24516 — Treat Humerus Fracture
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). TREAT HUMERUS FRACTURE (CPT 24516) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/24516?code_type=CPT
MLA (9th ed.)
“TREAT HUMERUS FRACTURE (CPT 24516) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/24516?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“TREAT HUMERUS FRACTURE (CPT 24516) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/24516?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,962–$14,930 (25th–75th percentile) across 1,753 hospitals · 3,631 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 24516 — 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
$3,962
$11,438 typical
$14,930
The middle 50% of negotiated facility rates for this procedure, measured across 1,753 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. | $11,438 |
| Surgeon (professional fee) Estimate national typical Medicare $798 × 1.22 commercial. | $973 |
| 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 | $13,119 |
Surgical episode (typical)
~$13,119
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)
~$16,904
- 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 |
|---|---|---|---|---|---|---|---|
| St Lawrence Rehabilitation Center Outpatient | Amerihealth | HMO | $2.00 | $3.00 | $3.00 | 2026-03-31 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Independence Keystone Health Plan | Commercial | $2.00 | $3.00 | $3.00 | 2026-03-31 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Aetna | Commercial | $3.00 | $3.00 | $3.00 | 2026-03-31 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UNITED HEALTHCARE ALTERNATE [100260] | UHC EMPIRE ALTERNATE [10026001] | $5.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UNITED HEALTHCARE ALTERNATE [100260] | UHC EMPIRE ALTERNATE [10026001] | $5.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | MASSHEALTH [20302] | All MASSHEALTH UM [10] Plans | $5.71 | $49,771.99 | $49,771.99 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | FALLON MEDICAID [10904] | All FALLON ACO UM [130] Plans | $5.71 | $49,771.99 | $49,771.99 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | FALLON MEDICAID [10904] | All FALLON MCO UM [104] Plans | $5.71 | $49,771.99 | $49,771.99 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER UM [121] Plans | $5.71 | $49,771.99 | $49,771.99 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | HNE MEDICAID [10905] | All HEALTH NEW ENGLAND/MINUTEMAN MCO UM [222] Plans | $5.71 | $49,771.99 | $49,771.99 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | MGB MEDICAID [10906] | All MGB (FORMERLY AHP) ACO UM [212] Plans | $5.71 | $49,771.99 | $49,771.99 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | INSTITUTION [10406] | All WORCESTER RECOVERY UM [233] Plans | $5.71 | $49,771.99 | $49,771.99 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) UM [75] Plans | $5.71 | $49,771.99 | $49,771.99 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE SPECIAL KIDS (FORMERLY BMC) UM [255] Plans | $7.14 | $49,771.99 | $49,771.99 | 2026-03-26 | MRF ↗ |
| UNIVERSITY OF VIRGINIA MEDICAL CENTER Outpatient | VETERANS [99909] | UVA HB VETERANS CHOICE | $8.43 | $41,425.61 | $24,855.37 | 2026-03-24 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STRATEGIC COMP SERVICES [700061] | WC STRATEGIC COMP SERVICES [70006101] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | SEDGWICK [700027] | WC SEDGWICK [70002701] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | PROGRESSIVE AUTO INSURANCE [800005] | NF PROGRESSIVE AUTO INSURANCE [80000501] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MADISON ONEIDA HERK WC [700056] | WC MADISON ONEIDA HERK [70005601] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | HARTFORD INS WC [700055] | WC HARTFORD INS [70005501] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UTICA NATIONAL NO FAULT [800007] | NF UTICA NATIONAL INS [80000701] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS WORK COMP [700028] | WC TRAVELERS [70002801] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC TRAVELER'S MVHS EMPLOYEE [70005903] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NCA WC [700057] | WC NCA [70005701] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA SEMC EMPLOYEE [70005902] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NF MISC. [809999] | NF MISC. [80999901] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | CORVEL CORP WC [700054] | WC CORVEL CORP [70005401] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ALLSTATE AUTO INSURANCE [800001] | NF ALLSTATE [80000101] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC TRAVELER'S SEMC EMPLOYEE [70005904] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | GEICO AUTO INSURANCE [800003] | NF GEICO AUTO INSURANCE [80000301] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | WC MISC. [709999] | WC MISC. [70999901] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UTICA NATIONAL WORKER'S COMP [700062] | WC UTICA NATIONAL INS [70006201] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC TRAVELER'S MVHS EMPLOYEE [70005903] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | CHARTIS WC [700029] | WC CHARTIS [70002901] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC TRAVELER'S SEMC EMPLOYEE [70005904] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NYSIF [700058] | WC NY STATE INSURANCE FUND [70005801] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ESIS WORK COMP [700010] | WC ESIS [70001001] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NCA WC [700057] | WC NCA [70005701] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NY CTRL MUTUAL NF [800004] | NF NY CTRL MUTUAL [80000401] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NYSIF [700058] | WC NY STATE INSURANCE FUND [70005801] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS NO FAULT [800006] | NF TRAVELERS [80000601] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | GALLAGHER BASSETT WORK COMP [700013] | WC GALLAGHER BASSETT [70001301] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA FSLH EMPLOYEE [70005901] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STATE FARM AUTO INSURANCE NF [800026] | NF STATE FARM AUTO INSURANCE [80002601] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL AUTO INSURANCE [800008] | NF LIBERTY MUTUAL AUTO INS [80000801] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UTICA NATIONAL WORKER'S COMP [700062] | WC UTICA NATIONAL INS [70006201] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | HARTFORD INS WC [700055] | WC HARTFORD INS [70005501] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | GALLAGHER BASSETT WORK COMP [700013] | WC GALLAGHER BASSETT [70001301] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STRATEGIC COMP SERVICES [700061] | WC STRATEGIC COMP SERVICES [70006101] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL AUTO INSURANCE [800008] | NF LIBERTY MUTUAL AUTO INS [80000801] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | WC MISC. [709999] | WC MISC. [70999901] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | PROGRESSIVE AUTO INSURANCE [800005] | NF PROGRESSIVE AUTO INSURANCE [80000501] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MET LIFE AUTO INSURANCE [800009] | NF MET LIFE AUTO INS [80000901] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS WORK COMP [700028] | WC TRAVELERS [70002801] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NF MISC. [809999] | NF MISC. [80999901] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA SEMC EMPLOYEE [70005902] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS NO FAULT [800006] | NF TRAVELERS [80000601] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MET LIFE AUTO INSURANCE [800009] | NF MET LIFE AUTO INS [80000901] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NY CTRL MUTUAL NF [800004] | NF NY CTRL MUTUAL [80000401] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | CORVEL CORP WC [700054] | WC CORVEL CORP [70005401] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL WORK COMP [700016] | WC LIBERTY MUTUAL [70001601] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ESIS WORK COMP [700010] | WC ESIS [70001001] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | GEICO AUTO INSURANCE [800003] | NF GEICO AUTO INSURANCE [80000301] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ALLSTATE AUTO INSURANCE [800001] | NF ALLSTATE [80000101] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MADISON ONEIDA HERK WC [700056] | WC MADISON ONEIDA HERK [70005601] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | PMA WORK COMP [700031] | WC PMA [70003101] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | SEDGWICK [700027] | WC SEDGWICK [70002701] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA FSLH EMPLOYEE [70005901] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL WORK COMP [700016] | WC LIBERTY MUTUAL [70001601] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ERIE INS NF [800002] | NF ERIE INS [80000201] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ERIE INS NF [800002] | NF ERIE INS [80000201] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STATE FARM AUTO INSURANCE NF [800026] | NF STATE FARM AUTO INSURANCE [80002601] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UTICA NATIONAL NO FAULT [800007] | NF UTICA NATIONAL INS [80000701] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | CHARTIS WC [700029] | WC CHARTIS [70002901] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | PMA WORK COMP [700031] | WC PMA [70003101] | $9.15 | $62,050.94 | $37,230.56 | 2025-01-17 | 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 ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | PADRES [2014] | GLOBAL SPORTS SERVICES PROVIDER ALLIANCE (PADRES) | $23.07 | $117,784.81 | $64,781.65 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CHARGERS FOOTBALL COMPANY [1109] | CHARGER FOOTBALL COMPANY [11090001] | $23.07 | $117,784.81 | $64,781.65 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | PADRES WORKERS COMPENSATION [2013] | GLOBAL SPORTS SERVICES PROVIDER ALLIANCE (PADRES) | $23.07 | $117,784.81 | $64,781.65 | 2026-04-01 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MEDI-CAL | MEDI-CAL | $30.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PREFERRED MEDI-CAL | PREFERRED MEDI-CAL | $30.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC ALLIANCE MEDI-CAL | PACIFIC ALLIANCE MEDI-CAL | $30.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | LASALLE MG MEDI-CAL | LASALLE MG MEDI-CAL | $30.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC IPA MEDI-CAL | PACIFIC IPA MEDI-CAL | $30.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BC MEDI-CAL | BC MEDI-CAL | $30.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ACCESS MEDI-CAL | ACCESS MEDI-CAL | $30.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ALTAMED MEDI-CAL - ALL OTHER PLANS | ALTAMED MEDI-CAL - ALL OTHER PLANS | $30.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | CARE FIRST MEDI-CAL | CARE FIRST MEDI-CAL | $30.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHCARE INC MEDI-CAL | HEALTHCARE INC MEDI-CAL | $30.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BLUE SHIELD MEDI-CAL | BLUE SHIELD MEDI-CAL | $30.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 3&4 | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED BEHAVORIAL HEALTH [120] | UNITED BEHAVORIAL HEALTH|MH OPTUM COMMERCIAL | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 1&2 | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS ESSENTIAL 1&2|FIDELIS ESSENTIAL 3&4 | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS MEDICARE [176] | FIDELIS MEDICARE|FIDELIS DUAL ADVANTAGE | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | INDEPENDENT HEALTH ASSOC|NOVA HEALTHCARE-IHA | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE DUAL | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA MEDICAID MANAGED CARE|MOLINA CHILD HEALTH PLUS | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK ESSENTIALS | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC MEDICARE COMPLETE | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| UNITED MEMORIAL MEDICAL CENTER Outpatient | MVP [109] | MVP ESSENTIAL 1&2 | $30.88 | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE|TRICARE FOR LIFE|MARTINS POINT/US FAMILY | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | MEDICARE HMO INDEPENDENT HLTH|NOVA HEALTHCARE MEDICARE | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 1&2|MVP ESSENTIAL 3&4 | $30.88 | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MVP [109] | MVP ROCHESTER|MVP|CIGNA|GWH CIGNA|NALC CIGNA | — | $20,369.42 | $13,240.12 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 3&4 | $30.88 | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP OPTION|MVP CHILD HEALTH PLUS | $30.88 | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| UNITED MEMORIAL MEDICAL CENTER Outpatient | MVP [109] | MVP OPTION|MVP CHILD HEALTH PLUS|MVP ESSENTIAL 3&4 | $30.88 | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| UNITED MEMORIAL MEDICAL CENTER Outpatient | MVP [109] | MVP EXCHANGE-INDIVIDUAL | $30.88 | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE MEDICARE HMO | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC DUAL COMPLETE | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN|UHC COMMUNITY MEDICAID DENTAL|UHC ESSENTIAL 1&2|UHC CHPS|UHC ESSENTIAL 3&4 | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | AETNA [100] | AETNA MEDICARE ADVANTAGE | — | $23,669.79 | $15,385.36 | 2024-12-30 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $32.02 | $17,790.00 | $14,325.75 | 2024-12-31 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP EXCHANGE-INDIVIDUAL | $32.98 | $23,669.79 | $15,385.36 | 2024-12-30 | 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 ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $35.73 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | FCS IPA MEDI-CAL OP/PROFEE ONLY | FCS IPA MEDI-CAL OP/PROFEE ONLY | $36.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Health First Health Plan | Health First Health Plan Medicare | $37.75 | $318.35 | $79.59 | 2026-05-08 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HCLA MCAL PROFEE ONLY | HCLA MCAL PROFEE ONLY | $42.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | GLOBAL CARE MCAL PROFEE ONLY | GLOBAL CARE MCAL PROFEE ONLY | $42.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | EL PROYECTO MCAL PROFEE ONLY | EL PROYECTO MCAL PROFEE ONLY | $42.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | $42.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ASSOC HISPANIC PHYSCNS MCAL | ASSOC HISPANIC PHYSCNS MCAL | $42.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | AHP MEDI-CAL | AHP MEDI-CAL | $42.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MOLINA MEDI-CAL | MOLINA MEDI-CAL | $48.00 | $435.00 | $78.30 | 2026-01-30 | MRF ↗ |
| HILTON HEAD REGIONAL 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 ↗ |
| EAST COOPER MEDICAL CENTER 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 | $2,574.00 | $2,574.00 | 2026-02-10 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Cigna | Cigna | $51.75 | $318.35 | $79.59 | 2026-05-08 | MRF ↗ |
| FAIRCHILD MEDICAL CENTER Outpatient | MEDI-CAL | MEDI-CAL | $60.00 | $1,921.00 | $1,921.00 | 2025-12-03 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Corizon Health | Yescare | $63.67 | $318.35 | $79.59 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Blue | Florida Blue Commercial Ppo | $64.96 | $318.35 | $79.59 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Blue | Florida Blue Commercial Hmo | $64.96 | $318.35 | $79.59 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Blue | Florida Blue Commercial Phs | $64.96 | $318.35 | $79.59 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Blue | Florida Blue Commercial Network Blue | $64.96 | $318.35 | $79.59 | 2026-05-08 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $70.14 | — | — | 2026-04-14 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Florida Healthy Kids | $74.35 | $318.35 | $79.59 | 2026-05-08 | MRF ↗ |
| St Anthony Regional Hospital & Nursing Home Outpatient | MIDLANDS CHOICE - ALL PLANS | MIDLANDS CHOICE - ALL PLANS | $76.98 | $2,451.00 | $2,451.00 | 2026-02-09 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $91.85 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $91.85 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $91.85 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $91.85 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $91.85 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $91.85 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $91.85 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $91.85 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $91.85 | — | — | 2026-04-14 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $92.02 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $92.02 | — | — | 2026-04-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Nhp | $93.91 | $318.35 | $79.59 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Health First Health Plan | Hfhp Individual Ppo/Marketplace | $94.87 | $318.35 | $79.59 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Nhp | $99.76 | $318.35 | $79.59 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Commercial Group 2 | $99.76 | $318.35 | $79.59 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Commercial Group 1 | $99.76 | $318.35 | $79.59 | 2026-05-08 | MRF ↗ |
| DODGE COUNTY HOSPITAL Outpatient | BCBS Pathway/HMO | HMO | $100.00 | $27,521.42 | — | 2026-03-24 | MRF ↗ |
| DODGE COUNTY HOSPITAL Outpatient | BCBS Pathway/HMO | HMO | $100.00 | $27,521.42 | — | 2026-05-14 | MRF ↗ |
| S E LACKEY MEMORIAL HOSPITAL Outpatient | BCBS AHS | BCBS AHS | $100.00 | $2,574.00 | $2,574.00 | 2026-02-10 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Healthcare Plans | Florida Healthcare Plans Bnn | $101.55 | $318.35 | $79.59 | 2026-05-08 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $103.14 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $103.14 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $103.14 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $103.14 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $103.14 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $103.14 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $103.14 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $103.14 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $103.14 | — | — | 2026-04-14 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $112.43 | $3,726.00 | $3,726.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $112.43 | $3,726.00 | $3,726.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $112.43 | $3,726.00 | $3,726.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $112.43 | $3,726.00 | $3,726.00 | 2025-10-04 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Medicaid HMO | $112.51 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Sunshine State Oncology | Medicaid HMO | $112.51 | — | — | 2025-08-01 | 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.