23615 — Optx Prox Humrl Fx W/int Fix
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). OPTX PROX HUMRL FX W/INT FIX (HCPCS 23615) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/23615?code_type=HCPCS
MLA (9th ed.)
“OPTX PROX HUMRL FX W/INT FIX (HCPCS 23615) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/23615?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“OPTX PROX HUMRL FX W/INT FIX (HCPCS 23615) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/23615?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $4,162–$14,930 (25th–75th percentile) across 1,989 hospitals · 4,754 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 23615 — 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
$4,162
$11,037 typical
$14,930
The middle 50% of negotiated facility rates for this procedure, measured across 1,989 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. | $11,037 |
| Surgeon (professional fee) Estimate national typical Medicare $824 × 1.22 commercial. | $1,005 |
| 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 | $12,750 |
Surgical episode (typical)
~$12,750
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)
~$16,535
- 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 |
|---|---|---|---|---|---|---|---|
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS HEALTH [70001] | CHA HB MEDICAID-STANDARD | $4.44 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB MEDICAID-STANDARD | $4.44 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB MEDICAID-STANDARD | $4.44 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS TOGETHER W CHA [75001] | CHA HB MEDICAID-STANDARD | $4.44 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | UNITED HEALTH [40002] | CHA HB MEDICAID-STANDARD | $4.44 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OOS MEDICAID [70002] | CHA HB MEDICAID-STANDARD | $4.44 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BOSTON MEDICAL CENTER - WELLSENSE [50003] | CHA HB MEDICAID-STANDARD | $4.44 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS GENERAL BRIGHAM [50021] | CHA HB MEDICAID-STANDARD | $4.44 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | AARP [40001] | CHA HB MEDICARE MANAGED CARE - UHC | $4.54 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | UNITED HEALTH [40002] | CHA HB MEDICARE MANAGED CARE - UHC | $4.54 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | COMMONWEALTH CARE ALLIANCE [65001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HEALTH SAFETY NET [80001] | CHA HB HEALTH SAFETY NET | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BCBS - MA [10001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | AETNA [50001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | SENIOR WHOLE HEALTH [65003] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BCBS - OUT OF STATE [10002] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS HEALTH PLAN [30001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | CHAMPVA [85001] | CHA HB TRICARE | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | RR MEDICARE [60002] | CHA HB MEDICARE | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER COMMERCIAL PAYOR [50015] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB FALLON | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MEDICARE [60001] | CHA HB MEDICARE | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER GOV'T PAYOR [85003] | CHA HB TRICARE | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB FALLON CAREPLUS | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HEALTH SAFETY NET [80001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | ELDER SERVICE PLAN [65002] | CHA HB ELDER SERVICE PLAN | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | CIGNA [50005] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TRICARE [85002] | CHA HB TRICARE | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HPHC [20001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS HEALTH PLAN [30001] | CHA HB Tufts Health Plan Medicare Preferred | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HUMANA [50008] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BOSTON MEDICAL CENTER - WELLSENSE [50003] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS GENERAL BRIGHAM [50021] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $7.57 | — | $17,062.10 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $7.57 | — | $17,062.10 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $7.57 | — | $17,062.10 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $7.57 | — | $17,062.10 | 2026-03-31 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB TUFTS HEALTH PUBLIC PLANS QHP NON-SUBSIDIZED | $8.13 | $11,285.70 | $11,285.70 | 2026-03-20 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) UM [75] Plans | $8.62 | $64,947.48 | $64,947.48 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE SPECIAL KIDS (FORMERLY BMC) UM [255] Plans | $10.78 | $64,947.48 | $64,947.48 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | FALLON MEDICAID [10904] | All FALLON ACO UM [130] Plans | $12.87 | $77,841.50 | $77,841.50 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | MGB MEDICAID [10906] | All MGB (FORMERLY AHP) ACO UM [212] Plans | $12.87 | $77,841.50 | $77,841.50 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | HNE MEDICAID [10905] | All HEALTH NEW ENGLAND/MINUTEMAN MCO UM [222] Plans | $12.87 | $77,841.50 | $77,841.50 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | MASSHEALTH [20302] | All MASSHEALTH UM [10] Plans | $12.87 | $58,461.76 | $58,461.76 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER UM [121] Plans | $12.87 | $58,461.76 | $58,461.76 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | MGB MEDICAID [10906] | All MGB (FORMERLY AHP) ACO UM [212] Plans | $12.87 | $58,461.76 | $58,461.76 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) UM [75] Plans | $12.87 | $58,461.76 | $58,461.76 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | INSTITUTION [10406] | All WORCESTER RECOVERY UM [233] Plans | $12.87 | $58,461.76 | $58,461.76 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | FALLON MEDICAID [10904] | All FALLON MCO UM [104] Plans | $12.87 | $77,841.50 | $77,841.50 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | FALLON MEDICAID [10904] | All FALLON ACO UM [130] Plans | $12.87 | $58,461.76 | $58,461.76 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | FALLON MEDICAID [10904] | All FALLON MCO UM [104] Plans | $12.87 | $58,461.76 | $58,461.76 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | INSTITUTION [10406] | All WORCESTER RECOVERY UM [233] Plans | $12.87 | $77,841.50 | $77,841.50 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) UM [75] Plans | $12.87 | $77,841.50 | $77,841.50 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | HNE MEDICAID [10905] | All HEALTH NEW ENGLAND/MINUTEMAN MCO UM [222] Plans | $12.87 | $58,461.76 | $58,461.76 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER UM [121] Plans | $12.87 | $77,841.50 | $77,841.50 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | MASSHEALTH [20302] | All MASSHEALTH UM [10] Plans | $12.87 | $77,841.50 | $77,841.50 | 2026-03-26 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Amerihealth | HMO | $14.00 | $18.00 | $18.00 | 2026-03-31 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Independence Keystone Health Plan | Commercial | $14.00 | $18.00 | $18.00 | 2026-03-31 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $2,503.00 | $550.66 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $2,503.00 | $550.66 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $2,503.00 | $550.66 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $2,503.00 | $675.81 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $2,503.00 | $550.66 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $2,503.00 | $575.69 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $2,503.00 | $475.57 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $2,503.00 | $600.72 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $2,503.00 | $600.72 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $2,503.00 | $550.66 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $2,503.00 | $550.66 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $2,503.00 | $575.69 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $2,503.00 | $575.69 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $2,503.00 | $550.66 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $2,503.00 | $475.57 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $2,503.00 | $450.54 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $2,503.00 | $575.69 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $2,503.00 | $675.81 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $2,503.00 | $450.54 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $2,503.00 | $650.78 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $2,503.00 | $650.78 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $2,503.00 | $550.66 | 2026-04-14 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE SPECIAL KIDS (FORMERLY BMC) UM [255] Plans | $16.09 | $58,461.76 | $58,461.76 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE SPECIAL KIDS (FORMERLY BMC) UM [255] Plans | $16.09 | $77,841.50 | $77,841.50 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | GRANTS [20507] | All TB GETCHELL [226] Plans | $17.46 | $77,841.50 | $77,841.50 | 2026-03-26 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Aetna | Commercial | $18.00 | $18.00 | $18.00 | 2026-03-31 | MRF ↗ |
| HOSPITAL FOR SPECIAL SURGERY OutpatientFacility | BLUE CROSS BLUE SHIELD NY [1022] | BCBS INDIVIDUAL NETWORK [102218] | $20.14 | — | $23,694.95 | 2026-04-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $21.94 | — | — | 2026-04-14 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $25.50 | $2,246.00 | $426.74 | 2026-01-25 | 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 ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | FALLON MEDICAID [10904] | All FALLON ACO UM [130] Plans | $30.94 | $75,217.98 | $75,217.98 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | MGB MEDICAID [10906] | All MGB (FORMERLY AHP) ACO UM [212] Plans | $30.94 | $75,217.98 | $75,217.98 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | HNE MEDICAID [10905] | All HEALTH NEW ENGLAND/MINUTEMAN MCO UM [222] Plans | $30.94 | $75,217.98 | $75,217.98 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | MASSHEALTH [20302] | All MASSHEALTH UM [10] Plans | $30.94 | $75,217.98 | $75,217.98 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) UM [75] Plans | $30.94 | $75,217.98 | $75,217.98 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER UM [121] Plans | $30.94 | $75,217.98 | $75,217.98 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | INSTITUTION [10406] | All WORCESTER RECOVERY UM [233] Plans | $30.94 | $75,217.98 | $75,217.98 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | FALLON MEDICAID [10904] | All FALLON MCO UM [104] Plans | $30.94 | $75,217.98 | $75,217.98 | 2026-03-26 | 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 ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $33.38 | $18,546.00 | $14,325.75 | 2024-12-31 | 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 ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE SPECIAL KIDS (FORMERLY BMC) UM [255] Plans | $38.68 | $75,217.98 | $75,217.98 | 2026-03-26 | MRF ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Medicare|Negotiated_Percentage | — | $49.00 | $2,006.00 | $1,203.60 | 2026-05-21 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Medicare|Negotiated_Percentage | — | $49.00 | $2,006.00 | $1,203.60 | 2026-05-18 | 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 ↗ |
| S E LACKEY MEMORIAL HOSPITAL Outpatient | CIGNA COMM - ALL PLANS | CIGNA COMM - ALL PLANS | $50.00 | $2,644.00 | $2,644.00 | 2026-02-10 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EDGERTON HOSPITAL AND HEALTH SERVICES Both | Aetna | Default | $55.00 | $2,477.00 | $1,808.21 | 2026-05-09 | MRF ↗ |
| FAIRCHILD MEDICAL CENTER Outpatient | MEDI-CAL | MEDI-CAL | $60.00 | $1,938.00 | $1,938.00 | 2025-12-03 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 1&2|MVP ESSENTIAL 3&4 | $71.18 | $23,246.96 | $15,110.52 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP OPTION|MVP CHILD HEALTH PLUS | $71.18 | $23,246.96 | $15,110.52 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 3&4 | $71.18 | $23,246.96 | $15,110.52 | 2024-12-30 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $72.19 | — | — | 2026-04-14 | MRF ↗ |
| St Anthony Regional Hospital & Nursing Home Outpatient | MIDLANDS CHOICE - ALL PLANS | MIDLANDS CHOICE - ALL PLANS | $76.98 | $2,518.00 | $2,518.00 | 2026-02-09 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Blue Cross Blue Shield of AZ | Medicare Advantage | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Cigna | Medicare Advantage | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Health Choice Pathway MCR Adv | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Humana | Medicare Advantage | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | VA Community Care Network VACCN Region 4 Triwest | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | UMR Wausau/UHIS | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Health Choice Pathway MCR Adv | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Presbyterian Health Plan MCR Adv | Medicare Advantage | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Sierra Health and Life MCR Adv | Medicare Advantage | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | United Healthcare | Medicare Advantage | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | United Healthcare | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Cigna | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Aetna | Medicare Advantage | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Blue Cross Blue Shield of AZ | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Blue Cross Blue Shield of AZ | Federal | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Tricare West | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Aetna | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | ASAGEHA | Federal | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Medicare A AZ JF | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | ASAGEHA | Federal | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Aetna | Medicare Advantage | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Aetna | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Arizona Foundation for Medical Care (AFMC) | PPO | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Tricare East Region DOS lt 01012025 | Federal | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Great West Healthcare AZ | PPO | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | VA Community Care Network VACCN Region 4 Triwest | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Tricare West | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Presbyterian Health Plan MCR Adv | Medicare Advantage | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Humana | Medicare Advantage | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Cigna | Medicare Advantage | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | United Healthcare | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Sierra Health and Life MCR Adv | Medicare Advantage | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | UMR Wausau/UHIS | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Great West Healthcare AZ | PPO | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Blue Cross Blue Shield of AZ | Federal | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Cigna | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Blue Cross Blue Shield of AZ | Medicare Advantage | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | United Healthcare | Medicare Advantage | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Blue Cross Blue Shield of AZ | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Tricare East Region DOS lt 01012025 | Federal | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Arizona Foundation for Medical Care (AFMC) | PPO | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| WHITE MOUNTAIN REGIONAL MEDICAL CENTER Both | Medicare A AZ JF | Default | — | $15,002.56 | $8,551.46 | 2026-03-16 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP EXCHANGE-INDIVIDUAL | $87.09 | $23,246.96 | $15,110.52 | 2024-12-30 | MRF ↗ |
| EDGERTON HOSPITAL AND HEALTH SERVICES Both | Quartz | Default | $88.00 | $2,477.00 | $1,808.21 | 2026-05-09 | 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.