25400 — Repair Radius Or Ulna
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). REPAIR RADIUS OR ULNA (CPT 25400) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/25400?code_type=CPT
MLA (9th ed.)
“REPAIR RADIUS OR ULNA (CPT 25400) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/25400?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“REPAIR RADIUS OR ULNA (CPT 25400) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/25400?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,362–$9,388 (25th–75th percentile) across 1,773 hospitals · 3,715 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 25400 — 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
$3,362
$6,957 typical
$9,388
The middle 50% of negotiated facility rates for this procedure, measured across 1,773 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. | $6,957 |
| Surgeon (professional fee) Estimate national typical Medicare $737 × 1.22 commercial. | $899 |
| 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 | $8,564 |
Surgical episode (typical)
~$8,564
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)
~$12,349
- 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 |
|---|---|---|---|---|---|---|---|
| CAMBRIDGE HEALTH ALLIANCE Outpatient | AARP [40001] | CHA HB MEDICARE MANAGED CARE - UHC | $4.54 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | UNITED HEALTH [40002] | CHA HB MEDICARE MANAGED CARE - UHC | $4.54 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MEDICARE [60001] | CHA HB MEDICARE | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BCBS - OUT OF STATE [10002] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS GENERAL BRIGHAM [50021] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS HEALTH PLAN [30001] | CHA HB Tufts Health Plan Medicare Preferred | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER COMMERCIAL PAYOR [50015] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BCBS - MA [10001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HEALTH SAFETY NET [80001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BOSTON MEDICAL CENTER - WELLSENSE [50003] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | COMMONWEALTH CARE ALLIANCE [65001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HPHC [20001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | SENIOR WHOLE HEALTH [65003] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | RR MEDICARE [60002] | CHA HB MEDICARE | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | ELDER SERVICE PLAN [65002] | CHA HB ELDER SERVICE PLAN | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HUMANA [50008] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | AETNA [50001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | CIGNA [50005] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS HEALTH PLAN [30001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) UM [75] Plans | $7.46 | $83,746.03 | $83,746.03 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER HA [122] Plans | $7.59 | $40,345.67 | $40,345.67 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | HNE MEDICAID [10905] | All HEALTH NEW ENGLAND/MINUTEMAN MCO HA [223] Plans | $7.59 | $40,345.67 | $40,345.67 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | MASSHEALTH [20302] | All MASSHEALTH HA [93] Plans | $7.59 | $40,345.67 | $40,345.67 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | INSTITUTION [10406] | All WORCESTER RECOVERY HA [235] Plans | $7.59 | $40,345.67 | $40,345.67 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | FALLON MEDICAID [10904] | All FALLON MCO HA [55] Plans | $7.59 | $40,345.67 | $40,345.67 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | FALLON MEDICAID [10904] | All FALLON ACO HA [79] Plans | $7.59 | $40,345.67 | $40,345.67 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTHALLIANCE HOSPITALS Outpatient | MGB MEDICAID [10906] | All MGB (FORMERLY AHP) ACO HA [197] Plans | $7.59 | $40,345.67 | $40,345.67 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER HR [124] Plans | $7.59 | $36,905.94 | $36,905.94 | 2026-04-03 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | UNITED HEALTH [40002] | CHA HB MEDICAID-STANDARD | $8.88 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB MEDICAID-STANDARD | $8.88 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB MEDICAID-STANDARD | $8.88 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS TOGETHER W CHA [75001] | CHA HB MEDICAID-STANDARD | $8.88 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OOS MEDICAID [70002] | CHA HB MEDICAID-STANDARD | $8.88 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS GENERAL BRIGHAM [50021] | CHA HB MEDICAID-STANDARD | $8.88 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS HEALTH [70001] | CHA HB MEDICAID-STANDARD | $8.88 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BOSTON MEDICAL CENTER - WELLSENSE [50003] | CHA HB MEDICAID-STANDARD | $8.88 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE SPECIAL KIDS (FORMERLY BMC) UM [255] Plans | $9.33 | $83,746.03 | $83,746.03 | 2026-03-26 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER GOV'T PAYOR [85003] | CHA HB TRICARE | $10.08 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | CHAMPVA [85001] | CHA HB TRICARE | $10.08 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB FALLON | $10.08 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TRICARE [85002] | CHA HB TRICARE | $10.08 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HEALTH SAFETY NET [80001] | CHA HB HEALTH SAFETY NET | $10.08 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB FALLON CAREPLUS | $10.08 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Martins Point | Default | $11.88 | $33.00 | $24.75 | 2026-05-18 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL UNITED HEALTHCARE LABS [106809] | $11.94 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL UNITED HEALTHCARE CARE [300609] | $11.94 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL UNITED HEALTHCARE CARE [700909] | $11.94 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,277.00 | $500.94 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,277.00 | $409.86 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,277.00 | $432.63 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,277.00 | $500.94 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,277.00 | $546.48 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,277.00 | $500.94 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,277.00 | $500.94 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,277.00 | $523.71 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,277.00 | $592.02 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,277.00 | $523.71 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,277.00 | $546.48 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,277.00 | $523.71 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,277.00 | $500.94 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,277.00 | $614.79 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,277.00 | $500.94 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,277.00 | $500.94 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,277.00 | $614.79 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,277.00 | $500.94 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,277.00 | $592.02 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | $2,277.00 | $409.86 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,277.00 | $432.63 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $12.00 | $2,277.00 | $523.71 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $12.00 | — | — | 2026-04-14 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Blue Cross Blue Shield Of Vt | Ppo | $12.24 | $33.00 | $24.75 | 2026-05-18 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Blue Cross Blue Shield Of Vt | Default | $12.24 | $33.00 | $24.75 | 2026-05-18 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Blue Cross Blue Shield Of Vt | Federal | $12.24 | $33.00 | $24.75 | 2026-05-18 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL AETNA BETTER HEALTH MEDICAID [300612] | $13.41 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL PRIORITY HEALTH PLAN [106814] | $15.63 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL CIGNA PRIORITY HEALTH [106826] | $15.63 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB TUFTS HEALTH PUBLIC PLANS QHP NON-SUBSIDIZED | $16.27 | $12,942.80 | $12,942.80 | 2026-03-20 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL HUMANA CARE LABS [700905] | $17.05 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL HUMANA LABS [106813] | $17.05 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL MERIDIAN CAID [300605] | $18.58 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL BLUE CROSS COMPLETE [300610] | $22.34 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL AETNA CARE [700912] | $22.34 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL WELLCARE CARE [700920] | $22.73 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL MERIDIAN HEALTH ADVANTAGE [700910] | $22.73 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL MED PLUS BLUE CARE [700903] | $22.73 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL MIDWEST HEALTH CAID [300607] | $22.81 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL HAP EMPOWERED [300613] | $22.81 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL BCN CARE LABS [700902] | $26.42 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $26.52 | $14,735.00 | $7,262.33 | 2024-12-31 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL GENERIC MEDICARE [700914] | $28.41 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | OMNICARE CARE [700906] | $28.41 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL HAP CARE [700904] | $28.41 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL PRIORITY HEALTH CARE [700911] | $28.41 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL AMERIHEALTH CARITAS VIP [700921] | $28.41 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL MIDWEST HEALTHCARE CARE [700907] | $28.41 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL VACCN [106827] | $28.41 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Harvard Pilgrim Healthcare | Pos | $30.69 | $33.00 | $24.75 | 2026-05-18 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Harvard Pilgrim Healthcare | Default | $30.69 | $33.00 | $24.75 | 2026-05-18 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | United Healthcare | Default | $31.35 | $33.00 | $24.75 | 2026-05-18 | 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 ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL AETNA LABS [106802] | $34.02 | $50,812.92 | $50,812.92 | 2026-03-23 | 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 ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL CIGNA LABS [106804] | $37.80 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL HAP PPO PLAN [106821] | $37.80 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL HAP LABS [106805] | $37.80 | $50,812.92 | $50,812.92 | 2026-03-23 | MRF ↗ |
| HOSPITAL FOR SPECIAL SURGERY OutpatientFacility | BLUE CROSS BLUE SHIELD NY [1022] | BCBS INDIVIDUAL NETWORK [102218] | $43.23 | — | $17,093.88 | 2026-04-01 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | MGB MEDICAID [10906] | All MGB (FORMERLY AHP) ACO UM [212] Plans | $45.60 | $45,313.14 | $45,313.14 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | MASSHEALTH [20302] | All MASSHEALTH UM [10] Plans | $45.60 | $45,313.14 | $45,313.14 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | INSTITUTION [10406] | All WORCESTER RECOVERY UM [233] Plans | $45.60 | $45,313.14 | $45,313.14 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | FALLON MEDICAID [10904] | All FALLON ACO UM [130] Plans | $45.60 | $45,313.14 | $45,313.14 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER UM [121] Plans | $45.60 | $45,313.14 | $45,313.14 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | FALLON MEDICAID [10904] | All FALLON MCO UM [104] Plans | $45.60 | $45,313.14 | $45,313.14 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | HNE MEDICAID [10905] | All HEALTH NEW ENGLAND/MINUTEMAN MCO UM [222] Plans | $45.60 | $45,313.14 | $45,313.14 | 2026-03-26 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) UM [75] Plans | $45.60 | $45,313.14 | $45,313.14 | 2026-03-26 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE SPECIAL KIDS (FORMERLY BMC) UM [255] Plans | $57.00 | $45,313.14 | $45,313.14 | 2026-03-26 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $65.67 | — | — | 2026-04-14 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $75.00 | $3,468.00 | $3,468.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $75.00 | $3,468.00 | $3,468.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $75.00 | $3,468.00 | $3,468.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $75.00 | $3,468.00 | $3,468.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $76.50 | $3,468.00 | $3,468.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $76.50 | $3,468.00 | $3,468.00 | 2025-10-04 | MRF ↗ |
| St Anthony Regional Hospital & Nursing Home Outpatient | MIDLANDS CHOICE - ALL PLANS | MIDLANDS CHOICE - ALL PLANS | $76.98 | $2,288.00 | $2,288.00 | 2026-02-09 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $86.00 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $86.00 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $86.00 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $86.00 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $86.00 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $86.00 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $86.00 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $86.00 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $86.00 | — | — | 2026-04-14 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $86.21 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $86.21 | — | — | 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 ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $96.58 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $96.58 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $96.58 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $96.58 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $96.58 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $96.58 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $96.58 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $96.58 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $96.58 | — | — | 2026-04-14 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $97.50 | $3,468.00 | $3,468.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $97.50 | $3,468.00 | $3,468.00 | 2025-10-04 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $105.00 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Aetna | Aetna Better Health CHIP | $105.00 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $105.00 | — | — | 2026-04-14 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Healthy Kids | $105.39 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Sunshine State Oncology | Medicaid HMO | $105.39 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Medicaid HMO | $105.39 | — | — | 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.