24545 — Treat Humerus Fracture
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). TREAT HUMERUS FRACTURE (HCPCS 24545) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/24545?code_type=HCPCS
MLA (9th ed.)
“TREAT HUMERUS FRACTURE (HCPCS 24545) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/24545?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“TREAT HUMERUS FRACTURE (HCPCS 24545) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/24545?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $4,013–$15,153 (25th–75th percentile) across 1,754 hospitals · 3,861 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 24545 — 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
$4,013
$11,706 typical
$15,153
The middle 50% of negotiated facility rates for this procedure, measured across 1,754 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. | $11,706 |
| Surgeon (professional fee) Estimate national typical Medicare $860 × 1.22 commercial. | $1,050 |
| 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 | $13,464 |
Surgical episode (typical)
~$13,464
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)
~$17,248
- 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 | $0.36 | $213.30 | $53.33 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Commercial Group 1 | $0.64 | $213.30 | $53.33 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Commercial Group 2 | $0.64 | $213.30 | $53.33 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Nhp | $0.64 | $213.30 | $53.33 | 2026-05-08 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $2,632.00 | $631.68 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $2,632.00 | $579.04 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $2,632.00 | $473.76 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $2,632.00 | $579.04 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $2,632.00 | $579.04 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $2,632.00 | $605.36 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $2,632.00 | $605.36 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $2,632.00 | $579.04 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $2,632.00 | $631.68 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $2,632.00 | $684.32 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $2,632.00 | $500.08 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $2,632.00 | $605.36 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $2,632.00 | $473.76 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $2,632.00 | $605.36 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $2,632.00 | $710.64 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $2,632.00 | $579.04 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $2,632.00 | $579.04 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $2,632.00 | $579.04 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $2,632.00 | $710.64 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $2,632.00 | $579.04 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $2,632.00 | $500.08 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $2,632.00 | $684.32 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $8.00 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $8.00 | — | — | 2026-04-14 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $26.84 | $2,356.00 | $447.64 | 2026-01-25 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $26.89 | $14,940.00 | $14,325.75 | 2024-12-31 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 1&2|MVP ESSENTIAL 3&4 | $30.88 | $36,012.83 | $23,408.34 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 3&4 | $30.88 | $36,012.83 | $23,408.34 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP OPTION|MVP CHILD HEALTH PLUS | $30.88 | $36,012.83 | $23,408.34 | 2024-12-30 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| HOSPITAL FOR SPECIAL SURGERY OutpatientFacility | BLUE CROSS BLUE SHIELD NY [1022] | BCBS INDIVIDUAL NETWORK [102218] | $32.64 | — | $23,694.95 | 2026-04-01 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP EXCHANGE-INDIVIDUAL | $32.98 | $36,012.83 | $23,408.34 | 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 | ACCESS MEDI-CAL | ACCESS MEDI-CAL | $35.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC ALLIANCE MEDI-CAL | PACIFIC ALLIANCE MEDI-CAL | $35.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | CARE FIRST MEDI-CAL | CARE FIRST MEDI-CAL | $35.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MEDI-CAL | MEDI-CAL | $35.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PREFERRED MEDI-CAL | PREFERRED MEDI-CAL | $35.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ALTAMED MEDI-CAL - ALL OTHER PLANS | ALTAMED MEDI-CAL - ALL OTHER PLANS | $35.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | LASALLE MG MEDI-CAL | LASALLE MG MEDI-CAL | $35.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BLUE SHIELD MEDI-CAL | BLUE SHIELD MEDI-CAL | $35.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BC MEDI-CAL | BC MEDI-CAL | $35.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC IPA MEDI-CAL | PACIFIC IPA MEDI-CAL | $35.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHCARE INC MEDI-CAL | HEALTHCARE INC MEDI-CAL | $35.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $41.69 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | FCS IPA MEDI-CAL OP/PROFEE ONLY | FCS IPA MEDI-CAL OP/PROFEE ONLY | $42.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Corizon Health | Yescare | $42.66 | $213.30 | $53.33 | 2026-05-08 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | GLOBAL CARE MCAL PROFEE ONLY | GLOBAL CARE MCAL PROFEE ONLY | $49.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | AHP MEDI-CAL | AHP MEDI-CAL | $49.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | EL PROYECTO MCAL PROFEE ONLY | EL PROYECTO MCAL PROFEE ONLY | $49.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HCLA MCAL PROFEE ONLY | HCLA MCAL PROFEE ONLY | $49.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | $49.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ASSOC HISPANIC PHYSCNS MCAL | ASSOC HISPANIC PHYSCNS MCAL | $49.00 | $471.00 | $84.78 | 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 ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MOLINA MEDI-CAL | MOLINA MEDI-CAL | $56.00 | $471.00 | $84.78 | 2026-01-30 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Nhp | $62.92 | $213.30 | $53.33 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Health First Health Plan | Hfhp Individual Ppo/Marketplace | $63.56 | $213.30 | $53.33 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Healthcare Plans | Florida Healthcare Plans Bnn | $68.04 | $213.30 | $53.33 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Florida Healthy Kids | $74.35 | $213.30 | $53.33 | 2026-05-08 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $75.83 | — | — | 2026-04-14 | MRF ↗ |
| St Anthony Regional Hospital & Nursing Home Outpatient | MIDLANDS CHOICE - ALL PLANS | MIDLANDS CHOICE - ALL PLANS | $76.98 | $2,645.00 | $2,645.00 | 2026-02-09 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $84.50 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Aetna | Aetna Better Health CHIP | $84.50 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $84.50 | — | — | 2026-04-14 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Cigna | Cigna | $87.88 | $213.30 | $53.33 | 2026-05-08 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $88.73 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $92.95 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $92.95 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $92.95 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | GEISINGER | MANAGED MEDICAID | $92.95 | — | — | 2025-08-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $92.95 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $92.95 | — | — | 2025-08-01 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $92.95 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | GEISINGER | MANAGED MEDICAID | $92.95 | — | — | 2025-08-01 | 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 ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $97.18 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $97.18 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $97.18 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $97.18 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $97.18 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $97.18 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | CHIP | $97.18 | — | — | 2025-08-01 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $97.18 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $97.18 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $97.18 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $97.18 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | CHIP | $97.18 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $97.18 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | CHIP | $97.18 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $97.18 | — | — | 2025-08-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $99.21 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $99.21 | — | — | 2026-04-01 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $99.31 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $99.31 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $99.31 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $99.31 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $99.31 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $99.31 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $99.31 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $99.31 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $99.31 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | GEISINGER | MANAGED MEDICAID | $100.56 | — | — | 2025-08-01 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $101.40 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $101.40 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $101.40 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $101.40 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $103.94 | — | — | 2025-08-01 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MANAGED MEDICAID | $105.63 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MANAGED MEDICAID | $105.63 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | GEISINGER | MANAGED MEDICAID | $105.63 | — | — | 2025-08-01 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Commercial Group 1 | $107.08 | $213.30 | $53.33 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Commercial Group 2 | $107.08 | $213.30 | $53.33 | 2026-05-08 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $107.32 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $107.32 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $107.32 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $107.32 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $107.32 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $107.32 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AETNA | MANAGED MEDICAID | $109.85 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AETNA | MANAGED MEDICAID | $109.85 | — | — | 2025-08-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $111.52 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $111.52 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $111.52 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $111.52 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $111.52 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $111.52 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $111.52 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $111.52 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $111.52 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $111.54 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $111.54 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $111.54 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $111.54 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $111.54 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $111.54 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $111.54 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $111.54 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $111.54 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $111.54 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $111.54 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $114.08 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $114.08 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $114.08 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $114.08 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $114.08 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $114.08 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $114.08 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $114.08 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $114.08 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $114.08 | — | — | 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.