23575 — Cltx Scap Fx W/mnpj +-tractj
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). CLTX SCAP FX W/MNPJ +-TRACTJ (CPT 23575) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/23575?code_type=CPT
MLA (9th ed.)
“CLTX SCAP FX W/MNPJ +-TRACTJ (CPT 23575) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/23575?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“CLTX SCAP FX W/MNPJ +-TRACTJ (CPT 23575) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/23575?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $948–$2,587 (25th–75th percentile) across 1,858 hospitals · 4,763 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 23575 — 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
$948
$1,653 typical
$2,587
The middle 50% of negotiated facility rates for this procedure, measured across 1,858 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. | $1,653 |
| Surgeon (professional fee) Estimate national typical Medicare $379 × 1.22 commercial. | $462 |
| 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 | $2,824 |
Surgical episode (typical)
~$2,824
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)
~$6,608
- 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 ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $2.00 | $1,100.00 | $297.00 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $2.00 | $1,100.00 | $242.00 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $2.00 | $1,100.00 | $264.00 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $2.00 | $1,100.00 | $242.00 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $2.00 | $1,100.00 | $286.00 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $2.00 | $1,100.00 | $242.00 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $2.00 | $1,100.00 | $264.00 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $2.00 | $1,100.00 | $209.00 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $2.00 | $1,100.00 | $297.00 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $2.00 | $1,100.00 | $253.00 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $2.00 | $1,100.00 | $242.00 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $2.00 | $1,100.00 | $242.00 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $2.00 | $1,100.00 | $198.00 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $2.00 | $1,100.00 | $209.00 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $2.00 | $1,100.00 | $253.00 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $2.00 | $1,100.00 | $242.00 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $2.00 | $1,100.00 | $286.00 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $2.00 | $1,100.00 | $242.00 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $2.00 | $1,100.00 | $242.00 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $2.00 | $1,100.00 | $253.00 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $2.00 | $1,100.00 | $253.00 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $2.00 | $1,100.00 | $198.00 | 2026-04-14 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $9.01 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $9.06 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $9.06 | — | — | 2026-03-18 | MRF ↗ |
| GROSSMONT HOSPITAL Outpatient | Blue Cross | Blue Cross - Prudent Buyer | $9.25 | $3,509.00 | $2,631.75 | 2026-04-01 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $10.32 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $10.39 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $10.39 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $11.24 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $11.31 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $11.31 | — | — | 2026-03-18 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $12.38 | $2,594.00 | $959.78 | 2026-03-31 | MRF ↗ |
| GROSSMONT HOSPITAL Outpatient | United Healthcare | United Healthcare - HMO | $17.02 | $3,509.00 | $2,631.75 | 2026-04-01 | 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 ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $31.81 | — | — | 2026-04-14 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC HEALTHCHOICE | ALL PRODUCTS | $32.96 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC HEALTHCHOICE | ALL PRODUCTS | $32.96 | — | — | 2026-01-01 | 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 ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $34.69 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $34.69 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $34.69 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $34.69 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $34.69 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $34.69 | — | — | 2026-04-16 | MRF ↗ |
| MAYERS MEMORIAL HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $35.00 | $191.00 | $191.00 | 2026-05-12 | MRF ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $41.33 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $41.33 | — | — | 2026-04-01 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $41.66 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $41.66 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $41.66 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $41.66 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $41.66 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $41.66 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $41.66 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $41.66 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $41.66 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $46.78 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $46.78 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $46.78 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $46.78 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $46.78 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $46.78 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $46.78 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $46.78 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $46.78 | — | — | 2026-04-14 | 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 ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| SKYLINE HOSPITAL Outpatient | REGENCE BS CARE | REGENCE BS CARE | $51.00 | $2,335.00 | $1,681.20 | 2026-05-04 | MRF ↗ |
| SKYLINE HOSPITAL Outpatient | REGENCE BS PPO/POS - ALL OTHER PLANS | REGENCE BS PPO/POS - ALL OTHER PLANS | $51.00 | $2,335.00 | $1,681.20 | 2026-05-04 | MRF ↗ |
| BAPTIST MEMORIAL HOSPITAL JONESBORO, INC. OutpatientFacility | Home State Health Plan | Medicaid | $51.00 | $1,913.00 | $363.47 | 2026-02-27 | MRF ↗ |
| SKYLINE HOSPITAL Outpatient | REGENCE BS PAR | REGENCE BS PAR | $51.00 | $2,335.00 | $1,681.20 | 2026-05-04 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Priority Health | PriorityHealthSEMIPartnersNet | $52.40 | — | — | 2025-01-31 | MRF ↗ |
| CHI HEALTH IMMANUEL Outpatient | United | Medicaid|Community Plan | $52.78 | $377.00 | $158.34 | 2026-02-28 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $53.60 | $397.00 | $297.75 | 2026-01-16 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Both | UHC MCR ADV | UHC MCR ADV | $54.40 | $160.00 | $96.00 | 2025-11-18 | MRF ↗ |
| CHI HEALTH MERCY COUNCIL BLUFFS Outpatient | Centene | Medicaid|NE Total Care | $56.55 | $377.00 | $158.34 | 2026-02-28 | MRF ↗ |
| CHI HEALTH IMMANUEL Outpatient | Centene | Medicaid|NE Total Care | $56.55 | $377.00 | $158.34 | 2026-02-28 | MRF ↗ |
| VALLEY REGIONAL HOSPITAL Both | WELL SENSE HEALTH PLAN | WELL SENSE HEALTH PLAN | $57.74 | $765.00 | $420.75 | 2026-04-10 | MRF ↗ |
| VALLEY REGIONAL HOSPITAL Both | BEACON HEALTH | CARELON BEHAVIORAL HEALTH | $57.74 | $765.00 | $420.75 | 2026-04-10 | MRF ↗ |
| COMMUNITY HOSPITAL OF HUNTINGTON PARK InpatientFacility | Blue Shield | HMO/PPO | — | $2,867.55 | $2,867.55 | 2026-02-04 | MRF ↗ |
| CHI HEALTH LAKESIDE Outpatient | Centene | Medicaid|NE Total Care | $60.32 | $377.00 | $158.34 | 2026-02-28 | MRF ↗ |
| CHI HEALTH LAKESIDE Outpatient | United | Medicaid|Community Plan | $60.32 | $377.00 | $158.34 | 2026-02-28 | MRF ↗ |
| VALLEY REGIONAL HOSPITAL Both | AMERIHEALTH CARITAS NH | AMERIHEALTH CARITAS NH | $60.72 | $765.00 | $420.75 | 2026-04-10 | MRF ↗ |
| VALLEY REGIONAL HOSPITAL Both | NH MEDICAID | NH MEDICAID | $61.32 | $765.00 | $420.75 | 2026-04-10 | MRF ↗ |
| VALLEY REGIONAL HOSPITAL Both | NH MEDICAID | NH MEDICAID DISABILITY | $61.32 | $765.00 | $420.75 | 2026-04-10 | MRF ↗ |
| VALLEY REGIONAL HOSPITAL Both | NH MEDICAID | NH MEDICAID PENDING | $61.32 | $765.00 | $420.75 | 2026-04-10 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | W/O DAP | $61.75 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | W/O DAP | $61.75 | — | — | 2026-01-01 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Both | TRICARE - ALL PLANS | TRICARE - ALL PLANS | $62.08 | $160.00 | $96.00 | 2025-11-18 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | FULLY | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | WITH DAP | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC IHS | ALL PRODUCTS | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CARE FIRST | ALL PRODUCTS | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC MERCY CARE | ALL PRODUCTS | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | ONLY | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | WITH DAP | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | PARTIAL | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | FULLY | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | ONLY | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC IHS | ALL PRODUCTS | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CARE FIRST | ALL PRODUCTS | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC MERCY CARE | ALL PRODUCTS | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC APIPA | ALL PRODUCTS | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | BEHAVIORAL HEALTH | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CMDP | ALL PRODUCTS | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | PARTIAL | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CMDP | ALL PRODUCTS | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | BEHAVIORAL HEALTH | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC APIPA | ALL PRODUCTS | $62.99 | — | — | 2026-01-01 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Both | AMERIGROUP MCR ADV | AMERIGROUP MCR ADV | $64.00 | $160.00 | $96.00 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Both | UHC VA CCN | UHC VA CCN | $64.00 | $160.00 | $96.00 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Both | IOWA TOTAL CARE MCR | IOWA TOTAL CARE MCR | $64.00 | $160.00 | $96.00 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Both | IOWA TOTAL CARE COMM - ALL OTHER PLANS | IOWA TOTAL CARE COMM - ALL OTHER PLANS | $64.00 | $160.00 | $96.00 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Both | HUMANA MEDICARE-ALL PLANS | HUMANA MEDICARE-ALL PLANS | $64.00 | $160.00 | $96.00 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Both | MOLINA MCR ADV | MOLINA MCR ADV | $64.00 | $160.00 | $96.00 | 2025-11-18 | MRF ↗ |
| Lasting Hope Recovery Center Outpatient | Centene | Medicaid|NE Total Care | $64.09 | $377.00 | $158.34 | 2026-02-28 | MRF ↗ |
| Lasting Hope Recovery Center Outpatient | United | Medicaid|Community Plan | $64.09 | $377.00 | $158.34 | 2026-02-28 | MRF ↗ |
| CHI HEALTH BERGAN MERCY Outpatient | Centene | Medicaid|NE Total Care | $64.09 | $377.00 | $158.34 | 2026-02-28 | MRF ↗ |
| CHI HEALTH BERGAN MERCY Outpatient | United | Medicaid|Community Plan | $64.09 | $377.00 | $158.34 | 2026-02-28 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $66.80 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Both | MOLINA MCAID/CHIP | MOLINA MCAID/CHIP | $67.20 | $160.00 | $96.00 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Both | IOWA TOTAL CARE MCAID | IOWA TOTAL CARE MCAID | $67.20 | $160.00 | $96.00 | 2025-11-18 | MRF ↗ |
| CHI HEALTH MIDLANDS Outpatient | Centene | Medicaid|NE Total Care | $67.86 | $377.00 | $158.34 | 2026-02-28 | MRF ↗ |
| CHI HEALTH MIDLANDS Outpatient | United | Medicaid|Community Plan | $67.86 | $377.00 | $158.34 | 2026-02-28 | MRF ↗ |
| BAPTIST MEMORIAL HOSPITAL-CRITTENDEN, INC OutpatientFacility | Tribute Health Plan | Medicaid | $68.01 | $2,013.00 | $301.95 | 2026-02-27 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Both | AMERIGROUP MEDICAID - ALL OTHER PLANS | AMERIGROUP MEDICAID - ALL OTHER PLANS | $68.54 | $160.00 | $96.00 | 2025-11-18 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | PGT | Medicare|All Plans | $68.93 | $541.00 | $94.68 | 2026-02-28 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC UNIVERSITY | FAMILY CARE BANNER | $69.45 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC UNIVERSITY | FAMILY CARE BANNER | $69.45 | — | — | 2026-01-01 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | BCBS | Medicare|All Plans | $70.33 | $541.00 | $94.68 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AETNA | Medicare|All Plans | $70.33 | $541.00 | $94.68 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | UNITED | Medicare|All Plans | $71.74 | $541.00 | $94.68 | 2026-02-28 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8813_ANTHEM UNIFIED GROUPS VKIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $72.42 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $72.42 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $72.42 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $72.42 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $72.42 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $72.42 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $72.42 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $72.42 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $72.42 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $72.42 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $72.42 | — | — | 2026-01-01 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AMERIVANTAGE | Medicare|All Plans | $72.44 | $541.00 | $94.68 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | SCANHealth | Medicare|All Plans | $75.26 | $541.00 | $94.68 | 2026-02-28 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Both | COVENTRY MEDICARE | COVENTRY MEDICARE | $78.40 | $160.00 | $96.00 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Both | AETNA MCR ADV | AETNA MCR ADV | $78.40 | $160.00 | $96.00 | 2025-11-18 | MRF ↗ |
| UNION GENERAL HOSPITAL Outpatient | CARESOURCE NETWORK PARTNERS, LLC. | CARE SOURCE MEDICAID | $78.61 | $514.00 | $257.00 | 2026-03-23 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Both | WORKERS COMPENSATION [20501] | All WORKERS COMP UM [16] Plans | $79.02 | $3,369.00 | $3,369.00 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | WORKERS COMPENSATION [20501] | All WORKERS COMP MH [27] Plans | $79.02 | $2,888.00 | $2,888.00 | 2025-12-08 | MRF ↗ |
| ST VINCENT HOSPITAL OutpatientFacility | HEALTHSMART | HEALTHSMART PREFERRED CARE WC | $79.02 | — | — | 2026-06-05 | MRF ↗ |
| ST VINCENT HOSPITAL OutpatientFacility | CORVEL | CORVEL HEALTHCARE CORP WC | $79.02 | — | — | 2026-06-05 | MRF ↗ |
| ST VINCENT HOSPITAL OutpatientFacility | HEALTH NET | GALAXY HEALTH NETWORK WC | $79.02 | — | — | 2026-06-05 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Both | WORKERS COMPENSATION [20501] | All WORKERS COMP HA [42] Plans | $79.02 | $3,007.00 | $3,007.00 | 2026-03-26 | MRF ↗ |
| ST VINCENT HOSPITAL OutpatientFacility | HEALTH NET | PRAXIS HEALTH NETWORK WC | $79.02 | — | — | 2026-06-05 | 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.