25260 — Repair Forearm Tendon/muscle
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). REPAIR FOREARM TENDON/MUSCLE (HCPCS 25260) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/25260?code_type=HCPCS
MLA (9th ed.)
“REPAIR FOREARM TENDON/MUSCLE (HCPCS 25260) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/25260?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“REPAIR FOREARM TENDON/MUSCLE (HCPCS 25260) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/25260?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $2,089–$5,498 (25th–75th percentile) across 1,903 hospitals · 5,567 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 25260 — 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 figures are estimates from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$2,089
$3,485 typical
$5,498
The middle 50% of negotiated facility rates for this procedure, measured across 1,903 hospitals. Surgeon & 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. | $3,485 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $599 × 1.22 commercial. | $731 |
| Likely subtotal | $4,216 |
Surgical episode (typical)
~$4,216
Your recovery plan — adjust to what your surgeon told you
After surgery, 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)
~$8,001
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
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 |
|---|---|---|---|---|---|---|---|
| CEDARS-SINAI MEDICAL CENTER Outpatient | HealthNet of California, Inc. | HMO | — | $16,289.40 | $10,588.11 | 2025-11-26 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Medicare | Medicare | $0.52 | $8,853.00 | $6,639.75 | 2026-04-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Molina | Molina - Exchange | $0.98 | $8,853.00 | $6,639.75 | 2026-04-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | SCAN Health Plan | Medicare Advantage | — | $16,289.40 | $10,588.11 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $16,289.40 | $10,588.11 | 2025-11-26 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $1,813.00 | $398.86 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $1,813.00 | $398.86 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $1,813.00 | $416.99 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $1,813.00 | $471.38 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $1,813.00 | $398.86 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $1,813.00 | $344.47 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $1,813.00 | $416.99 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $1,813.00 | $398.86 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $1,813.00 | $398.86 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $1,813.00 | $398.86 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $1,813.00 | $489.51 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $1,813.00 | $471.38 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $1,813.00 | $489.51 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $1,813.00 | $344.47 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $1,813.00 | $435.12 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $1,813.00 | $435.12 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $1,813.00 | $398.86 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $1,813.00 | $398.86 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $1,813.00 | $326.34 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $1,813.00 | $416.99 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $6.00 | $1,813.00 | $416.99 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $6.00 | $1,813.00 | $326.34 | 2026-04-14 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicare A MS JH | Default | — | $1,278.00 | $958.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Multiplan Inc. for American Family | Default | — | $1,278.00 | $958.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Advanced Health | Default | — | $1,278.00 | $958.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicare B MS JH | Default | — | $1,278.00 | $958.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Mississippi Physicians Care Network | Default | — | $1,278.00 | $958.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Magnolia Health Plan MCD Rep | Default | — | $1,278.00 | $958.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Mississippi Select Health Care | Default | — | $1,278.00 | $958.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Primewell Vantage Health Plan | Default | — | $1,278.00 | $958.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $10.05 | $1,278.00 | $958.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Private Healthcare Systems PHCS | Default | — | $1,278.00 | $958.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Connecticut General Cigna | Default | — | $1,278.00 | $958.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | GEHA Multiplan Network | Default | — | $1,278.00 | $958.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicaid Mississippi | Default | — | $1,278.00 | $958.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | First Choice Health Network | Default | — | $1,278.00 | $958.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | UHC Community Plan MS | Default | — | $1,278.00 | $958.50 | 2025-03-07 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $20.01 | $1,923.90 | $1,923.90 | 2026-04-24 | 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 ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | $4,624.88 | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | $4,624.88 | 2024-12-08 | MRF ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | BLUE CROSS | BCBS ILLINOIS TRADITIONAL | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | CIGNA | CIGNA HMO & PPO PLANS | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | HUMANA | HUMANA COMMERCIAL HMO, PPO, POS, EPO | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | HEALTH ALLIANCE | HEALTH ALLIANCE HMO & PPO | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | SIHO | SIHO MEDICARE ADVANTAGE | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | BLUE CROSS | BLUE CROSS COMMUNITY (MMAI) | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | HEALTH LINK | HEALTH LINK ALL PPO | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | UNITED HEALTHCARE | UNITED HEALTHCARE HMO & PPO | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | MOLINA | MOLINA DUAL OPTIONS (MMAI) | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | HEALTH SMART | HEALTH SMART | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | BLUE CROSS | BCBS ILLINOIS MEDICARE ADVANTAGE | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | SIHO | SIHO COMMERCIAL PPO | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | HUMANA | HUMANA GOLD INTEGRATED PLUS (MMAI) | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | MULTIPLAN | MULTIPLAN | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | BLUE CROSS | BCBS ILLINOIS BLUE CHOICE | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | BLUE CROSS | BCBS ILLINOIS PPO | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | HEALTH ALLIANCE | HEALTH ALLIANCE MEDICARE ADVANTAGE | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | HUMANA | HUMANA MEDICARE ADVANTAGE | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | ZELIS | ZELIS | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | UNITED HEALTHCARE | UNITED HEALTHCARE VA COMMUNITY CARE NETWORK | — | $139.60 | $60.37 | 2025-02-07 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | $4,624.88 | 2024-12-08 | 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 ↗ |
| SKYLINE HOSPITAL Outpatient | REGENCE BS CARE | REGENCE BS CARE | $51.00 | $1,898.00 | $1,366.56 | 2026-05-04 | MRF ↗ |
| SKYLINE HOSPITAL Outpatient | REGENCE BS PPO/POS - ALL OTHER PLANS | REGENCE BS PPO/POS - ALL OTHER PLANS | $51.00 | $1,898.00 | $1,366.56 | 2026-05-04 | MRF ↗ |
| SKYLINE HOSPITAL Outpatient | REGENCE BS PAR | REGENCE BS PAR | $51.00 | $1,898.00 | $1,366.56 | 2026-05-04 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Both | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $51.92 | $4,992.15 | $4,992.15 | 2026-04-24 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $52.31 | — | — | 2026-04-14 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | Medicare | HMO | $57.24 | $139.60 | $104.70 | 2026-03-10 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | HMO, City of LA, Vivity | — | $16,289.40 | $10,588.11 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | HMO, Non-City of LA, Vivity | — | $16,289.40 | $10,588.11 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | HMO | — | $16,289.40 | $10,588.11 | 2025-11-26 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $68.50 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $68.50 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $68.50 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $68.50 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $68.50 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $68.50 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $68.50 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $68.50 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $68.50 | — | — | 2026-04-14 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $68.52 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $68.52 | — | — | 2026-04-01 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $70.00 | $2,867.00 | $2,867.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $70.00 | $2,867.00 | $2,867.00 | 2025-10-04 | MRF ↗ |
| FAIRCHILD MEDICAL CENTER Outpatient | MEDI-CAL | MEDI-CAL | $70.00 | $2,261.00 | $2,261.00 | 2025-12-03 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $74.83 | $2,264.00 | $430.16 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | $74.83 | $2,264.00 | $430.16 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | MEDI-CAL | MEDI-CAL | $74.83 | $2,264.00 | $430.16 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | HEALTHNET MEDI-CAL | HEALTHNET MEDI-CAL | $74.83 | $2,264.00 | $430.16 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | CCIPA MEDI-CAL - ALL PLANS | CCIPA MEDI-CAL - ALL PLANS | $74.83 | $2,264.00 | $430.16 | 2026-01-31 | MRF ↗ |
| MAYERS MEMORIAL HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $75.00 | $718.00 | $718.00 | 2026-05-12 | MRF ↗ |
| CAROLINAS MEDICAL CENTER/BEHAV HEALTH OutpatientFacility | Molina | Managed Medicaid | $75.38 | $4,484.10 | $2,242.05 | 2025-12-04 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Molina | Managed Medicaid | $75.38 | $4,484.10 | $2,242.05 | 2025-12-04 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $76.92 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $76.92 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $76.92 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $76.92 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $76.92 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $76.92 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $76.92 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $76.92 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $76.92 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | GEISINGER | MANAGED MEDICAID | $78.65 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | GEISINGER | MANAGED MEDICAID | $78.65 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $78.65 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $78.65 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $78.65 | — | — | 2025-08-01 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | UHC MCR ADV | UHC MCR ADV | $81.26 | $239.00 | $143.40 | 2025-11-18 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Brighton Health Plan | All Products | $82.15 | $7,953.00 | $3,268.13 | 2024-12-31 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $82.23 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | CHIP | $82.23 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $82.23 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | CHIP | $82.23 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $82.23 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | CHIP | $82.23 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $82.23 | — | — | 2025-08-01 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $84.78 | $628.00 | $471.00 | 2026-01-16 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | GEISINGER | MANAGED MEDICAID | $85.09 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $87.95 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MANAGED MEDICAID | $89.38 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MANAGED MEDICAID | $89.38 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | GEISINGER | MANAGED MEDICAID | $89.38 | — | — | 2025-08-01 | MRF ↗ |
| ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL OutpatientFacility | Wellpoint | NJ Family Care | $90.61 | — | — | 2026-03-04 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $90.81 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $90.81 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $90.81 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $90.81 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $90.81 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $90.81 | — | — | 2025-08-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | AIDS Healthcare Foundation and AHF Healthcare Centers | PHC California/Medi-Cal HMO | — | $16,289.40 | $10,588.11 | 2025-11-26 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | TRICARE - ALL PLANS | TRICARE - ALL PLANS | $92.73 | $239.00 | $143.40 | 2025-11-18 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AETNA | MANAGED MEDICAID | $92.95 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AETNA | MANAGED MEDICAID | $92.95 | — | — | 2025-08-01 | MRF ↗ |
| CHAMBERS MEMORIAL HOSPITAL Outpatient | CARESOURCE MCAID | CARESOURCE MCAID | $93.00 | $1,836.58 | $918.29 | 2026-05-05 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | IOWA TOTAL CARE MCR | IOWA TOTAL CARE MCR | $95.60 | $239.00 | $143.40 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | UHC VA CCN | UHC VA CCN | $95.60 | $239.00 | $143.40 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | AMERIGROUP MCR ADV | AMERIGROUP MCR ADV | $95.60 | $239.00 | $143.40 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | HUMANA MEDICARE-ALL PLANS | HUMANA MEDICARE-ALL PLANS | $95.60 | $239.00 | $143.40 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | MOLINA MCR ADV | MOLINA MCR ADV | $95.60 | $239.00 | $143.40 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | IOWA TOTAL CARE COMM - ALL OTHER PLANS | IOWA TOTAL CARE COMM - ALL OTHER PLANS | $95.60 | $239.00 | $143.40 | 2025-11-18 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $96.53 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $96.53 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $96.53 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $96.53 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $96.53 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $96.53 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $96.53 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $96.53 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $96.53 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $96.53 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $96.53 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $96.53 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | GEISINGER | MANAGED MEDICAID | $96.58 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $96.58 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $96.58 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | GEISINGER | MANAGED MEDICAID | $96.58 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $96.58 | — | — | 2025-08-01 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | MOLINA MCAID/CHIP | MOLINA MCAID/CHIP | $100.38 | $239.00 | $143.40 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | IOWA TOTAL CARE MCAID | IOWA TOTAL CARE MCAID | $100.38 | $239.00 | $143.40 | 2025-11-18 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | CHIP | $100.97 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | CHIP | $100.97 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $100.97 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $100.97 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | CHIP | $100.97 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $100.97 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $100.97 | — | — | 2025-08-01 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | AMERIGROUP MEDICAID - ALL OTHER PLANS | AMERIGROUP MEDICAID - ALL OTHER PLANS | $102.39 | $239.00 | $143.40 | 2025-11-18 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | AETNA | MANAGED MEDICAID | $103.65 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AETNA | MANAGED MEDICAID | $103.65 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | MANAGED MEDICAID | $103.65 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | MANAGED MEDICAID | $103.65 | — | — | 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.