25690 — Cltx Lunate Dislc W/mnpj
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). CLTX LUNATE DISLC W/MNPJ (CPT 25690) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/25690?code_type=CPT
MLA (9th ed.)
“CLTX LUNATE DISLC W/MNPJ (CPT 25690) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/25690?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“CLTX LUNATE DISLC W/MNPJ (CPT 25690) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/25690?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,347–$3,123 (25th–75th percentile) across 1,901 hospitals · 5,282 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 25690 — 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
$1,347
$2,022 typical
$3,123
The middle 50% of negotiated facility rates for this procedure, measured across 1,901 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. | $2,022 |
| Surgeon (professional fee) Estimate national typical Medicare $482 × 1.22 commercial. | $588 |
| 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 | $3,318 |
Surgical episode (typical)
~$3,318
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)
~$7,103
- 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 | Multiplan | Multiplan | $2.53 | $3,607.00 | $2,705.25 | 2026-04-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Kaiser | Kaiser - HMO | $2.53 | $3,607.00 | $2,705.25 | 2026-04-01 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $3.00 | $1,414.00 | $268.66 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $3.00 | $1,414.00 | $268.66 | 2026-04-14 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | United Healthcare | United Healthcare - PPO | $4.98 | $3,607.00 | $2,705.25 | 2026-04-01 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $14.59 | $3,111.00 | $1,151.07 | 2026-03-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | $17.00 | $1,777.00 | $337.63 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | CCIPA MEDI-CAL - ALL PLANS | CCIPA MEDI-CAL - ALL PLANS | $17.00 | $1,777.00 | $337.63 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | HEALTHNET MEDI-CAL | HEALTHNET MEDI-CAL | $17.00 | $1,777.00 | $337.63 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $17.00 | $1,777.00 | $337.63 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | MEDI-CAL | MEDI-CAL | $17.00 | $1,777.00 | $337.63 | 2026-01-31 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | HMO, Non-City of LA, Vivity | — | $8,103.82 | $5,267.48 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | HMO, City of LA, Vivity | — | $8,103.82 | $5,267.48 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | HMO | — | $8,103.82 | $5,267.48 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | California PhysiciansÆ Service, dba Blue Shield of California | Medi-Cal | — | $8,103.82 | $5,267.48 | 2025-11-26 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Blue Shield | Blue Shield - HMO | $25.78 | $3,607.00 | $2,705.25 | 2026-04-01 | MRF ↗ |
| EL CAMPO MEMORIAL HOSPITAL Outpatient | None | — | — | $138.00 | $138.00 | 2026-03-01 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $28.00 | $1,876.00 | $1,876.00 | 2026-02-13 | 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 ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $32.64 | $2,035.00 | $2,035.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $32.64 | $2,035.00 | $2,035.00 | 2025-10-04 | 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 ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $33.89 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $34.11 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $34.11 | — | — | 2026-03-18 | 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 ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Both | Anthem Blue Cross Blue Shield | Medicaid | $35.20 | $4,604.00 | $1,841.60 | 2026-05-23 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Both | Anthem Blue Cross Blue Shield | Medicaid | $35.20 | $4,604.00 | $1,841.60 | 2026-05-14 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $37.00 | $1,777.00 | $479.79 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | UNIVERSAL IPA MCAL OP/PROFEE ONLY | UNIVERSAL IPA MCAL OP/PROFEE ONLY | $37.00 | $1,777.00 | $479.79 | 2026-01-31 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Partners | Managed Medicaid | $37.54 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Partners | Managed Medicaid | $37.54 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $38.10 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Alliance | Behavioral Health | $38.48 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $38.48 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Healthy Blue | Managed Medicaid | $38.82 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Carolina Complete Health | Managed Medicaid | $38.82 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Wellcare | Managed Medicaid | $38.82 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $38.84 | — | — | 2026-03-18 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Alliance | Behavioral Health | $38.85 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $39.09 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $39.09 | — | — | 2026-03-18 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Healthy Blue | Managed Medicaid | $39.19 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Vaya | Managed Medicaid | $39.19 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Wellcare | Managed Medicaid | $39.19 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Carolina Complete Health | Managed Medicaid | $39.19 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Vaya | Managed Medicaid | $39.57 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Alliance | Managed Medicaid | $39.79 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Alliance | Managed Medicaid | $39.98 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Trillium | Managed Medicaid | $39.98 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Trillium | Managed Medicaid | $40.36 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $40.96 | — | — | 2026-04-14 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $42.29 | — | — | 2026-03-18 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $42.35 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $42.56 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $42.56 | — | — | 2026-03-18 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Alliance | Behavioral Health | $42.76 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Carolina Complete Health | Managed Medicaid | $43.13 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Healthy Blue | Managed Medicaid | $43.13 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Wellcare | Managed Medicaid | $43.13 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Partners | Managed Medicaid | $43.55 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Vaya | Managed Medicaid | $43.55 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Alliance | Managed Medicaid | $44.00 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | MODA HEALTH PLAN - ALL OTHER PLANS | MODA HEALTH PLAN - ALL OTHER PLANS | $44.25 | $1,951.01 | $1,951.01 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $44.25 | $1,951.01 | $1,951.01 | 2025-05-29 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Trillium | Managed Medicaid | $44.41 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | BLUE CROSS - ALL PLANS | BLUE CROSS - ALL PLANS | $44.63 | $1,951.01 | $1,951.01 | 2025-05-29 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Partners | Managed Medicaid | $45.05 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Alliance | Behavioral Health | $45.09 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Healthy Blue | Managed Medicaid | $45.46 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Wellcare | Managed Medicaid | $45.46 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Carolina Complete Health | Managed Medicaid | $45.46 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $45.91 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Vaya | Managed Medicaid | $45.91 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $46.06 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Alliance | Managed Medicaid | $46.36 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Alliance | Behavioral Health | $46.51 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Trillium | Managed Medicaid | $46.81 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Carolina Complete Health | Managed Medicaid | $46.93 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Healthy Blue | Managed Medicaid | $46.93 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Wellcare | Managed Medicaid | $46.93 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Partners | Managed Medicaid | $47.30 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Vaya | Managed Medicaid | $47.41 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | United Healthcare | Managed Medicaid | $47.79 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Alliance | Managed Medicaid | $47.86 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| CHI HEALTH IMMANUEL Outpatient | United | Medicaid|Community Plan | $48.30 | $345.00 | $144.90 | 2026-02-28 | MRF ↗ |
| CAROLINAS MEDICAL CENTER-NORTHEAST OutpatientFacility | Trillium | Managed Medicaid | $48.35 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Partners | Managed Medicaid | $48.80 | $375.40 | $187.70 | 2025-12-04 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $49.18 | $375.40 | $187.70 | 2025-12-04 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | PROVIDENCE PREFERRED - ALL PLANS | PROVIDENCE PREFERRED - ALL PLANS | $49.50 | $1,951.01 | $1,951.01 | 2025-05-29 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Alliance | Managed Medicaid | $49.67 | $375.40 | $187.70 | 2025-12-04 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| S E LACKEY MEMORIAL HOSPITAL Outpatient | CIGNA COMM - ALL PLANS | CIGNA COMM - ALL PLANS | $50.00 | $953.00 | $953.00 | 2026-02-10 | 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 UNION OutpatientFacility | Carolina Complete Health | Managed Medicaid | $50.12 | $375.40 | $187.70 | 2025-12-04 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Wellcare | Managed Medicaid | $50.12 | $375.40 | $187.70 | 2025-12-04 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Healthy Blue | Managed Medicaid | $50.12 | $375.40 | $187.70 | 2025-12-04 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | United Healthcare | Managed Medicaid | $50.30 | $375.40 | $187.70 | 2025-12-04 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Vaya | Managed Medicaid | $50.60 | $375.40 | $187.70 | 2025-12-04 | MRF ↗ |
| BAPTIST MEMORIAL HOSPITAL JONESBORO, INC. OutpatientFacility | Home State Health Plan | Medicaid | $51.00 | $4,655.00 | $884.45 | 2026-02-27 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Trillium | Managed Medicaid | $51.62 | $375.40 | $187.70 | 2025-12-04 | MRF ↗ |
| CHI HEALTH SCHUYLER Outpatient | Amerigroup | Medicaid|All Plans | $51.63 | $241.00 | $204.85 | 2026-02-28 | MRF ↗ |
| CHI HEALTH MERCY COUNCIL BLUFFS Outpatient | Centene | Medicaid|NE Total Care | $51.75 | $345.00 | $144.90 | 2026-02-28 | MRF ↗ |
| CHI HEALTH IMMANUEL Outpatient | Centene | Medicaid|NE Total Care | $51.75 | $345.00 | $144.90 | 2026-02-28 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Partners | Managed Medicaid | $52.56 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| CHI HEALTH SCHUYLER Outpatient | IAMolina | Medicaid|All Plans | $52.64 | $241.00 | $204.85 | 2026-02-28 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $52.97 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $53.33 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $53.33 | — | — | 2026-04-01 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $53.64 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $53.64 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $53.64 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $53.64 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $53.64 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $53.64 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $53.64 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $53.64 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $53.64 | — | — | 2026-04-14 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Healthy Blue | Managed Medicaid | $53.98 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Wellcare | Managed Medicaid | $53.98 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Carolina Complete Health | Managed Medicaid | $53.98 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Vaya | Managed Medicaid | $54.51 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| CHI HEALTH LAKESIDE Outpatient | Centene | Medicaid|NE Total Care | $55.20 | $345.00 | $144.90 | 2026-02-28 | MRF ↗ |
| CHI HEALTH LAKESIDE Outpatient | United | Medicaid|Community Plan | $55.20 | $345.00 | $144.90 | 2026-02-28 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Trillium | Managed Medicaid | $55.60 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH CLEVELAND OutpatientFacility | Alliance | Managed Medicaid | $55.71 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | United Healthcare | Managed Medicaid | $56.16 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $56.16 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Alliance | Behavioral Health | $56.72 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | United Healthcare | Managed Medicaid | $56.72 | $375.40 | $187.70 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Healthy Blue | Managed Medicaid | $57.21 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Carolina Complete Health | Managed Medicaid | $57.21 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Wellcare | Managed Medicaid | $57.21 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Partners | Managed Medicaid | $57.21 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| CHI HEALTH ST. MARYS Outpatient | Amerigroup | Medicaid|All Plans | $57.41 | $268.00 | $222.44 | 2026-02-28 | MRF ↗ |
| CHI HEALTH ST. MARYS Outpatient | Amerigroup | Medicaid|All Plans | $57.41 | $268.00 | $222.44 | 2026-02-28 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | HEALTH NET LIFE INS CO | HEALTH NET LIFE INS CO | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLCARE | WELLCARE | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | CIGNA HEALTHSPRING | CIGNA HEALTHSPRING | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | AETNA | AETNA MEDICARE LIFE INS | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UMWA THE FUNDS 2ND ALWAYS | UMWA RETIREE | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | CIRSA | CIRSA | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | CMI | CMI | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | SECUREHORIZONS | SECUREHORIZONS | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | VHA OFFICE OF COMM CARE | VHA OFFICE OF COMM CARE | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICARE | MEDICARE | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | HALIBURTON | ESIS | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | US DEPT OF LABOR | US DEPT OF LABOR | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | AARP SUPPLEMENT | AARP MC ADVANTAGE | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MUTUAL OF OMAHA | MUTUAL OF OMAHA | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | TRICARE WEST | TRICARE WEST | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | PINNACOL ASSURANCE | PINNACOL ASSURANCE | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WPS CHAMPVA | CHAMPVA | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DEVOTED | DEVOTED HEALTH PLAN | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WPS TRICARE FOR LIFE | TRICARE FOR LIFE | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MISC MCR ADV | MISC MEDICARE ADV | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | TRIWEST | TRIWEST | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | CORVEL | CORVEL | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UNITED HEALTHCARE | AARP MC LIFE1 | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | PRESBYTERIAN CENTENNIAL | PRESBYTERIAN MEDICARE | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | RAILROAD MEDICARE SERVICE | RAILROAD MEDICARE SERVICE | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UNITED HEALTHCARE | UNITED MC LIFE1 | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UNITED HEALTHCARE | UNITED MEDICARE HEALTHPLA | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | CTSI WOODMAN & POWERS | CTSI | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | HUMANA GOLD CHOICE | HUMANA GOLD CHOICE | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | HUMANA GOLD CHOICE | HUMANA LIFE1 | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | FREEDOM NETWORK SELECT | FREEDOM NETWORK SELECT | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MISC WORK COMP | MISC WC GET COMPANY NAME | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | LIBERTY MUTUAL | LIBERTY MUTUAL | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | BANKERS LIFE | BANKERS LIFE | $57.50 | $287.50 | — | 2026-03-31 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Vaya | Managed Medicaid | $57.77 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH ANSON OutpatientFacility | Alliance | Managed Medicaid | $57.77 | $375.40 | $187.70 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH UNION OutpatientFacility | Alliance | Behavioral Health | $58.07 | $375.40 | $187.70 | 2025-12-04 | MRF ↗ |
| CHI HEALTH ST. MARYS Outpatient | IAMolina | Medicaid|All Plans | $58.54 | $268.00 | $222.44 | 2026-02-28 | MRF ↗ |
| CHI HEALTH ST. MARYS Outpatient | IAMolina | Medicaid|All Plans | $58.54 | $268.00 | $222.44 | 2026-02-28 | MRF ↗ |
| CHI HEALTH BERGAN MERCY Outpatient | Centene | Medicaid|NE Total Care | $58.65 | $345.00 | $144.90 | 2026-02-28 | MRF ↗ |
| CHI HEALTH BERGAN MERCY Outpatient | United | Medicaid|Community Plan | $58.65 | $345.00 | $144.90 | 2026-02-28 | 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.