24515 — Treat Humerus Fracture
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). TREAT HUMERUS FRACTURE (HCPCS 24515) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/24515?code_type=HCPCS
MLA (9th ed.)
“TREAT HUMERUS FRACTURE (HCPCS 24515) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/24515?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“TREAT HUMERUS FRACTURE (HCPCS 24515) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/24515?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,839–$15,000 (25th–75th percentile) across 1,884 hospitals · 4,226 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 24515 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Estimated complete episode
What the whole episode might cost
Your hospital facility price plus the separately-billed professional fees a complete episode adds. The facility figure is an actual negotiated rate from our data; the surgeon and anesthesia fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$3,839
$11,226 typical
$15,000
The middle 50% of negotiated facility rates for this procedure, measured across 1,884 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. | $11,226 |
| Surgeon (professional fee) Estimate national typical Medicare $822 × 1.22 commercial. | $1,003 |
| 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 | $12,937 |
Surgical episode (typical)
~$12,937
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)
~$16,722
- 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 |
|---|---|---|---|---|---|---|---|
| CAPE CANAVERAL HOSPITAL Outpatient | Health First Health Plan | Health First Health Plan Medicare | $0.84 | $209.05 | $52.26 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Cigna | Cigna | $1.05 | $209.05 | $52.26 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Nhp | $1.20 | $209.05 | $52.26 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Commercial Group 2 | $1.20 | $209.05 | $52.26 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Commercial Group 1 | $1.20 | $209.05 | $52.26 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Blue | Florida Blue Commercial Ppo | $1.32 | $209.05 | $52.26 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Blue | Florida Blue Commercial Phs | $1.32 | $209.05 | $52.26 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Blue | Florida Blue Commercial Hmo | $1.32 | $209.05 | $52.26 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Blue | Florida Blue Commercial Network Blue | $1.32 | $209.05 | $52.26 | 2026-05-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) HA [43] Plans | $2.89 | $38,605.53 | $38,605.53 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE SPECIAL KIDS (FORMERLY BMC) HA [257] Plans | $3.61 | $38,605.53 | $38,605.53 | 2026-03-26 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $4.80 | $2,495.00 | $548.90 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $4.80 | $2,495.00 | $548.90 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $4.80 | $2,495.00 | $474.05 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $4.80 | $2,495.00 | $673.65 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $4.80 | $2,495.00 | $598.80 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $4.80 | $2,495.00 | $548.90 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $4.80 | $2,495.00 | $573.85 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $4.80 | $2,495.00 | $648.70 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $4.80 | $2,495.00 | $573.85 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $4.80 | $2,495.00 | $548.90 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $4.80 | $2,495.00 | $573.85 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $4.80 | $2,495.00 | $449.10 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $4.80 | $2,495.00 | $548.90 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $4.80 | $2,495.00 | $548.90 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $4.80 | $2,495.00 | $673.65 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $4.80 | $2,495.00 | $449.10 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $4.80 | $2,495.00 | $474.05 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $4.80 | $2,495.00 | $573.85 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $4.80 | $2,495.00 | $648.70 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $4.80 | $2,495.00 | $598.80 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $4.80 | $2,495.00 | $548.90 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $4.80 | $2,495.00 | $548.90 | 2026-04-14 | MRF ↗ |
| HOSPITAL FOR SPECIAL SURGERY OutpatientFacility | BLUE CROSS BLUE SHIELD NY [1022] | BCBS INDIVIDUAL NETWORK [102218] | $5.56 | — | $23,694.95 | 2026-04-01 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB MEDICAID-STANDARD | $8.62 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS TOGETHER W CHA [75001] | CHA HB MEDICAID-STANDARD | $8.62 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS GENERAL BRIGHAM [50021] | CHA HB MEDICAID-STANDARD | $8.62 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BOSTON MEDICAL CENTER - WELLSENSE [50003] | CHA HB MEDICAID-STANDARD | $8.62 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | UNITED HEALTH [40002] | CHA HB MEDICAID-STANDARD | $8.62 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OOS MEDICAID [70002] | CHA HB MEDICAID-STANDARD | $8.62 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS HEALTH [70001] | CHA HB MEDICAID-STANDARD | $8.62 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB MEDICAID-STANDARD | $8.62 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | AARP [40001] | CHA HB MEDICARE MANAGED CARE - UHC | $8.79 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | UNITED HEALTH [40002] | CHA HB MEDICARE MANAGED CARE - UHC | $8.79 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HEALTH SAFETY NET [80001] | CHA HB HEALTH SAFETY NET | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BCBS - OUT OF STATE [10002] | CHA HB MEDICARE MANAGED CARE 100 PCT | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB MEDICARE MANAGED CARE 100 PCT | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB FALLON | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BOSTON MEDICAL CENTER - WELLSENSE [50003] | CHA HB MEDICARE MANAGED CARE 100 PCT | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | CHAMPVA [85001] | CHA HB TRICARE | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | AETNA [50001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HUMANA [50008] | CHA HB MEDICARE MANAGED CARE 100 PCT | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS GENERAL BRIGHAM [50021] | CHA HB MEDICARE MANAGED CARE 100 PCT | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | ELDER SERVICE PLAN [65002] | CHA HB ELDER SERVICE PLAN | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BCBS - MA [10001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HPHC [20001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TRICARE [85002] | CHA HB TRICARE | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER GOV'T PAYOR [85003] | CHA HB TRICARE | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | RR MEDICARE [60002] | CHA HB MEDICARE | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | SENIOR WHOLE HEALTH [65003] | CHA HB MEDICARE MANAGED CARE 100 PCT | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB FALLON CAREPLUS | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | COMMONWEALTH CARE ALLIANCE [65001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER COMMERCIAL PAYOR [50015] | CHA HB MEDICARE MANAGED CARE 100 PCT | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HEALTH SAFETY NET [80001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS HEALTH PLAN [30001] | CHA HB Tufts Health Plan Medicare Preferred | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MEDICARE [60001] | CHA HB MEDICARE | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | CIGNA [50005] | CHA HB MEDICARE MANAGED CARE 100 PCT | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS HEALTH PLAN [30001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $9.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | GRANTS [20507] | All TB GETCHELL [226] Plans | $10.89 | $63,835.48 | $63,835.48 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient | MGB MEDICAID [10906] | All MGB (FORMERLY AHP) ACO HR [307] Plans | $11.00 | $35,378.80 | $35,378.80 | 2026-04-03 | MRF ↗ |
| UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient | FALLON MEDICAID [10904] | All FALLON MCO HR [305] Plans | $11.00 | $35,378.80 | $35,378.80 | 2026-04-03 | MRF ↗ |
| UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient | HNE MEDICAID [10905] | All HEALTH NEW ENGLAND/MINUTEMAN MCO HR [303] Plans | $11.00 | $35,378.80 | $35,378.80 | 2026-04-03 | MRF ↗ |
| UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient | FALLON MEDICAID [10904] | All FALLON ACO HR [304] Plans | $11.00 | $35,378.80 | $35,378.80 | 2026-04-03 | MRF ↗ |
| UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient | MASSHEALTH [20302] | All MASSHEALTH HR [91] Plans | $11.00 | $35,378.80 | $35,378.80 | 2026-04-03 | MRF ↗ |
| UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER HR [124] Plans | $11.00 | $35,378.80 | $35,378.80 | 2026-04-03 | MRF ↗ |
| UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) HR [40] Plans | $11.00 | $35,378.80 | $35,378.80 | 2026-04-03 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | INSTITUTION [10406] | All WORCESTER RECOVERY UM [233] Plans | $12.87 | $63,835.48 | $63,835.48 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | FALLON MEDICAID [10904] | All FALLON ACO UM [130] Plans | $12.87 | $63,835.48 | $63,835.48 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) UM [75] Plans | $12.87 | $63,835.48 | $63,835.48 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | FALLON MEDICAID [10904] | All FALLON MCO UM [104] Plans | $12.87 | $63,835.48 | $63,835.48 | 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 | $63,835.48 | $63,835.48 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER UM [121] Plans | $12.87 | $63,835.48 | $63,835.48 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | MGB MEDICAID [10906] | All MGB (FORMERLY AHP) ACO UM [212] Plans | $12.87 | $63,835.48 | $63,835.48 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | MASSHEALTH [20302] | All MASSHEALTH UM [10] Plans | $12.87 | $63,835.48 | $63,835.48 | 2026-03-26 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | UHC COMMUNITY MEDICAID [2175] | HB XR UHC INDIANA PATHWAYS MEDICAID | $14.71 | $35,819.66 | $21,871.18 | 2025-12-19 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $14.83 | — | — | 2026-04-14 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB TUFTS HEALTH PUBLIC PLANS QHP NON-SUBSIDIZED | $15.77 | $13,928.30 | $13,928.30 | 2026-03-20 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE SPECIAL KIDS (FORMERLY BMC) UM [255] Plans | $16.09 | $63,835.48 | $63,835.48 | 2026-03-26 | 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 ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $31.18 | $17,322.00 | $14,325.75 | 2024-12-31 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Corizon Health | Yescare | $41.81 | $209.05 | $52.26 | 2026-05-08 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Medicare|Negotiated_Percentage | — | $49.00 | $2,223.00 | $1,333.80 | 2026-05-21 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Medicare|Negotiated_Percentage | — | $49.00 | $2,223.00 | $1,333.80 | 2026-05-18 | 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 ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Nhp | $61.67 | $209.05 | $52.26 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Health First Health Plan | Hfhp Individual Ppo/Marketplace | $62.30 | $209.05 | $52.26 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Healthcare Plans | Florida Healthcare Plans Bnn | $66.69 | $209.05 | $52.26 | 2026-05-08 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $72.00 | — | — | 2026-04-14 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Florida Healthy Kids | $74.35 | $209.05 | $52.26 | 2026-05-08 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP OPTION|MVP CHILD HEALTH PLUS | $75.49 | $24,822.97 | $19,858.38 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 1&2|MVP ESSENTIAL 3&4 | $75.49 | $24,822.97 | $19,858.38 | 2024-12-30 | MRF ↗ |
| St Anthony Regional Hospital & Nursing Home Outpatient | MIDLANDS CHOICE - ALL PLANS | MIDLANDS CHOICE - ALL PLANS | $76.98 | $2,455.00 | $2,455.00 | 2026-02-09 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $78.50 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Aetna | Aetna Better Health CHIP | $78.50 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $78.50 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $82.43 | — | — | 2026-04-14 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Cigna | Cigna | $86.13 | $209.05 | $52.26 | 2026-05-08 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $86.35 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $86.35 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $86.35 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $86.35 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | GEISINGER | MANAGED MEDICAID | $86.35 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | GEISINGER | MANAGED MEDICAID | $86.35 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $86.35 | — | — | 2025-08-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $86.35 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $90.28 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $90.28 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $90.28 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $90.28 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $90.28 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $90.28 | — | — | 2025-08-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $90.28 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | CHIP | $90.28 | — | — | 2025-08-01 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $90.28 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $90.28 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $90.28 | — | — | 2025-08-01 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $90.28 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $90.28 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | CHIP | $90.28 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | CHIP | $90.28 | — | — | 2025-08-01 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Blue Cross Blue Shield Ip|Negotiated_Percentage | — | $91.00 | $2,223.00 | $1,333.80 | 2026-05-21 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Blue Cross Blue Shield Ip|Negotiated_Percentage | — | $91.00 | $2,223.00 | $1,333.80 | 2026-05-18 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP EXCHANGE-INDIVIDUAL | $92.36 | $24,822.97 | $19,858.38 | 2024-12-30 | 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.