27197 — Clsd Tx Pelvic Ring Fx
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). CLSD TX PELVIC RING FX (HCPCS 27197) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/27197?code_type=HCPCS
MLA (9th ed.)
“CLSD TX PELVIC RING FX (HCPCS 27197) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/27197?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“CLSD TX PELVIC RING FX (HCPCS 27197) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/27197?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $234–$784 (25th–75th percentile) across 1,797 hospitals · 4,605 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 27197 — 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
$234
$337 typical
$784
The middle 50% of negotiated facility rates for this procedure, measured across 1,797 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. | $337 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $124 × 1.22 commercial. | $151 |
| Likely subtotal | $488 |
Surgical episode (typical)
~$488
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)
~$4,272
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 | — | $2,224.90 | $1,446.19 | 2025-11-26 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | SCAN Health Plan | Medicare Advantage | — | $2,224.90 | $1,446.19 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $2,224.90 | $1,446.19 | 2025-11-26 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Corizon Health | Yescare | $1.65 | $8.25 | $2.06 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Health First Health Plan | Hfhp Individual Ppo/Marketplace | $2.46 | $8.25 | $2.06 | 2026-05-08 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Humana | Choice Care Network | $2.53 | $967.00 | $725.25 | 2026-04-01 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Healthcare Plans | Florida Healthcare Plans Bnn | $2.63 | $8.25 | $2.06 | 2026-05-08 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.87 | $1,323.00 | $793.80 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.87 | $1,323.00 | $793.80 | 2025-08-11 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Cigna | Cigna | $3.40 | $8.25 | $2.06 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Commercial Group 1 | $4.14 | $8.25 | $2.06 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Commercial Group 2 | $4.14 | $8.25 | $2.06 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Aetna | Aetna Commercial | $4.70 | $8.25 | $2.06 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Disney Cruise Line | Disney Cruise Line | $4.95 | $8.25 | $2.06 | 2026-05-08 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $5.05 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $5.08 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $5.08 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $5.79 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $5.83 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $5.83 | — | — | 2026-03-18 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Prime Heath Services, Inc. | Prime Heath Services Inc | $6.19 | $8.25 | $2.06 | 2026-05-08 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $6.30 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $6.34 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $6.34 | — | — | 2026-03-18 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Multiplan | Multiplan | $6.60 | $8.25 | $2.06 | 2026-05-08 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $7.36 | $281.00 | $281.00 | 2026-02-13 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Choicecare | Choicecare | $7.42 | $8.25 | $2.06 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Inpatient | Aetna | Aetna Coventry First Health Facility Rental | $7.84 | $8.25 | $2.06 | 2026-05-08 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $19.00 | $372.00 | $96.72 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $19.00 | $372.00 | $100.44 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $19.00 | $372.00 | $81.84 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $19.00 | $372.00 | $89.28 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $19.00 | $372.00 | $89.28 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $19.00 | $372.00 | $81.84 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $19.00 | $372.00 | $96.72 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $19.00 | $372.00 | $66.96 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $19.00 | $372.00 | $85.56 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $19.00 | $372.00 | $81.84 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $19.00 | $372.00 | $66.96 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $19.00 | $372.00 | $81.84 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $19.00 | $372.00 | $85.56 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $19.00 | $372.00 | $100.44 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $19.00 | $372.00 | $70.68 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $19.00 | $372.00 | $81.84 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $19.00 | $372.00 | $85.56 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $19.00 | $372.00 | $85.56 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $19.00 | $372.00 | $81.84 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $19.00 | $372.00 | $81.84 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $19.00 | $372.00 | $81.84 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $19.00 | $372.00 | $70.68 | 2026-04-14 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $19.41 | — | — | 2025-12-31 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - United | Medicaid - United | $21.00 | $213.00 | $106.00 | 2025-02-03 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $22.94 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $22.94 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $22.94 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $22.94 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Inpatient | SMARTHEALTH PPO | 8842_SMARTHEALTH PPO 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $22.94 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $22.94 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8813_ANTHEM UNIFIED GROUPS VKIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $22.94 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $22.94 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $22.94 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $22.94 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $22.94 | — | — | 2026-01-01 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - Molina | Medicaid - Molina | $25.00 | $213.00 | $106.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - Meridian | Medicaid - Meridian | $25.00 | $253.00 | $126.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - United | Medicaid - United | $26.00 | $253.00 | $126.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $27.00 | $213.00 | $106.00 | 2025-02-03 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Cigna | Cigna - PPO | $27.04 | $967.00 | $725.25 | 2026-04-01 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | AETNA | MEDICARE | $27.12 | $240.00 | $36.00 | 2025-12-23 | MRF ↗ |
| The Hospitals of Providence Emergency Room Montwood OutpatientFacility | Imperial Health | Medicare Advantage | $28.00 | $823.56 | $658.85 | 2026-03-24 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - Molina | Medicaid - Molina | $28.00 | $253.00 | $126.00 | 2025-02-03 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | PENSACOLA | CHRISTIAN COLL | $29.25 | $195.00 | $29.25 | 2025-12-23 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - Molina | Medicaid - Molina | $30.00 | $253.00 | $126.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - Meridian | Medicaid - Meridian | $30.00 | $213.00 | $106.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - Meridian | Medicaid - Meridian | $30.00 | $213.00 | $106.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $30.00 | $213.00 | $106.00 | 2025-02-03 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Medicaid - United | Medicaid - United | $32.00 | $253.00 | $126.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $32.00 | $253.00 | $126.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $33.00 | $213.00 | $106.00 | 2025-02-03 | 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 ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - United | Medicaid - United | $34.00 | $253.00 | $126.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - Meridian | Medicaid - Meridian | $34.00 | $213.00 | $106.00 | 2025-02-03 | 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 ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PPO PREFERRED | 9232_ANTHEM PREFERRED VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM SHORT TERM LIMITED DURATION | 9361_ANTHEM SHORT TERM LIMITED DURATION VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PATHWAY X | 9231_ANTHEM PATHWAY X VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HMO/POS | 9229_ANTHEM HMO POS VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM TRADITIONAL | 9233_ANTHEM TRADITIONAL VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PATHWAY | 9230_ANTHEM PATHWAY VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HEALTHSYNC POS | 9228_ANTHEM HEALTHSYNC POS VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HEALTHSYNC HMO | 9227_ANTHEM HEALTHSYNC HMO VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $35.01 | — | — | 2026-01-01 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $36.00 | $253.00 | $126.00 | 2025-02-03 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | PENSACOLA | CHRISTIAN COLL | $36.00 | $240.00 | $36.00 | 2025-12-23 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - United | Medicaid - United | $36.00 | $253.00 | $126.00 | 2025-02-03 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | PENSACOLA | CHRISTIAN COLL | $36.00 | $240.00 | $36.00 | 2025-12-23 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $36.00 | $213.00 | $106.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - Meridian | Medicaid - Meridian | $36.00 | $253.00 | $126.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - Meridian | Medicaid - Meridian | $36.00 | $253.00 | $126.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $36.00 | $253.00 | $126.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - United | Medicaid - United | $37.00 | $213.00 | $106.00 | 2025-02-03 | MRF ↗ |
| The Hospitals of Providence Emergency Room Montwood OutpatientFacility | Imperial Health | Medicare Advantage | $37.06 | $823.56 | $658.85 | 2026-03-24 | MRF ↗ |
| SOUTHWEST MEMORIAL HOSPITAL Outpatient | Medicare | Part B | $38.00 | $352.00 | $176.00 | 2025-06-12 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Tricare | Tricare | $38.00 | $213.00 | $106.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $39.00 | $253.00 | $126.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - Molina | Medicaid - Molina | $39.00 | $213.00 | $106.00 | 2025-02-03 | MRF ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - Molina | Medicaid - Molina | $40.00 | $213.00 | $106.00 | 2025-02-03 | MRF ↗ |
| CHI ST ALEXIUS HEALTH WILLISTON Outpatient | Medica | Medicare|All Plans | $40.92 | $93.00 | $53.94 | 2026-02-28 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - Meridian | Medicaid - Meridian | $41.00 | $253.00 | $126.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | WC - Workers Compensation | WC - Workers Compensation | $41.00 | $213.00 | $106.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicare - United | Medicare - United | $41.00 | $213.00 | $106.00 | 2025-02-03 | MRF ↗ |
| CHI ST ALEXIUS HEALTH WILLISTON Outpatient | BCBS - ND | Medicare|All Plans | $41.74 | $93.00 | $53.94 | 2026-02-28 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $41.92 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $41.92 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $41.92 | — | — | 2026-03-18 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Traditional Medicare HMO PPO | Traditional Medicare HMO PPO | $42.00 | $213.00 | $106.00 | 2025-02-03 | MRF ↗ |
| CAREWELL HEALTH MEDICAL CENTER OutpatientFacility | Horizon New Jersey Health | Managed Medicaid | $42.65 | — | — | 2025-06-17 | MRF ↗ |
| ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO Outpatient | Medicare | Medicare | $42.67 | $251.00 | $175.70 | 2026-04-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - EAST CAMPUS OutpatientFacility | Imperial Health | Medicare Advantage | $42.82 | $823.56 | $658.85 | 2026-03-24 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH LAPEER COUNTY [901004] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH SHIAWASSEE COUNTY [901003] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH CLINTON EATON & INGHAM COUNTY [901006] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH OAKLAND COUNTY [901005] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | HARBOR HEALTH PLAN [9016] | HARBOR HEALTH PLAN [901601] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | BLUE CROSS COMPLETE [9001] | BLUE CROSS COMPLETE [900102] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | CHILDRENS SPECIAL HEALTHCARE SERVICES (CSHCS) [3002] | CHILDRENS SPECIAL HEALTHCARE SERVICES [300201] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID QMB [300007] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID [300001] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | EMERGENCY MEDICAID [300004] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | BCCCP/WISEWOMAN [300006] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | UNITED HEALTH CARE COMMUNITY PLAN MEDICAID [9004] | UNITED HEALTH CARE MEDICAID [900401] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MATERNITY OUT PATIENT MEDICAL (MOMS) [300002] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL GREAT LAKES [300602] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MOLINA [1071] | MOLINA MICHILD [107101] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID HEALTHY MICHIGAN [3007] | MEDICAID HEALTHY MICHIGAN [300701] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | COVENTRY CARES MEDICAID [9009] | OMNICARE HEALTH PLAN MEDICAID [900901] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | GENERIC MEDICAID HMO [9000] | GENERIC MEDICAID HMO [900001] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL BLUE CROSS COMPLETE [300610] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL MERIDIAN CAID [300605] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL UNITED HEALTHCARE CARE [300609] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID TEMPORARY PRESUMPTIVE [300005] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID MICHILD [300008] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL MIDWEST HEALTH CAID [300607] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | PACE MEDICAID HMO [9020] | GENESYS PACE [902001] | $42.92 | $234.00 | $234.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | AETNA BETTER HEALTH PLAN [9018] | AETNA BETTER HEALTH PLAN [901801] | $42.92 | $234.00 | $234.00 | 2026-03-23 | 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.