Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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27130 — Total Hip Arthroplasty

Per-row negotiated rates, exactly as filed by each hospital. Aggregated views below summarize across hospitals; the bottom table shows the underlying rows.

Typical negotiated price $13,090

Usually $4,786–$17,503 (25th–75th percentile) across 2,633 hospitals · 5,532 payers.

“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 27130 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.

Also priced as a different code

The same procedure is billed under different code systems depending on the setting. These facilities price it under a code you won’t see in the CPT/HCPCS 27130 table above — including hospitals that only publish the bundled version.

MS_DRG 469 — Total hip replacement (primary) Inpatient stay bundle
2,978 facilities · 838 not in the CPT/HCPCS table
MS_DRG 470 — Total hip replacement (primary) Inpatient stay bundle
3,143 facilities · 925 not in the CPT/HCPCS table
APR_DRG 301 — Total hip replacement (primary) Inpatient stay bundle
1,051 facilities · 229 not in the CPT/HCPCS table

An MS-DRG / APR-DRG price is the hospital’s single bundled charge for the entire inpatient stay — operating room, room & board, recovery, imaging, anesthesia (facility), implants and supplies — so it’s a broader, usually higher figure than the CPT/HCPCS 27130 line above, which prices the procedure alone. Neither includes the surgeon’s or anesthesiologist’s professional fees, which are billed separately.

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.

Pick your insurer to anchor on your plan’s negotiated rate.
Measured
$4,786 $13,090 typical $17,503

The middle 50% of negotiated facility rates for this procedure, measured across 2,633 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. $13,090
Surgeon (professional fee) Estimate national typical Medicare $1,162 × 1.5 commercial. $1,743
Anesthesia Estimate national typical 01214, ~120 min typical. Medicare $328 × 3.14 commercial. $1,030
Likely subtotal $15,863

You might also be billed (if it applies to your case)

Assistant surgeon Estimate ~12% of cases 16% of the surgeon's fee (CMS modifier convention). $279
Radiologist read Estimate ~70% of cases · modeled Medicare $11 × 1.8 commercial. $19
Pathology Estimate ~10% of cases · modeled Medicare $35 × 2.166 commercial. $76
Typical added cost weighted by how often each applies ~$55
Surgical episode (typical) ~$15,917

Not included in this estimate:

  • Rehab, physical therapy, and other post-acute care after discharge (see the recovery plan below)
  • Complications, revisions, or readmissions
  • Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)

The biggest swing: which insurer's rate applies — negotiated prices here run $4,786–$17,503.

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.

After discharge
Recovery cost ~$3,785
With your recovery plan (typical) ~$19,702
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: Urban Institute ortho 1.5x
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
Assistant surgeon (estimate)
rule: 16% of primary surgeon (CMS Pub 100-04)
Radiologist read (estimate)
rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: Urban radiology 1.8x
Pathology (estimate)
rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: in-house pt_negotiated_rates 88305-26 ÷ CMS PFS-26 (n=16216); supersedes 1.18 global proxy

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
BARTON MEMORIAL HOSPITAL Outpatient Blue Shield Of California Ppo — $119,291.00 $83,503.70 2026-08-01 MRF ↗
CITIZENS MEDICAL CENTER Outpatient Hpk (Incl. Cigna) Commercial — $5,706.00 $3,708.90 2026-08-01 MRF ↗
CITIZENS MEDICAL CENTER Outpatient Sunflower Medicaid — $5,706.00 $3,708.90 2026-08-01 MRF ↗
CITIZENS MEDICAL CENTER Outpatient United Healthcare Commercial — $5,706.00 $3,708.90 2026-08-01 MRF ↗
CITIZENS MEDICAL CENTER Outpatient Phcs/Multiplan Commercial — $5,706.00 $3,708.90 2026-08-01 MRF ↗
CITIZENS MEDICAL CENTER Outpatient Aetna Commercial — $5,706.00 $3,708.90 2026-08-01 MRF ↗
CITIZENS MEDICAL CENTER Outpatient Wppa/Providrscare Commercial — $5,706.00 $3,708.90 2026-08-01 MRF ↗
CITIZENS MEDICAL CENTER Outpatient Healthy Blue Medicaid — $5,706.00 $3,708.90 2026-08-01 MRF ↗
SPRINGHILL MEDICAL CENTER Outpatient Humana Inc. Standard — $2,696.43 $2,291.97 2026-07-15 MRF ↗
SPRINGHILL MEDICAL CENTER Outpatient Unitedhealthcare Insurance Company (Contracting On Behalf Of Itself, Unitedhealthcare Of Alabama, Inc. And United'S Affiliates) Commercial All Payer — $2,696.43 $2,291.97 2026-07-15 MRF ↗
WINNMED Outpatient AETNA/FIRST HEALTH PPO-ALL OTHER PLANS AETNA/FIRST HEALTH PPO-ALL OTHER PLANS $19.59 $5,293.00 $3,705.10 2026-07-14 MRF ↗
WINNMED Outpatient AETNA/FIRST HEALTH PHO AETNA/FIRST HEALTH PHO $19.59 $5,293.00 $3,705.10 2026-07-14 MRF ↗
WINNMED Outpatient AETNA/FIRST HEALTH HMO AETNA/FIRST HEALTH HMO $19.59 $5,293.00 $3,705.10 2026-07-14 MRF ↗
MITCHELL COUNTY REGIONAL HEALTH Outpatient MEDICAL ASSOCIATES-ALL PLANS MEDICAL ASSOCIATES-ALL PLANS $22.16 $61.55 $55.40 2026-01-03 MRF ↗
MITCHELL COUNTY REGIONAL HEALTH Outpatient VA CCN -ALL PLANS VA CCN -ALL PLANS $22.16 $61.55 $55.40 2026-01-03 MRF ↗
MITCHELL COUNTY REGIONAL HEALTH Outpatient TRIWEST WELLMARK-ALL PLANS TRIWEST WELLMARK-ALL PLANS $22.16 $61.55 $55.40 2026-01-03 MRF ↗
MITCHELL COUNTY REGIONAL HEALTH Outpatient TRICARE- ALL PLANS TRICARE- ALL PLANS $22.16 $61.55 $55.40 2026-01-03 MRF ↗
MITCHELL COUNTY REGIONAL HEALTH Outpatient WELLMARK MCR ADV- ALL PLANS WELLMARK MCR ADV- ALL PLANS $22.38 $61.55 $55.40 2026-01-03 MRF ↗
MITCHELL COUNTY REGIONAL HEALTH Outpatient UHC MCR ADV UHC MCR ADV $22.82 $61.55 $55.40 2026-01-03 MRF ↗
BEAUFORT COUNTY MEMORIAL HOSPITAL Both Aetna Commercial — — — 2026-10-03 MRF ↗
BEAUFORT COUNTY MEMORIAL HOSPITAL Both Cigna Commercial — — — 2026-10-03 MRF ↗
BEAUFORT COUNTY MEMORIAL HOSPITAL Both United Health Care Medicare Advantage — — — 2026-10-03 MRF ↗
BEAUFORT COUNTY MEMORIAL HOSPITAL Both Molina Mangaged Medicare — — — 2026-10-03 MRF ↗
BEAUFORT COUNTY MEMORIAL HOSPITAL Both First Choice Select Health Managed Medicaid — — — 2026-10-03 MRF ↗
BEAUFORT COUNTY MEMORIAL HOSPITAL Both America'S First Choice Medicare Advantage — — — 2026-10-03 MRF ↗
BEAUFORT COUNTY MEMORIAL HOSPITAL Both Absolute Total Care Medicare Advantage — — — 2026-10-03 MRF ↗
BEAUFORT COUNTY MEMORIAL HOSPITAL Both Aetna Managed Medicare — — — 2026-10-03 MRF ↗
BEAUFORT COUNTY MEMORIAL HOSPITAL Both Blue Cross Medicare Advantage — — — 2026-10-03 MRF ↗
RARITAN BAY MEDICAL CENTER OutpatientFacility Clover Managed Medicare $29.20 $16,225.00 $14,325.75 2024-12-31 MRF ↗
ADVENTIST HEALTH CASTLE Outpatient PACIFIC ADMIN PPO - ALL PLANS PACIFIC ADMIN PPO - ALL PLANS $29.27 $1,516.00 $485.12 2026-05-18 MRF ↗
MITCHELL COUNTY REGIONAL HEALTH Outpatient OSCAR-ALL PLANS OSCAR-ALL PLANS $33.24 $61.55 $55.40 2026-01-03 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient DIGNITY MCR ADV OP/PROFEE ONLY DIGNITY MCR ADV OP/PROFEE ONLY $39.21 $704.00 $133.76 2026-05-20 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient DIGNITY MCR ADV OP/PROFEE ONLY DIGNITY MCR ADV OP/PROFEE ONLY $39.21 $3,206.00 $609.14 2026-01-25 MRF ↗
ISLAND HOSPITAL Outpatient MULTIPLAN - ALL PLANS MULTIPLAN - ALL PLANS $40.00 $765.00 $765.00 2025-03-18 MRF ↗
INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient Ccbh - Behavioral Health Behavioral — — — 2026-07-19 MRF ↗
ISLAND HOSPITAL Outpatient MULTIPLAN - ALL PLANS MULTIPLAN - ALL PLANS $40.00 $765.00 $765.00 2025-03-18 MRF ↗
MITCHELL COUNTY REGIONAL HEALTH Outpatient MIDLANDS NEW BUSINESS MIDLANDS NEW BUSINESS $43.09 $61.55 $55.40 2026-01-03 MRF ↗
S E LACKEY MEMORIAL HOSPITAL Outpatient CIGNA COMM - ALL PLANS CIGNA COMM - ALL PLANS $50.00 $4,393.00 $4,393.00 2026-02-10 MRF ↗
MITCHELL COUNTY REGIONAL HEALTH Outpatient UHC ALL PAYER - ALL OTHER PLANS UHC ALL PAYER - ALL OTHER PLANS $53.06 $61.55 $55.40 2026-01-03 MRF ↗
WALLOWA MEMORIAL HOSPITAL Outpatient CIGNA - ALL PLANS CIGNA - ALL PLANS $56.97 $3,257.00 $3,257.00 2026-07-09 MRF ↗
MITCHELL COUNTY REGIONAL HEALTH Outpatient MULTIPLAN-ALL PLANS MULTIPLAN-ALL PLANS $58.47 $61.55 $55.40 2026-01-03 MRF ↗
MITCHELL COUNTY REGIONAL HEALTH Outpatient MIDLANDS CHOICE - ALL OTHER PLANS MIDLANDS CHOICE - ALL OTHER PLANS $59.70 $61.55 $55.40 2026-01-03 MRF ↗
WALLOWA MEMORIAL HOSPITAL Outpatient BCBS OREGON PAR BCBS OREGON PAR $60.61 $3,257.00 $3,257.00 2026-07-09 MRF ↗
WALLOWA MEMORIAL HOSPITAL Outpatient BCBS OREGON NON-PAR - ALL OTHER PLANS BCBS OREGON NON-PAR - ALL OTHER PLANS $60.61 $3,257.00 $3,257.00 2026-07-09 MRF ↗
ADVENTIST HEALTH UKIAH VALLEY Outpatient BLUE CROSS NON-MCS BLUE CROSS NON-MCS $66.41 $704.00 $140.80 2026-05-24 MRF ↗
ADVENTIST HEALTH UKIAH VALLEY Outpatient BLUE CROSS MCS-ALL OTHER PLANS BLUE CROSS MCS-ALL OTHER PLANS $66.41 $704.00 $140.80 2026-05-24 MRF ↗
GRANT REGIONAL HEALTH CENTER Outpatient DEAN HEALTH PLAN - ALL PLANS DEAN HEALTH PLAN - ALL PLANS $71.99 $7,404.00 $4,812.60 2026-01-15 MRF ↗
SEARHC WRANGELL MEDICAL CENTER & LTC Outpatient UHC-ALL PLANS UHC-ALL PLANS $72.00 $6,624.80 $6,624.80 2024-12-09 MRF ↗
St Anthony Regional Hospital & Nursing Home Outpatient MIDLANDS CHOICE - ALL PLANS MIDLANDS CHOICE - ALL PLANS $76.98 $3,653.00 $3,653.00 2026-02-09 MRF ↗
BELLEVUE MEDICAL CENTER Outpatient AETNA COMM-ALL OTHER PLANS AETNA COMM-ALL OTHER PLANS $78.57 $6,821.40 $4,433.91 2026-08-10 MRF ↗
REGIONAL WEST MEDICAL CENTER Outpatient UHC ALL PAYER - ALL OTHER PLANS UHC ALL PAYER - ALL OTHER PLANS $90.00 $48,250.58 $42,460.51 2025-11-14 MRF ↗
REGIONAL WEST MEDICAL CENTER Outpatient UHC ALL PAYER - ALL OTHER PLANS UHC ALL PAYER - ALL OTHER PLANS $90.00 $32,167.05 $28,307.00 2025-11-14 MRF ↗
SUBLETTE COUNTY HEALTH Outpatient TRICARE PROFEE ONLY - ALL PLANS TRICARE PROFEE ONLY - ALL PLANS $97.00 $3,064.00 $2,757.60 2026-10-07 MRF ↗
GOUVERNEUR HOSPITAL Outpatient FIDELIS CARE NEW YORK [112] FIDELIS CARE NEW YORK|FIDELIS FHP|FIDELIS CHP — $30,491.15 $19,819.25 2024-12-30 MRF ↗
GOUVERNEUR HOSPITAL Outpatient AETNA [100] AETNA MEDICARE ADVANTAGE — $30,491.15 $19,819.25 2024-12-30 MRF ↗
GOUVERNEUR HOSPITAL Outpatient EXCELLUS HMO [104] BLUE CHOICE OPTION|CHILD HEALTH PLUS|UNIVERA MYHEALTH PLUS|EXCELLUS ESSENTIAL 1&2|EXCELLUS ESSENTIAL 3&4|UNIVERA MYHEALTH|UNIVERA ESSENTIAL 1&2|HEALTHY NY — $30,491.15 $19,819.25 2024-12-30 MRF ↗
GOUVERNEUR HOSPITAL Outpatient UNITED HEALTHCARE [101] UHC COMMUNITY PLAN|UHC COMMUNITY MEDICAID DENTAL|UHC ESSENTIAL 1&2|UHC CHPS|UHC ESSENTIAL 3&4 — $30,491.15 $19,819.25 2024-12-30 MRF ↗
GOUVERNEUR HOSPITAL Outpatient GENERIC MEDICARE HMO [125] WELLCARE TODAY'S OPTIONS [12503] — $30,491.15 $19,819.25 2024-12-30 MRF ↗
GOUVERNEUR HOSPITAL Outpatient GENERIC CARRIER [107] ST REGIS MOHAWK [10724] — $30,491.15 $19,819.25 2024-12-30 MRF ↗
GOUVERNEUR HOSPITAL Outpatient GENERIC MEDICARE HMO [125] HUMANA MEDICARE HMO — $30,491.15 $19,819.25 2024-12-30 MRF ↗
GOUVERNEUR HOSPITAL Outpatient FIDELIS EXCHANGE [157] FIDELIS(INCLUDING GOLD,SILVER,BRONZE AND PLATINUM) — $30,491.15 $19,819.25 2024-12-30 MRF ↗
S E LACKEY MEMORIAL HOSPITAL Outpatient BCBS AHS BCBS AHS $100.00 $4,393.00 $4,393.00 2026-02-10 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient ALTAMED MEDI-CAL - ALL OTHER PLANS ALTAMED MEDI-CAL - ALL OTHER PLANS $100.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient ACCESS MEDI-CAL ACCESS MEDI-CAL $100.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient PACIFIC IPA MEDI-CAL PACIFIC IPA MEDI-CAL $100.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient MEDI-CAL MEDI-CAL $100.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient BC MEDI-CAL BC MEDI-CAL $100.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient BLUE SHIELD MEDI-CAL BLUE SHIELD MEDI-CAL $100.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient PREFERRED MEDI-CAL PREFERRED MEDI-CAL $100.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient HEALTHCARE INC MEDI-CAL HEALTHCARE INC MEDI-CAL $100.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient CARE FIRST MEDI-CAL CARE FIRST MEDI-CAL $100.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient LASALLE MG MEDI-CAL LASALLE MG MEDI-CAL $100.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient PACIFIC ALLIANCE MEDI-CAL PACIFIC ALLIANCE MEDI-CAL $100.00 $752.00 $135.36 2026-05-23 MRF ↗
Madera Community Hospital Outpatient MEDI-CAL MEDI-CAL $105.00 $3,952.00 $2,371.20 2026-07-30 MRF ↗
ADVENTIST HEALTH ST HELENA Outpatient MEDI-CAL MEDI-CAL $105.00 $777.00 $116.55 2026-07-15 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both MEDICA MEDICA — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both MEDICARE NGS MEDICARE B — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both MEDICAID MN MEDICAID OUTPATIENT — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both HP HEALTH PARTNERS — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both ADVANTRA FREEDOM ADVANTRA FREEDOM MC ADVANTAGE — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both BCBSMN BLUE LINK — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both BCBSMN BLUE CROSS PLATINUM BLUE CP — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both TRIWEST CHAMPVA — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both MEDICA MEDICA PRIME SOLUTION — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both TRIWEST TRICARE WEST — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both UHC UNITED HEALTHCARE — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both BCBSMN BLUE CROSS OF MN — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both MEDICA SELECTCARE — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both UHC AETNA LIFE & CASUALTY — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both UHC LABORCARE UNITED HEALTHCARE — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both UMR UMR — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both UHC CIGNA — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both UHC AETNA MEDICARE ADVANTAGE — $4,896.00 $3,133.44 2026-04-01 MRF ↗
COMMUNITY MEMORIAL HOSPITAL Both BCBSMN BLUE CROSS MEDICARE ADVANTAGE — $4,896.00 $3,133.44 2026-04-01 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient HEALTHNET MCAL HEALTHNET MCAL $119.10 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient FCS IPA MEDI-CAL OP/PROFEE ONLY FCS IPA MEDI-CAL OP/PROFEE ONLY $120.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient BC MCAL BC MCAL $130.00 $704.00 $133.76 2026-05-20 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient MEDI-CAL MEDI-CAL $130.00 $704.00 $133.76 2026-05-20 MRF ↗
Southwest Healthcare System-wildomar Both Anthem Blue Cross Blue Shield Medicaid $130.00 — — 2026-07-17 MRF ↗
ADVENTIST HEALTH HANFORD Outpatient BC MCAL BC MCAL $130.00 $704.00 $133.76 2026-05-19 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS $130.00 $704.00 $133.76 2026-05-20 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient CAL VIVA HLTH MCAL - ALL PLANS CAL VIVA HLTH MCAL - ALL PLANS $130.00 $704.00 $133.76 2026-05-20 MRF ↗
ADVENTIST HEALTH HANFORD Outpatient UNIVERSAL HC MCAL PROFEE UNIVERSAL HC MCAL PROFEE $130.00 $704.00 $133.76 2026-05-19 MRF ↗
ADVENTIST HEALTH HANFORD Outpatient KAISER MCAL KAISER MCAL $130.00 $704.00 $133.76 2026-05-19 MRF ↗
FAIRCHILD MEDICAL CENTER Outpatient MEDI-CAL MEDI-CAL $130.00 $6,732.00 $6,732.00 2026-09-24 MRF ↗
ADVENTIST HEALTH HANFORD Outpatient HEALTHNET MCAL HEALTHNET MCAL $130.00 $704.00 $133.76 2026-05-19 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient UPN MCAL PROFEE ONLY-ALL OTHER PLANS UPN MCAL PROFEE ONLY-ALL OTHER PLANS $130.00 $704.00 $133.76 2026-05-20 MRF ↗
ADVENTIST HEALTH HANFORD Outpatient MEDI-CAL MEDI-CAL $130.00 $704.00 $133.76 2026-05-19 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient CENTRAL CA ALLIANCE MCAL PROFEE ONLY CENTRAL CA ALLIANCE MCAL PROFEE ONLY $130.00 $704.00 $133.76 2026-05-20 MRF ↗
CENTRAL VALLEY MEDICAL CENTER - CAH OutpatientFacility Humana Choice Care All — — — 2026-03-30 MRF ↗
Mayo Clinic OutpatientFacility UNITEDHEALTHCARE [91160438] UNITED HEALTHCARE [45] — — — 2026-03-31 MRF ↗
TAHOE FOREST HOSPITAL Outpatient MEDI-CAL MEDI-CAL $135.00 $5,887.00 $5,887.00 2025-10-04 MRF ↗
TAHOE FOREST HOSPITAL Outpatient MEDI-CAL MEDI-CAL $135.00 $5,887.00 $5,887.00 2025-10-04 MRF ↗
TAHOE FOREST HOSPITAL Outpatient MEDI-CAL MEDI-CAL $135.00 $11,774.00 $11,774.00 2025-10-04 MRF ↗
GLENDALE ADVENTIST MEDICAL CENTER Outpatient MEDI-CAL MEDI-CAL $135.00 $752.00 $112.80 2026-07-30 MRF ↗
GLENDALE ADVENTIST MEDICAL CENTER Outpatient MOLINA MCAL MOLINA MCAL $135.00 $752.00 $112.80 2026-07-30 MRF ↗
TAHOE FOREST HOSPITAL Outpatient BLUE CROSS MCAL BLUE CROSS MCAL $135.00 $11,774.00 $11,774.00 2025-10-04 MRF ↗
TAHOE FOREST HOSPITAL Outpatient BLUE CROSS MCAL BLUE CROSS MCAL $135.00 $11,774.00 $11,774.00 2025-10-04 MRF ↗
GLENDALE ADVENTIST MEDICAL CENTER Outpatient BC MEDI-CAL BC MEDI-CAL $135.00 $752.00 $112.80 2026-07-30 MRF ↗
GLENDALE ADVENTIST MEDICAL CENTER Outpatient BLUE SHIELD MEDI-CAL BLUE SHIELD MEDI-CAL $135.00 $752.00 $112.80 2026-07-30 MRF ↗
TAHOE FOREST HOSPITAL Outpatient MEDI-CAL MEDI-CAL $135.00 $11,774.00 $11,774.00 2025-10-04 MRF ↗
TAHOE FOREST HOSPITAL Outpatient BLUE CROSS MCAL BLUE CROSS MCAL $135.00 $5,887.00 $5,887.00 2025-10-04 MRF ↗
TAHOE FOREST HOSPITAL Outpatient BLUE CROSS MCAL BLUE CROSS MCAL $135.00 $5,887.00 $5,887.00 2025-10-04 MRF ↗
Bradford Regional Medical Center OutpatientFacility Univera Medicare Managed Care Plan $136.66 — — 2026-04-01 MRF ↗
BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility Univera Medicare Managed Care Plan $136.66 — — 2026-04-01 MRF ↗
TAHOE FOREST HOSPITAL Outpatient CA HEALTH AND WELLNESS-ALL PLANS CA HEALTH AND WELLNESS-ALL PLANS $137.70 $11,774.00 $11,774.00 2025-10-04 MRF ↗
TAHOE FOREST HOSPITAL Outpatient CA HEALTH AND WELLNESS-ALL PLANS CA HEALTH AND WELLNESS-ALL PLANS $137.70 $5,887.00 $5,887.00 2025-10-04 MRF ↗
TAHOE FOREST HOSPITAL Outpatient CA HEALTH AND WELLNESS-ALL PLANS CA HEALTH AND WELLNESS-ALL PLANS $137.70 $11,774.00 $11,774.00 2025-10-04 MRF ↗
TAHOE FOREST HOSPITAL Outpatient CA HEALTH AND WELLNESS-ALL PLANS CA HEALTH AND WELLNESS-ALL PLANS $137.70 $5,887.00 $5,887.00 2025-10-04 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient BELLA VISTA MEDI-CAL OP/PROFEE ONLY BELLA VISTA MEDI-CAL OP/PROFEE ONLY $140.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient GLOBAL CARE MCAL PROFEE ONLY GLOBAL CARE MCAL PROFEE ONLY $140.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient AHP MEDI-CAL AHP MEDI-CAL $140.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient EL PROYECTO MCAL PROFEE ONLY EL PROYECTO MCAL PROFEE ONLY $140.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient ASSOC HISPANIC PHYSCNS MCAL ASSOC HISPANIC PHYSCNS MCAL $140.00 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient HCLA MCAL PROFEE ONLY HCLA MCAL PROFEE ONLY $140.00 $752.00 $135.36 2026-05-23 MRF ↗
GLENDALE ADVENTIST MEDICAL CENTER Outpatient HERITAGE MCAL HERITAGE MCAL $143.10 $752.00 $112.80 2026-07-30 MRF ↗
ADVENTIST HEALTH HANFORD Outpatient UPN MCAL PROFEE UPN MCAL PROFEE $149.75 $599.00 $113.81 2026-05-19 MRF ↗
MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient Bcbs Medicare Medicare $153.80 $9,677.00 $7,257.75 2026-10-01 MRF ↗
MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient Medicare Medicare $153.80 $9,677.00 $7,257.75 2026-10-01 MRF ↗
MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient Bcbs Medicare Medicare $153.80 $968.00 $726.00 2026-10-01 MRF ↗
MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient Medicare Medicare $153.80 $968.00 $726.00 2026-10-01 MRF ↗
MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient Vaccn Medicare $153.80 $968.00 $726.00 2026-10-01 MRF ↗
MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient Vaccn Medicare $153.80 $9,677.00 $7,257.75 2026-10-01 MRF ↗
CARIBOU MEDICAL CENTER Outpatient AETNA MCR ADV AETNA MCR ADV $158.00 $3,825.00 $2,677.50 2026-03-16 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient MOLINA MEDI-CAL MOLINA MEDI-CAL $160.00 $752.00 $135.36 2026-05-23 MRF ↗
GLENDALE ADVENTIST MEDICAL CENTER Outpatient HEALTHNET MCAL HEALTHNET MCAL $160.79 $752.00 $112.80 2026-07-30 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient KERN HEALTH SYSTEMS MCAL-ALL PLANS KERN HEALTH SYSTEMS MCAL-ALL PLANS $162.50 $704.00 $133.76 2026-05-20 MRF ↗
PENOBSCOT VALLEY HOSPITAL Both Medicare B ME JK Default $169.31 $1,283.16 $1,026.53 2026-04-24 MRF ↗
COLUMBUS COMMUNITY HOSPITAL Outpatient United Healthcare - Medicare Advantage Medicare Advantage — $2,487.00 $1,865.25 2026-03-31 MRF ↗
PENOBSCOT VALLEY HOSPITAL Both Wellcare Health Plan Inc MCR Adv Default $171.01 $1,283.16 $1,026.53 2026-04-24 MRF ↗
PENOBSCOT VALLEY HOSPITAL Both Wellcare Health Plan Inc MCR Adv Default $171.01 $4,061.88 $3,249.50 2026-04-24 MRF ↗
ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both Medicare B NY Upstate JK Default $172.86 $3,724.00 $2,308.88 2026-03-16 MRF ↗
TAHOE FOREST HOSPITAL Outpatient PARTNERSHIP HEALTH PLAN- ALL PLANS PARTNERSHIP HEALTH PLAN- ALL PLANS $175.50 $5,887.00 $5,887.00 2025-10-04 MRF ↗
TAHOE FOREST HOSPITAL Outpatient PARTNERSHIP HEALTH PLAN- ALL PLANS PARTNERSHIP HEALTH PLAN- ALL PLANS $175.50 $11,774.00 $11,774.00 2025-10-04 MRF ↗
TAHOE FOREST HOSPITAL Outpatient PARTNERSHIP HEALTH PLAN- ALL PLANS PARTNERSHIP HEALTH PLAN- ALL PLANS $175.50 $5,887.00 $5,887.00 2025-10-04 MRF ↗
TAHOE FOREST HOSPITAL Outpatient PARTNERSHIP HEALTH PLAN- ALL PLANS PARTNERSHIP HEALTH PLAN- ALL PLANS $175.50 $11,774.00 $11,774.00 2025-10-04 MRF ↗
ADVENTIST HEALTH HANFORD Outpatient UPN MCAL PROFEE UPN MCAL PROFEE $176.00 $704.00 $133.76 2026-05-19 MRF ↗
PENOBSCOT VALLEY HOSPITAL Both — — — $1,283.16 $1,026.53 2025-03-04 MRF ↗
EAST CARROLL PARISH HOSPITAL Outpatient UNITED CHICAGO TEACHER FUND-ALL PLANS UNITED CHICAGO TEACHER FUND-ALL PLANS $184.55 $1,367.00 $1,025.25 2026-01-16 MRF ↗
ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both Blue Cross Blue Shield of NY Empire Medicare Advantage $185.21 $3,724.00 $2,308.88 2026-03-16 MRF ↗
WITHAM HEALTH SERVICES Outpatient ANTHEM EXCH ANTHEM EXCH $190.74 $307.65 $215.36 2026-03-31 MRF ↗
WITHAM HEALTH SERVICES Outpatient ANTHEM EXCH ANTHEM EXCH $190.74 $307.65 $215.36 2026-03-31 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient PROSPECT MG MCR ADV PROFEE ONLY PROSPECT MG MCR ADV PROFEE ONLY $191.70 $639.00 $115.02 2026-01-30 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient PROSPECT MG COM/POS PROFEE ONLY-ALL OTHER PLAN PROSPECT MG COM/POS PROFEE ONLY-ALL OTHER PLAN $191.70 $639.00 $115.02 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient PROSPECT MG MCAL PROFEE ONLY PROSPECT MG MCAL PROFEE ONLY $191.70 $639.00 $115.02 2026-01-30 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient PROSPECT MG MCAL PROFEE ONLY PROSPECT MG MCAL PROFEE ONLY $191.70 $639.00 $115.02 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient PROSPECT MG COM/POS PROFEE ONLY-ALL OTHER PLAN PROSPECT MG COM/POS PROFEE ONLY-ALL OTHER PLAN $191.70 $639.00 $115.02 2026-01-30 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient PROSPECT MG MCR ADV PROFEE ONLY PROSPECT MG MCR ADV PROFEE ONLY $191.70 $639.00 $115.02 2026-05-23 MRF ↗
PENOBSCOT VALLEY HOSPITAL Both Medicare A ME JK Default $194.72 $1,283.16 $1,026.53 2026-04-24 MRF ↗
PENOBSCOT VALLEY HOSPITAL Both Humana Medicare Advantage $194.72 $4,061.88 $3,249.50 2026-04-24 MRF ↗
PENOBSCOT VALLEY HOSPITAL Both United Healthcare Medicare Advantage $194.72 $1,283.16 $1,026.53 2026-04-24 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient CENTRAL CA ALLIANCE CCS PROFEE ONLY CENTRAL CA ALLIANCE CCS PROFEE ONLY $195.00 $704.00 $133.76 2026-05-20 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P $195.00 $704.00 $133.76 2026-05-20 MRF ↗
PENOBSCOT VALLEY HOSPITAL Both Humana Medicare Advantage $196.67 $1,283.16 $1,026.53 2026-04-24 MRF ↗
PENOBSCOT VALLEY HOSPITAL Both VA Community Care Network VACCN Region 1-3 Optum Default $198.69 $1,283.16 $1,026.53 2026-04-24 MRF ↗
PENOBSCOT VALLEY HOSPITAL Both Aetna Medicare Advantage Medicare Advantage $198.69 $4,061.88 $3,249.50 2026-04-24 MRF ↗
PENOBSCOT VALLEY HOSPITAL Both Blue Cross Blue Shield of ME Anthem Medicare Advantage $200.56 $1,283.16 $1,026.53 2026-04-24 MRF ↗
THREE RIVERS HOSPITAL Both — — — $1,542.00 $1,542.00 2024-12-12 MRF ↗
WITHAM HEALTH SERVICES Outpatient ANTHEM HMO ANTHEM HMO $211.94 $307.65 $215.36 2026-03-31 MRF ↗
WITHAM HEALTH SERVICES Outpatient ANTHEM PPO ANTHEM PPO $211.94 $307.65 $215.36 2026-03-31 MRF ↗
WITHAM HEALTH SERVICES Outpatient ANTHEM PPO ANTHEM PPO $211.94 $307.65 $215.36 2026-03-31 MRF ↗
WITHAM HEALTH SERVICES Outpatient ANTHEM HMO ANTHEM HMO $211.94 $307.65 $215.36 2026-03-31 MRF ↗
ADVENTIST HEALTH HANFORD Outpatient VALLEY CHILDRENS - ALL PLANS VALLEY CHILDRENS - ALL PLANS $218.40 $704.00 $133.76 2026-05-19 MRF ↗
TOMAH MEMORIAL HOSPITAL Outpatient SECURITY HP MCAID SECURITY HP MCAID $224.83 $5,500.00 $3,162.50 2026-03-03 MRF ↗
TOMAH MEMORIAL HOSPITAL Outpatient MANAGED HLTH MCAID - ALL PLANS MANAGED HLTH MCAID - ALL PLANS $224.83 $5,500.00 $3,162.50 2026-03-03 MRF ↗
TOMAH MEMORIAL HOSPITAL Outpatient QUARTZ MCAID QUARTZ MCAID $224.83 $5,500.00 $3,162.50 2026-03-03 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient PROSPECT MG MCAL PROFEE ONLY PROSPECT MG MCAL PROFEE ONLY $225.60 $752.00 $135.36 2026-01-30 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient PROSPECT MG MCR ADV PROFEE ONLY PROSPECT MG MCR ADV PROFEE ONLY $225.60 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient PROSPECT MG MCR ADV PROFEE ONLY PROSPECT MG MCR ADV PROFEE ONLY $225.60 $752.00 $135.36 2026-01-30 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient PROSPECT MG MCAL PROFEE ONLY PROSPECT MG MCAL PROFEE ONLY $225.60 $752.00 $135.36 2026-05-23 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient PROSPECT MG COM/POS PROFEE ONLY-ALL OTHER PLAN PROSPECT MG COM/POS PROFEE ONLY-ALL OTHER PLAN $225.60 $752.00 $135.36 2026-01-30 MRF ↗
ADVENTIST HEALTH WHITE MEMORIAL Outpatient PROSPECT MG COM/POS PROFEE ONLY-ALL OTHER PLAN PROSPECT MG COM/POS PROFEE ONLY-ALL OTHER PLAN $225.60 $752.00 $135.36 2026-05-23 MRF ↗
WITHAM HEALTH SERVICES Outpatient AETNA-ALL OTHER PLANS AETNA-ALL OTHER PLANS $227.66 $307.65 $215.36 2026-03-31 MRF ↗
WITHAM HEALTH SERVICES Outpatient AETNA-ALL OTHER PLANS AETNA-ALL OTHER PLANS $227.66 $307.65 $215.36 2026-03-31 MRF ↗
NEWMAN REGIONAL HEALTH Inpatient Medicare MCR_2 — $37,532.47 $30,025.98 2026-07-07 MRF ↗
NEWMAN REGIONAL HEALTH Inpatient Medicare Mcr 2 — $37,532.47 $30,025.98 2026-10-09 MRF ↗
STE GENEVIEVE COUNTY MEMORIAL HOSPITAL Outpatient Cigna Commercial — $2,872.00 $1,436.00 2026-07-15 MRF ↗
WITHAM HEALTH SERVICES Outpatient UHC-ALL PLANS UHC-ALL PLANS $239.97 $307.65 $215.36 2026-03-31 MRF ↗
WITHAM HEALTH SERVICES Outpatient UHC-ALL PLANS UHC-ALL PLANS $239.97 $307.65 $215.36 2026-03-31 MRF ↗
WITHAM HEALTH SERVICES Outpatient ANTHEM TRAD-ALL OTHER PLANS ANTHEM TRAD-ALL OTHER PLANS $242.24 $307.65 $215.36 2026-03-31 MRF ↗

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