24565 — Treat Humerus Fracture
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). TREAT HUMERUS FRACTURE (CPT 24565) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/24565?code_type=CPT
MLA (9th ed.)
“TREAT HUMERUS FRACTURE (CPT 24565) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/24565?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“TREAT HUMERUS FRACTURE (CPT 24565) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/24565?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $935–$2,702 (25th–75th percentile) across 1,877 hospitals · 5,248 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 24565 — 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
$935
$1,687 typical
$2,702
The middle 50% of negotiated facility rates for this procedure, measured across 1,877 hospitals. The surgeon and anesthesia fees are modeled estimates added on top.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $1,687 |
| Surgeon (professional fee) Estimate national typical Medicare $487 × 1.22 commercial. | $595 |
| Anesthesia Estimate national typical Generic anesthesia (~90 min typical, median CMS base units). Medicare $225 × 3.14 commercial. Approximate — no procedure-specific anesthesia mapping for this code. | $708 |
| Likely subtotal | $2,989 |
Surgical episode (typical)
~$2,989
Your recovery plan — adjust to what your doctor told you
After your procedure, recovery care is billed separately. We pre-fill the typical plan; change it to your situation.
Recovery cost modeled
~$3,785
With your recovery plan (typical)
~$6,774
- The anesthesia component is a generic, approximate estimate — no procedure-specific anesthesia mapping exists for this code, so a typical anesthesia for this procedure type is shown.
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Surgeon (professional fee) (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
- Anesthesia (estimate)
- base_units_version: CY2022 file (base units unchanged for CY2026 per CMS) · anesthesia_cf: $20.49754 (National) · cf_rule: CMS-1832-F · multiplier_source: AJMC/Duffy 2016-2017 (PMID 34156223) national · basis: generic surgical anesthesia — 5 base units (typical CMS value) × ~90 min; approximate, NOT a procedure-specific crosswalk
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Medi-Cal | Medi-Cal | $4.50 | $3,607.00 | $2,705.25 | 2026-04-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Inpatient | Aetna | First Health - Direct | $7.20 | $3,607.00 | $2,705.25 | 2026-04-01 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $16.22 | $3,165.00 | $1,171.05 | 2026-03-31 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $23.21 | $1,427.00 | $313.94 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $23.21 | $1,427.00 | $342.48 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $23.21 | $1,427.00 | $328.21 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $23.21 | $1,427.00 | $371.02 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $23.21 | $1,427.00 | $313.94 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $23.21 | $1,427.00 | $313.94 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $23.21 | $1,427.00 | $342.48 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $23.21 | $1,427.00 | $271.13 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $23.21 | $1,427.00 | $256.86 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $23.21 | $1,427.00 | $385.29 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $23.21 | $1,427.00 | $313.94 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $23.21 | $1,427.00 | $385.29 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $23.21 | $1,427.00 | $371.02 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $23.21 | $1,427.00 | $328.21 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $23.21 | $1,427.00 | $313.94 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $23.21 | $1,427.00 | $313.94 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $23.21 | $1,427.00 | $328.21 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $23.21 | $1,427.00 | $313.94 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $23.21 | $1,427.00 | $328.21 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $23.21 | $1,427.00 | $271.13 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $23.21 | $1,427.00 | $313.94 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $23.21 | $1,427.00 | $256.86 | 2026-04-14 | 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 ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | PGT | Medicare|All Plans | $31.60 | $248.00 | $43.40 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | BCBS | Medicare|All Plans | $32.24 | $248.00 | $43.40 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AETNA | Medicare|All Plans | $32.24 | $248.00 | $43.40 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | UNITED | Medicare|All Plans | $32.89 | $248.00 | $43.40 | 2026-02-28 | MRF ↗ |
| Crosbyton Clinic Hospital Outpatient | Aetna | Commercial | $33.00 | $175.00 | $175.00 | 2025-10-01 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AMERIVANTAGE | Medicare|All Plans | $33.21 | $248.00 | $43.40 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | SCANHealth | Medicare|All Plans | $34.50 | $248.00 | $43.40 | 2026-02-28 | 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 ↗ |
| The Hospitals of Providence Emergency Room Montwood OutpatientFacility | Imperial Health | Medicare Advantage | $35.56 | $1,045.95 | $836.76 | 2026-03-24 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Partners | Managed Medicaid | $36.13 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Partners | Managed Medicaid | $36.13 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $36.67 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $37.03 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Alliance | Behavioral Health | $37.03 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Carolina Complete Health | Managed Medicaid | $37.36 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Wellcare | Managed Medicaid | $37.36 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Healthy Blue | Managed Medicaid | $37.36 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Alliance | Behavioral Health | $37.39 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Wellcare | Managed Medicaid | $37.72 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Carolina Complete Health | Managed Medicaid | $37.72 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Healthy Blue | Managed Medicaid | $37.72 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Vaya | Managed Medicaid | $37.72 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Vaya | Managed Medicaid | $38.08 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Alliance | Managed Medicaid | $38.30 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Alliance | Managed Medicaid | $38.48 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Trillium | Managed Medicaid | $38.48 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Trillium | Managed Medicaid | $38.84 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER OutpatientFacility | Peach State | All Products | $39.83 | $197.00 | $137.90 | 2026-01-25 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $40.75 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Alliance | Behavioral Health | $41.15 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $41.28 | — | — | 2026-04-14 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Wellcare | Managed Medicaid | $41.51 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Carolina Complete Health | Managed Medicaid | $41.51 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Healthy Blue | Managed Medicaid | $41.51 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| Magee Rehabilitation Hospital OutpatientFacility | Magee Health Partners | Medicaid | $41.62 | — | — | 2026-03-18 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Partners | Managed Medicaid | $41.91 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Vaya | Managed Medicaid | $41.91 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Alliance | Managed Medicaid | $42.34 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Trillium | Managed Medicaid | $42.74 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Partners | Managed Medicaid | $43.36 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Alliance | Behavioral Health | $43.39 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Carolina Complete Health | Managed Medicaid | $43.75 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Healthy Blue | Managed Medicaid | $43.75 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Wellcare | Managed Medicaid | $43.75 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Vaya | Managed Medicaid | $44.19 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $44.19 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $44.33 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Alliance | Managed Medicaid | $44.62 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Alliance | Behavioral Health | $44.77 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Trillium | Managed Medicaid | $45.05 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Healthy Blue | Managed Medicaid | $45.16 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Wellcare | Managed Medicaid | $45.16 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Carolina Complete Health | Managed Medicaid | $45.16 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Partners | Managed Medicaid | $45.52 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Vaya | Managed Medicaid | $45.63 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | United Healthcare | Managed Medicaid | $45.99 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Alliance | Managed Medicaid | $46.07 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Trillium | Managed Medicaid | $46.54 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | Ambetter | Commercial|All Plans | $46.75 | $248.00 | $43.40 | 2026-02-28 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Partners | Managed Medicaid | $46.97 | $361.30 | $180.65 | 2025-12-04 | MRF ↗ |
| The Hospitals of Providence Emergency Room Montwood OutpatientFacility | Imperial Health | Medicare Advantage | $47.06 | $1,045.95 | $836.76 | 2026-03-24 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $47.33 | $361.30 | $180.65 | 2025-12-04 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Alliance | Managed Medicaid | $47.80 | $361.30 | $180.65 | 2025-12-04 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Carolina Complete Health | Managed Medicaid | $48.23 | $361.30 | $180.65 | 2025-12-04 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Healthy Blue | Managed Medicaid | $48.23 | $361.30 | $180.65 | 2025-12-04 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Wellcare | Managed Medicaid | $48.23 | $361.30 | $180.65 | 2025-12-04 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | Wellpoint | Commercial|Exchange | $48.36 | $248.00 | $43.40 | 2026-02-28 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | United Healthcare | Managed Medicaid | $48.41 | $361.30 | $180.65 | 2025-12-04 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Vaya | Managed Medicaid | $48.70 | $361.30 | $180.65 | 2025-12-04 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Medicare|Negotiated_Percentage | — | $49.00 | $1,014.00 | $608.40 | 2026-05-21 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Medicare|Negotiated_Percentage | — | $49.00 | $1,014.00 | $608.40 | 2026-05-18 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER OutpatientFacility | UNITEDHEALTHCARE | MEDICARE ADVANTAGE | $49.25 | $197.00 | $137.90 | 2026-01-25 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $49.25 | $197.00 | $137.90 | 2026-01-25 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Trillium | Managed Medicaid | $49.68 | $361.30 | $180.65 | 2025-12-04 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Partners | Managed Medicaid | $50.58 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $50.98 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER OutpatientFacility | BCBSNC | MEDICARE ADVANTAGE | $51.22 | $197.00 | $137.90 | 2026-01-25 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC LCD | ALL PRODUCTS | $51.85 | $3,404.00 | — | 2026-01-01 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $51.85 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $51.85 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $51.85 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $51.85 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $51.85 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $51.85 | — | — | 2026-04-16 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC LCD | ALL PRODUCTS | $51.85 | $3,404.00 | — | 2026-01-01 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Carolina Complete Health | Managed Medicaid | $51.95 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Healthy Blue | Managed Medicaid | $51.95 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Wellcare | Managed Medicaid | $51.95 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Priority Health | PriorityHealthSEMIPartnersNet | $52.40 | — | — | 2025-01-31 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Vaya | Managed Medicaid | $52.46 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Trillium | Managed Medicaid | $53.51 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Alliance | Managed Medicaid | $53.62 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $53.77 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $53.77 | — | — | 2026-04-01 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | United Healthcare | Managed Medicaid | $54.05 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $54.05 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $54.06 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $54.06 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $54.06 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $54.06 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $54.06 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $54.06 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $54.06 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $54.06 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $54.06 | — | — | 2026-04-14 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | BCBS | Medicare|All Plans | $54.56 | $248.00 | $43.40 | 2026-02-28 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Alliance | Behavioral Health | $54.59 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | United Healthcare | Managed Medicaid | $54.59 | $361.30 | $180.65 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Wellcare | Managed Medicaid | $55.06 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Healthy Blue | Managed Medicaid | $55.06 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Partners | Managed Medicaid | $55.06 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Carolina Complete Health | Managed Medicaid | $55.06 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Vaya | Managed Medicaid | $55.60 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Alliance | Managed Medicaid | $55.60 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | UNITED | Medicare|All Plans | $55.66 | $248.00 | $43.40 | 2026-02-28 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Alliance | Behavioral Health | $55.89 | $361.30 | $180.65 | 2025-12-04 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | AMERIVANTAGE | Medicare|All Plans | $56.20 | $248.00 | $43.40 | 2026-02-28 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Trillium | Managed Medicaid | $56.72 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| THOMAS JEFFERSON UNIVERSITY HOSPITAL OutpatientFacility | Health Partners Medicaid | JCC001 JCC002 Caid MCO | $57.80 | — | — | 2026-03-18 | MRF ↗ |
| Jefferson Methodist Hospital OutpatientFacility | Health Partners Medicaid | JCC001 JCC002 Caid MCO | $57.80 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | JNE Health Partners | JNE001_JNE002_JNE003 Medicaid | $57.80 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON LANSDALE HOSPITAL OutpatientFacility | JAB Health Partners | JAB002 Medicaid | $57.80 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | JNE Health Partners | JNE001_JNE002_JNE003 CHIP | $57.80 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | JNE Health Partners | JNE001_JNE002_JNE003 Medicaid | $57.80 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | JNE Health Partners | JNE001_JNE002_JNE003 CHIP | $57.80 | — | — | 2026-03-18 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | SCANHealth | Medicare|All Plans | $58.38 | $248.00 | $43.40 | 2026-02-28 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | United Healthcare | Managed Medicaid | $60.08 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Alliance | Behavioral Health | $60.48 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $60.71 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $60.71 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $60.71 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $60.71 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $60.71 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $60.71 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $60.71 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $60.71 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $60.71 | — | — | 2026-04-14 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | AETNA | Medicare|All Plans | $62.00 | $248.00 | $43.40 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | Wellpoint | Medicaid|All Other Plans | $62.50 | $248.00 | $43.40 | 2026-02-28 | MRF ↗ |
| COMMUNITY FIRST MEDICAL CENTER Both | BCBS BLUE CHOICE | BCBS BLUE CHOICE | $62.59 | $229.25 | $114.63 | 2026-04-01 | MRF ↗ |
| COMMUNITY FIRST MEDICAL CENTER Both | BCBS BLUE CHOICE | BCBS BLUE CHOICE | $62.59 | $229.25 | $114.63 | 2026-04-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | United Healthcare | Managed Medicaid | $63.44 | $361.30 | $180.65 | 2025-12-01 | MRF ↗ |
| KNOX COUNTY HOSPITAL OutpatientFacility | United Health Care / UMR | Commercial Plans | — | $419.00 | $251.40 | 2025-01-22 | MRF ↗ |
| KNOX COUNTY HOSPITAL OutpatientFacility | United Health Care | Veteran Affairs | — | $419.00 | $251.40 | 2025-01-22 | MRF ↗ |
| KNOX COUNTY HOSPITAL OutpatientFacility | Anthem | Pathway Transition HMO | — | $419.00 | $251.40 | 2025-01-22 | MRF ↗ |
| KNOX COUNTY HOSPITAL OutpatientFacility | Anthem/Atena | Medicaid | — | $419.00 | $251.40 | 2025-01-22 | MRF ↗ |
| KNOX COUNTY HOSPITAL BothFacility | Aetna | Commercial Health | — | $419.00 | $251.40 | 2025-01-22 | MRF ↗ |
| KNOX COUNTY HOSPITAL OutpatientFacility | Humana | Choice Care | — | $419.00 | $251.40 | 2025-01-22 | MRF ↗ |
| KNOX COUNTY HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | — | $419.00 | $251.40 | 2025-01-22 | 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.