALTHCARE INC MEDI-CAL | $40.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BLUE SHIELD MEDI-CAL | BLUE SHIELD MEDI-CAL | $40.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | LASALLE MG MEDI-CAL | LASALLE MG MEDI-CAL | $40.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC ALLIANCE MEDI-CAL | PACIFIC ALLIANCE MEDI-CAL | $40.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ACCESS MEDI-CAL | ACCESS MEDI-CAL | $40.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $40.23 | $67.05 | $67.05 | 2026-03-16 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $41.98 | $792.00 | $150.48 | 2026-05-20 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MIDLANDS NEW BUSINESS | MIDLANDS NEW BUSINESS | $43.09 | $61.55 | $55.40 | 2026-01-03 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $43.99 | $24,441.00 | $14,325.75 | 2024-12-31 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BC MEDI-CAL | BC MEDI-CAL | $45.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PREFERRED MEDI-CAL | PREFERRED MEDI-CAL | $45.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | CARE FIRST MEDI-CAL | CARE FIRST MEDI-CAL | $45.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | BC MCAL | BC MCAL | $45.00 | $792.00 | $150.48 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH ST HELENA Outpatient | MEDI-CAL | MEDI-CAL | $45.00 | $875.00 | $131.25 | 2026-07-15 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ALTAMED MEDI-CAL - ALL OTHER PLANS | ALTAMED MEDI-CAL - ALL OTHER PLANS | $45.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE MCAL PROFEE ONLY | CENTRAL CA ALLIANCE MCAL PROFEE ONLY | $45.00 | $792.00 | $150.48 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS | DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS | $45.00 | $792.00 | $150.48 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CAL VIVA HLTH MCAL - ALL PLANS | CAL VIVA HLTH MCAL - ALL PLANS | $45.00 | $792.00 | $150.48 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHCARE INC MEDI-CAL | HEALTHCARE INC MEDI-CAL | $45.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC ALLIANCE MEDI-CAL | PACIFIC ALLIANCE MEDI-CAL | $45.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | LASALLE MG MEDI-CAL | LASALLE MG MEDI-CAL | $45.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC IPA MEDI-CAL | PACIFIC IPA MEDI-CAL | $45.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | MEDI-CAL | MEDI-CAL | $45.00 | $792.00 | $150.48 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BLUE SHIELD MEDI-CAL | BLUE SHIELD MEDI-CAL | $45.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MEDI-CAL | MEDI-CAL | $45.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | UPN MCAL PROFEE ONLY-ALL OTHER PLANS | UPN MCAL PROFEE ONLY-ALL OTHER PLANS | $45.00 | $792.00 | $150.48 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ACCESS MEDI-CAL | ACCESS MEDI-CAL | $45.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA ACA PPO - ALL OTHER PLANS | AVERA ACA PPO - ALL OTHER PLANS | $46.00 | $5,495.00 | $3,297.00 | 2025-12-20 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA HMO | AVERA HMO | $46.00 | $5,495.00 | $3,297.00 | 2025-12-20 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $47.43 | $79.05 | $79.05 | 2026-03-16 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $47.64 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | FCS IPA MEDI-CAL OP/PROFEE ONLY | FCS IPA MEDI-CAL OP/PROFEE ONLY | $48.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA ASO PPO | AVERA ASO PPO | $48.00 | $5,495.00 | $3,297.00 | 2025-12-20 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $48.15 | $80.25 | $80.25 | 2026-03-16 | MRF ↗ |
| S E LACKEY MEMORIAL HOSPITAL Outpatient | CIGNA COMM - ALL PLANS | CIGNA COMM - ALL PLANS | $50.00 | $4,555.00 | $4,555.00 | 2026-02-10 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $51.27 | $85.45 | $85.45 | 2026-03-16 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $53.06 | $61.55 | $55.40 | 2026-01-03 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $53.60 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | FCS IPA MEDI-CAL OP/PROFEE ONLY | FCS IPA MEDI-CAL OP/PROFEE ONLY | $54.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA NONACA PPO | AVERA NONACA PPO | $54.00 | $5,495.00 | $3,297.00 | 2025-12-20 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $55.62 | $92.70 | $92.70 | 2026-03-16 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | $56.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ASSOC HISPANIC PHYSCNS MCAL | ASSOC HISPANIC PHYSCNS MCAL | $56.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | AHP MEDI-CAL | AHP MEDI-CAL | $56.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HCLA MCAL PROFEE ONLY | HCLA MCAL PROFEE ONLY | $56.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | EL PROYECTO MCAL PROFEE ONLY | EL PROYECTO MCAL PROFEE ONLY | $56.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | GLOBAL CARE MCAL PROFEE ONLY | GLOBAL CARE MCAL PROFEE ONLY | $56.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | KERN HEALTH SYSTEMS MCAL-ALL PLANS | KERN HEALTH SYSTEMS MCAL-ALL PLANS | $56.25 | $792.00 | $150.48 | 2026-05-20 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $58.23 | $97.05 | $97.05 | 2026-03-16 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MULTIPLAN-ALL PLANS | MULTIPLAN-ALL PLANS | $58.47 | $61.55 | $55.40 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MIDLANDS CHOICE - ALL OTHER PLANS | MIDLANDS CHOICE - ALL OTHER PLANS | $59.70 | $61.55 | $55.40 | 2026-01-03 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HCLA MCAL PROFEE ONLY | HCLA MCAL PROFEE ONLY | $63.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | $63.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ASSOC HISPANIC PHYSCNS MCAL | ASSOC HISPANIC PHYSCNS MCAL | $63.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | AHP MEDI-CAL | AHP MEDI-CAL | $63.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | EL PROYECTO MCAL PROFEE ONLY | EL PROYECTO MCAL PROFEE ONLY | $63.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | GLOBAL CARE MCAL PROFEE ONLY | GLOBAL CARE MCAL PROFEE ONLY | $63.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| MADISON COUNTY HEALTH CARE SYSTEM Outpatient | MIDLANDS CHOICE - ALL PLANS | MIDLANDS CHOICE - ALL PLANS | $63.50 | $3,841.00 | $3,072.80 | 2026-06-05 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MOLINA MEDI-CAL | MOLINA MEDI-CAL | $64.00 | $845.00 | $152.10 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | BLUE CROSS MCS-ALL OTHER PLANS | BLUE CROSS MCS-ALL OTHER PLANS | $66.41 | $792.00 | $158.40 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | BLUE CROSS NON-MCS | BLUE CROSS NON-MCS | $66.41 | $792.00 | $158.40 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE CCS PROFEE ONLY | CENTRAL CA ALLIANCE CCS PROFEE ONLY | $67.50 | $792.00 | $150.48 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P | CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P | $67.50 | $792.00 | $150.48 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | KAISER MEDI-CAL | KAISER MEDI-CAL | $70.00 | $792.00 | $158.40 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $70.00 | $792.00 | $158.40 | 2026-05-24 | MRF ↗ |
| GRANT REGIONAL HEALTH CENTER Outpatient | DEAN HEALTH PLAN - ALL PLANS | DEAN HEALTH PLAN - ALL PLANS | $71.99 | $4,539.00 | $2,950.35 | 2026-01-15 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MOLINA MEDI-CAL | MOLINA MEDI-CAL | $72.00 | $845.00 | $152.10 | 2026-05-23 | MRF ↗ |
| SEARHC WRANGELL MEDICAL CENTER & LTC Outpatient | UHC-ALL PLANS | UHC-ALL PLANS | $72.00 | $7,146.57 | $7,146.57 | 2024-12-09 | MRF ↗ |
| CLAY COUNTY MEDICAL CENTER Outpatient | HEALTH PARTNERS - ALL PLANS | HEALTH PARTNERS - ALL PLANS | $75.00 | $3,068.90 | $3,068.90 | 2026-07-22 | MRF ↗ |
| CLAY COUNTY MEDICAL CENTER Outpatient | HEALTH PARTNERS - ALL PLANS | HEALTH PARTNERS - ALL PLANS | $75.00 | $3,068.90 | $3,068.90 | 2026-04-24 | MRF ↗ |
| FAIRCHILD MEDICAL CENTER Outpatient | MEDI-CAL | MEDI-CAL | $75.00 | $7,509.00 | $7,509.00 | 2025-12-03 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $76.14 | $126.90 | $126.90 | 2026-03-16 | MRF ↗ |
| St Anthony Regional Hospital & Nursing Home Outpatient | MIDLANDS CHOICE - ALL PLANS | MIDLANDS CHOICE - ALL PLANS | $76.98 | $3,961.00 | $3,961.00 | 2026-02-09 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $82.08 | $136.80 | $136.80 | 2026-03-16 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $83.96 | $8,965.00 | $8,965.00 | 2026-02-13 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $84.94 | $141.57 | $141.57 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $85.84 | $143.07 | $143.07 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $86.49 | $144.15 | $144.15 | 2026-03-16 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE CHDP PROFEE ONLY | CENTRAL CA ALLIANCE CHDP PROFEE ONLY | $90.00 | $792.00 | $150.48 | 2026-05-20 | MRF ↗ |
| REGIONAL WEST MEDICAL CENTER Outpatient | UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $90.00 | $45,975.13 | $40,458.11 | 2025-11-14 | MRF ↗ |
| REGIONAL WEST MEDICAL CENTER Outpatient | UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $90.00 | $68,962.70 | $60,687.18 | 2025-11-14 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $97.81 | $163.02 | $163.02 | 2026-03-16 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS(INCLUDING GOLD,SILVER,BRONZE AND PLATINUM) | — | $38,942.32 | $25,312.51 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | FIDELIS CARE NEW YORK [112] | FIDELIS CARE NEW YORK|FIDELIS FHP|FIDELIS CHP | — | $38,942.32 | $25,312.51 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | WELLCARE TODAY'S OPTIONS [12503] | — | $38,942.32 | $25,312.51 | 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 | — | $38,942.32 | $25,312.51 | 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 | — | $38,942.32 | $25,312.51 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | HUMANA MEDICARE HMO | — | $38,942.32 | $25,312.51 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | AETNA [100] | AETNA MEDICARE ADVANTAGE | — | $38,942.32 | $25,312.51 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | GENERIC CARRIER [107] | ST REGIS MOHAWK [10724] | — | $38,942.32 | $25,312.51 | 2024-12-30 | MRF ↗ |
| S E LACKEY MEMORIAL HOSPITAL Outpatient | BCBS AHS | BCBS AHS | $100.00 | $4,555.00 | $4,555.00 | 2026-02-10 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | EXCELLUS-BC_MEDICAID | EXCELLUS BLUE CROSS SPECIAL PROGRAMS | $102.98 | $406.88 | $125.10 | 2025-01-19 | MRF ↗ |
| NORTH ALABAMA SHOALS HOSPITAL Outpatient | AETNA | POS | $122.32 | $10,925.33 | $3,823.87 | 2025-07-01 | MRF ↗ |
| NORTH ALABAMA MEDICAL CENTER Outpatient | AETNA | POS | $122.32 | $10,925.33 | $3,823.87 | 2025-07-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | MEDICARE NGS | MEDICARE B | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | MEDICAID MN | MEDICAID OUTPATIENT | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | BCBSMN | BLUE CROSS OF MN | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | BCBSMN | BLUE LINK | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | BCBSMN | BLUE CROSS MEDICARE ADVANTAGE | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | HP | HEALTH PARTNERS | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | MEDICA | MEDICA | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | MEDICA | MEDICA PRIME SOLUTION | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | MEDICA | SELECTCARE | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | TRIWEST | CHAMPVA | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | UHC | AETNA MEDICARE ADVANTAGE | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | UHC | CIGNA | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | UHC | AETNA LIFE & CASUALTY | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | ADVANTRA FREEDOM | ADVANTRA FREEDOM MC ADVANTAGE | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | UHC | LABORCARE UNITED HEALTHCARE | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | UHC | UNITED HEALTHCARE | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | TRIWEST | TRICARE WEST | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | UMR | UMR | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| COMMUNITY MEMORIAL HOSPITAL Both | BCBSMN | BLUE CROSS PLATINUM BLUE CP | — | $4,745.00 | $3,036.80 | 2026-04-01 | MRF ↗ |
| OHIOHEALTH MORROW COUNTY HOSPITAL Outpatient | MOLINA MEDICARE | MOLINA MEDICARE | $153.77 | $415.60 | $270.14 | 2025-10-22 | MRF ↗ |
| OHIOHEALTH MORROW COUNTY HOSPITAL Outpatient | UHC MEDICARE ADVANTAGE | UHC MEDICARE ADVANTAGE | $153.77 | $415.60 | $270.14 | 2025-10-22 | MRF ↗ |
| OHIOHEALTH MORROW COUNTY HOSPITAL Outpatient | DEVOTED MEDICARE ADV - ALL PLANS | DEVOTED MEDICARE ADV - ALL PLANS | $153.77 | $415.60 | $270.14 | 2025-10-22 | MRF ↗ |
| OHIOHEALTH MORROW COUNTY HOSPITAL Outpatient | MOLINA EXCHANGE - ALL OTHER PLANS | MOLINA EXCHANGE - ALL OTHER PLANS | $153.77 | $415.60 | $270.14 | 2025-10-22 | MRF ↗ |
| OHIOHEALTH MORROW COUNTY HOSPITAL Outpatient | ANTHEM MEDICARE ADV | ANTHEM MEDICARE ADV | $153.77 | $415.60 | $270.14 | 2025-10-22 | MRF ↗ |
| OHIOHEALTH MORROW COUNTY HOSPITAL Outpatient | UHC VA CCN | UHC VA CCN | $153.77 | $415.60 | $270.14 | 2025-10-22 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Univera | Medicare Managed Care Plan | $153.88 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $153.88 | — | — | 2026-04-01 | MRF ↗ |
| OHIOHEALTH MORROW COUNTY HOSPITAL Outpatient | BUCKEYE MEDICARE - ALL OTHER PLANS | BUCKEYE MEDICARE - ALL OTHER PLANS | $155.31 | $415.60 | $270.14 | 2025-10-22 | MRF ↗ |
| OHIOHEALTH MORROW COUNTY HOSPITAL Outpatient | HUMANA MEDICARE ADV | HUMANA MEDICARE ADV | $155.31 | $415.60 | $270.14 | 2025-10-22 | MRF ↗ |
| OHIOHEALTH MORROW COUNTY HOSPITAL Outpatient | AETNA MEDICARE ADV | AETNA MEDICARE ADV | $156.68 | $415.60 | $270.14 | 2025-10-22 | MRF ↗ |
| OHIOHEALTH MORROW COUNTY HOSPITAL Outpatient | MEDICAL MUTUAL OF OHIO - MEDICARE | MEDICAL MUTUAL OF OHIO - MEDICARE | $156.85 | $415.60 | $270.14 | 2025-10-22 | MRF ↗ |
| CARIBOU MEDICAL CENTER Outpatient | AETNA MCR ADV | AETNA MCR ADV | $158.00 | $4,067.00 | $2,846.90 | 2026-03-16 | MRF ↗ |
| PATIENTS' HOSPITAL OF REDDING Both | Cigna | All | $160.60 | $267.66 | $267.66 | 2026-03-16 | MRF ↗ |
| THREE RIVERS HOSPITAL Both | — | — | — | $230.00 | $230.00 | 2024-12-12 | 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.