27324 — Biopsy Thigh Soft Tissues
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). BIOPSY THIGH SOFT TISSUES (HCPCS 27324) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/27324?code_type=HCPCS
MLA (9th ed.)
“BIOPSY THIGH SOFT TISSUES (HCPCS 27324) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/27324?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“BIOPSY THIGH SOFT TISSUES (HCPCS 27324) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/27324?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,530–$4,522 (25th–75th percentile) across 1,671 hospitals · 3,556 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 27324 — 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
$1,530
$3,035 typical
$4,522
The middle 50% of negotiated facility rates for this procedure, measured across 1,671 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. | $3,035 |
| Surgeon (professional fee) Estimate national typical Medicare $402 × 1.22 commercial. | $491 |
| 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 | $4,234 |
Surgical episode (typical)
~$4,234
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 $1,530–$4,522.
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)
~$8,018
- 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 |
|---|---|---|---|---|---|---|---|
| CAPE CANAVERAL HOSPITAL Outpatient | Health First Health Plan | Health First Health Plan Medicare | $0.34 | $115.65 | $28.91 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Cigna | Cigna | $0.42 | $115.65 | $28.91 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Nhp | $0.45 | $115.65 | $28.91 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Commercial Group 1 | $0.45 | $115.65 | $28.91 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Commercial Group 2 | $0.45 | $115.65 | $28.91 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Blue | Florida Blue Commercial Network Blue | $0.76 | $115.65 | $28.91 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Blue | Florida Blue Commercial Hmo | $0.76 | $115.65 | $28.91 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Blue | Florida Blue Commercial Phs | $0.76 | $115.65 | $28.91 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Blue | Florida Blue Commercial Ppo | $0.76 | $115.65 | $28.91 | 2026-05-08 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $4.18 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $4.18 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $4.18 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $4.30 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $4.41 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $4.52 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $5.43 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $5.43 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $5.54 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $5.54 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $5.54 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $5.54 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $5.66 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $5.77 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $5.88 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $6.11 | $1,131.00 | $1,074.45 | 2026-02-20 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $11.37 | $6,318.00 | $2,836.20 | 2024-12-31 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $11.65 | $1,062.00 | $201.78 | 2026-01-25 | MRF ↗ |
| HOSPITAL FOR SPECIAL SURGERY OutpatientFacility | BLUE CROSS BLUE SHIELD NY [1022] | BCBS NY EXCHANGE [102200] | $18.72 | — | $12,043.75 | 2026-04-01 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Corizon Health | Yescare | $23.13 | $115.65 | $28.91 | 2026-05-08 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BRAND NEW DAY [1089] | MEDI-CAL | $25.00 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | XIMED [2016] | MEDI-CAL | $25.00 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | AETNA [1003] | AETNA MEDI-CAL | $25.00 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE SHIELD PROMISE [1017] | BLUE SHIELD PROMISE (FKA CARE1ST HEALTHPLAN MEDI-CAL) | $25.00 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MEDI-CAL [1048] | MEDI-CAL | $25.00 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | COMMUNITY ELDERCARE [1027] | MEDI-CAL | $25.00 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CAREMORE [2028] | MEDI-CAL | $25.00 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE CROSS [1013] | BLUE CROSS MEDI-CAL UNLISTED IPA [10130011] | $25.00 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MEDI-CAL [2001] | MEDI-CAL | $25.00 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE CROSS [1013] | MEDI-CAL | $25.00 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | VANTAGE [1092] | PROSPECT VANTAGE MEDICAL GROUP MEDI-CAL | $25.00 | $14,725.00 | $8,098.75 | 2026-04-01 | 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 ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | PGT | Medicare|All Plans | $31.09 | $244.00 | $42.70 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MOLINA [1055] | MOLINA MEDI-CAL COMMUNITY CARE [10550015] | $31.50 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MOLINA [1240] | MOLINA MEDI-CAL | $31.50 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MOLINA [1055] | MOLINA MEDI-CAL [10550002] | $31.50 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MOLINA [1240] | MOLINA MEDI-CAL [12400001] | $31.50 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MOLINA [1055] | MOLINA MEDI-CAL | $31.50 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | BCBS | Medicare|All Plans | $31.72 | $244.00 | $42.70 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AETNA | Medicare|All Plans | $31.72 | $244.00 | $42.70 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | COMMUNITY HEALTH GROUP [1022] | COMMUNITY HEALTH GROUP (MEDI-CAL) | $32.25 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | UNITED | Medicare|All Plans | $32.36 | $244.00 | $42.70 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AMERIVANTAGE | Medicare|All Plans | $32.68 | $244.00 | $42.70 | 2026-02-28 | 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 ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.71 | — | — | 2026-04-14 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | HEALTH NET [1039] | HEALTH NET MEDI-CAL | $33.75 | $14,725.00 | $8,098.75 | 2026-04-01 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | SCANHealth | Medicare|All Plans | $33.95 | $244.00 | $42.70 | 2026-02-28 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | United Healthcare | United Healthcare Nhp | $34.12 | $115.65 | $28.91 | 2026-05-08 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Health First Health Plan | Hfhp Individual Ppo/Marketplace | $34.46 | $115.65 | $28.91 | 2026-05-08 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Geisinger Health Plan | F8109_Geisinger Health Plan - Medicaid Chip | $34.50 | — | — | 2026-04-01 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | AETNA HEALTH INC | AETNA BETTER HEALTH MEDICAID | $34.50 | $5,294.00 | $1,429.38 | 2025-01-14 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | AETNA HEALTH INC | AETNA BETTER HEALTH MEDICAID | $34.50 | $5,294.00 | $1,429.38 | 2025-01-14 | MRF ↗ |
| HERITAGE VALLEY SEWICKLEY Both | AETNA HEALTH INC | AETNA BETTER HEALTH MEDICAID | $34.50 | $6,374.00 | $1,720.98 | 2026-03-27 | MRF ↗ |
| SUBURBAN COMMUNITY HOSPITAL Outpatient | Traditional Medicaid | Traditional Medicaid | $34.50 | $10,744.50 | $3,521.00 | 2024-12-19 | MRF ↗ |
| Heritage Valley Kennedy Hospital Both | AETNA HEALTH INC | AETNA BETTER HEALTH MEDICAID | $34.50 | $5,294.00 | $1,429.38 | 2024-12-30 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Amerihealth | F8102_Amerihealth | $34.50 | — | — | 2026-04-01 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | AETNA HEALTH INC | AETNA BETTER HEALTH MEDICAID | $34.50 | $5,294.00 | $1,429.38 | 2024-12-30 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $34.50 | $1,169.00 | $257.18 | 2026-04-14 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Geisinger Health Plan | F8109_Geisinger Health Plan - Medicaid Chip | $34.50 | — | — | 2026-04-01 | MRF ↗ |
| HERITAGE VALLEY SEWICKLEY Both | AETNA HEALTH INC | AETNA BETTER HEALTH MEDICAID | $34.50 | $6,374.00 | $1,720.98 | 2026-03-27 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | AETNA HEALTH INC | AETNA BETTER HEALTH MEDICAID | $34.50 | $6,374.00 | $1,720.98 | 2026-03-27 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | Medicaid | Medicaid | $34.50 | $6,871.00 | $4,260.02 | 2025-07-01 | MRF ↗ |
| ARNOT OGDEN MEDICAL CENTER OutpatientFacility | AmeriHealth | All Products | $34.50 | — | — | 2026-03-27 | MRF ↗ |
| Heritage Valley Kennedy Hospital Both | AETNA HEALTH INC | AETNA BETTER HEALTH MEDICAID | $34.50 | $5,294.00 | $1,429.38 | 2024-12-30 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Amerihealth | F8102_Amerihealth | $34.50 | — | — | 2026-04-01 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $34.50 | $1,169.00 | $268.87 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Aetna | Aetna Better Health CHIP | $34.50 | $1,169.00 | $268.87 | 2026-04-14 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | Medicaid | Medicaid | $34.50 | $10,307.00 | $6,390.34 | 2025-07-01 | MRF ↗ |
| SURGICAL INSTITUTE OF READING BothFacility | Unison | Med Plus | $34.50 | $5,338.00 | $4,190.51 | 2026-04-08 | 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 ↗ |
| GEISINGER MEDICAL CENTER Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $35.53 | $6,871.00 | $4,260.02 | 2025-07-01 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $35.53 | $10,307.00 | $6,390.34 | 2025-07-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $36.23 | $1,169.00 | $257.18 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $36.23 | $1,169.00 | $257.18 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $36.23 | $1,169.00 | $257.18 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $36.23 | $1,169.00 | $257.18 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $36.23 | — | — | 2026-04-14 | MRF ↗ |
| CAPE CANAVERAL HOSPITAL Outpatient | Florida Healthcare Plans | Florida Healthcare Plans Bnn | $36.89 | $115.65 | $28.91 | 2026-05-08 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $37.95 | $1,169.00 | $315.63 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $37.95 | $1,169.00 | $315.63 | 2026-04-14 | MRF ↗ |
| Upmc Presbyterian Shadyside OutpatientFacility | UPMC Health Plan | Managed Medicaid | $37.95 | — | — | 2026-03-06 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $37.95 | $1,169.00 | $210.42 | 2026-04-14 | MRF ↗ |
| ST LUKE'S MINERS MEMORIAL HOSPITAL OutpatientFacility | Keystone First | Medicaid | $39.67 | — | — | 2026-02-27 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $39.67 | $1,169.00 | $210.42 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $39.67 | $1,169.00 | $268.87 | 2026-04-14 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $39.67 | $6,871.00 | $4,260.02 | 2025-07-01 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $39.67 | $1,169.00 | $222.11 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $39.67 | $1,169.00 | $222.11 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $39.67 | $1,169.00 | $222.11 | 2026-04-14 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $39.67 | $10,307.00 | $6,390.34 | 2025-07-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $39.67 | $1,169.00 | $210.42 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $39.67 | $1,169.00 | $268.87 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $39.67 | $1,169.00 | $268.87 | 2026-04-14 | MRF ↗ |
| ST LUKE'S HOSPITAL - GRAND VIEW CAMPUS OutpatientFacility | United Healthcare Community | Managed Medicaid | $39.68 | — | — | 2024-12-31 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $40.54 | $6,871.00 | $4,260.02 | 2025-07-01 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $40.54 | $10,307.00 | $6,390.34 | 2025-07-01 | MRF ↗ |
| ST LUKE'S MINERS MEMORIAL HOSPITAL OutpatientFacility | Geisinger | Medicaid/CHIP | $40.71 | — | — | 2026-02-27 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | GATEWAY HEALTH PLAN | GATEWAY MEDICAID DBA HIGHMARK WHOLECARE | $41.40 | $5,294.00 | $1,429.38 | 2025-01-14 | MRF ↗ |
| ST LUKE'S MINERS MEMORIAL HOSPITAL OutpatientFacility | AmeriHealth Caritas | Medicaid | $41.40 | — | — | 2026-02-27 | MRF ↗ |
| HERITAGE VALLEY SEWICKLEY Both | GATEWAY HEALTH PLAN | GATEWAY MEDICAID DBA HIGHMARK WHOLECARE | $41.40 | $6,374.00 | $1,720.98 | 2026-03-27 | MRF ↗ |
| HERITAGE VALLEY SEWICKLEY Both | HIGHMARK CHOICE COMPANY (BCBS) | BC HIGHMARK WHOLECARE MEDICAID | $41.40 | $6,374.00 | $1,720.98 | 2026-03-27 | MRF ↗ |
| Heritage Valley Kennedy Hospital Both | GATEWAY HEALTH PLAN | GATEWAY MEDICAID DBA HIGHMARK WHOLECARE | $41.40 | $5,294.00 | $1,429.38 | 2024-12-30 | MRF ↗ |
| Heritage Valley Kennedy Hospital Both | PA HEALTH AND WELLNESS INC | PA HEALTH AND WELLNESS INC | $41.40 | $5,294.00 | $1,429.38 | 2024-12-30 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | PA HEALTH AND WELLNESS INC | PA HEALTH AND WELLNESS INC | $41.40 | $5,294.00 | $1,429.38 | 2025-01-14 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | GATEWAY HEALTH PLAN | GATEWAY MEDICAID DBA HIGHMARK WHOLECARE | $41.40 | $5,294.00 | $1,429.38 | 2024-12-30 | MRF ↗ |
| ST LUKE'S MINERS MEMORIAL HOSPITAL OutpatientFacility | UPMC Health Plan | Medicaid | $41.40 | — | — | 2026-02-27 | MRF ↗ |
| ST LUKE'S HOSPITAL - GRAND VIEW CAMPUS OutpatientFacility | PA Health & Wellness Community Health Choices | Dual Plan Managed Medicaid | $41.40 | — | — | 2024-12-31 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | HIGHMARK CHOICE COMPANY (BCBS) | BC HIGHMARK WHOLECARE MEDICAID | $41.40 | $6,374.00 | $1,720.98 | 2026-03-27 | MRF ↗ |
| HERITAGE VALLEY SEWICKLEY Both | HIGHMARK CHOICE COMPANY (BCBS) | BC HIGHMARK WHOLECARE MEDICAID | $41.40 | $6,374.00 | $1,720.98 | 2026-03-27 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | Health Partners | Health Partners - Managed Medicaid | $41.40 | $6,871.00 | $4,260.02 | 2025-07-01 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | GATEWAY HEALTH PLAN | GATEWAY MEDICAID DBA HIGHMARK WHOLECARE | $41.40 | $5,294.00 | $1,429.38 | 2025-01-14 | MRF ↗ |
| Heritage Valley Kennedy Hospital Both | GATEWAY HEALTH PLAN | GATEWAY MEDICAID DBA HIGHMARK WHOLECARE | $41.40 | $5,294.00 | $1,429.38 | 2024-12-30 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $41.40 | $1,169.00 | $222.11 | 2026-04-14 | MRF ↗ |
| ST LUKE'S MINERS MEMORIAL HOSPITAL OutpatientFacility | Highmark Wholecare | Medicaid | $41.40 | — | — | 2026-02-27 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $41.40 | $1,169.00 | $280.56 | 2026-04-14 | MRF ↗ |
| Heritage Valley Kennedy Hospital Both | PA HEALTH AND WELLNESS INC | PA HEALTH AND WELLNESS INC | $41.40 | $5,294.00 | $1,429.38 | 2024-12-30 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | Health Partners | Health Partners - Managed Medicaid | $41.40 | $10,307.00 | $6,390.34 | 2025-07-01 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | GATEWAY HEALTH PLAN | GATEWAY MEDICAID DBA HIGHMARK WHOLECARE | $41.40 | $6,374.00 | $1,720.98 | 2026-03-27 | MRF ↗ |
| HERITAGE VALLEY SEWICKLEY Both | GATEWAY HEALTH PLAN | GATEWAY MEDICAID DBA HIGHMARK WHOLECARE | $41.40 | $6,374.00 | $1,720.98 | 2026-03-27 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $41.40 | $1,169.00 | $315.63 | 2026-04-14 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | PA HEALTH AND WELLNESS INC | PA HEALTH AND WELLNESS INC | $41.40 | $5,294.00 | $1,429.38 | 2024-12-30 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | PA HEALTH AND WELLNESS INC | PA HEALTH AND WELLNESS INC | $41.40 | $5,294.00 | $1,429.38 | 2025-01-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $41.40 | $1,169.00 | $257.18 | 2026-04-14 | MRF ↗ |
| JEFFERSON LANSDALE HOSPITAL OutpatientFacility | Keystone First | JAB002 Caid MCO | $42.44 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON LANSDALE HOSPITAL OutpatientFacility | Keystone First | JAB002 Caid CHIP | $42.44 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON ABINGTON HOSPITAL OutpatientFacility | Keystone First | JAB001 Caid MCO | $42.44 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON ABINGTON HOSPITAL OutpatientFacility | Keystone First | JAB001 Caid CHIP | $42.44 | — | — | 2026-03-18 | MRF ↗ |
| TRINITAS REGIONAL MEDICAL CENTER OutpatientFacility | Wellpoint | NJ Family Care | $42.88 | — | — | 2026-03-04 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | UPMC CHIP | UPMC CHIP - Managed Medicaid | $43.13 | $10,307.00 | $6,390.34 | 2025-07-01 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | UPMC CHIP | UPMC CHIP - Managed Medicaid | $43.13 | $6,871.00 | $4,260.02 | 2025-07-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $44.06 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $44.06 | — | — | 2026-04-01 | MRF ↗ |
| NEWARK BETH ISRAEL MEDICAL CENTER OutpatientFacility | United Healthcare | Community Plan | $44.14 | — | — | 2026-03-04 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $44.15 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $44.15 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $44.15 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $44.15 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $44.15 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $44.15 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $44.15 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $44.15 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $44.15 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | PA Health_Wellness CHC | JNJ001_JNJ002_JNJ003 CHC | $44.85 | — | — | 2026-03-18 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $44.85 | $5,294.00 | $1,429.38 | 2025-01-14 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | UPMC HEALTH PLAN | UPMC MEDICAID | $44.85 | $5,294.00 | $1,429.38 | 2025-01-14 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | UPMC HEALTH PLAN | UPMC MEDICAID | $44.85 | $5,294.00 | $1,429.38 | 2024-12-30 | MRF ↗ |
| HERITAGE VALLEY SEWICKLEY Both | UPMC HEALTH PLAN | UPMC MEDICAID | $44.85 | $6,374.00 | $1,720.98 | 2026-03-27 | MRF ↗ |
| Heritage Valley Kennedy Hospital Both | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $44.85 | $5,294.00 | $1,429.38 | 2024-12-30 | MRF ↗ |
| HERITAGE VALLEY BEAVER Both | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $44.85 | $5,294.00 | $1,429.38 | 2024-12-30 | MRF ↗ |
| Heritage Valley Kennedy Hospital Both | UPMC HEALTH PLAN | UPMC MEDICAID | $44.85 | $5,294.00 | $1,429.38 | 2024-12-30 | MRF ↗ |
| Magee Rehabilitation Hospital OutpatientFacility | Magee PA Health_Wellness | Medicaid | $44.85 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON LANSDALE HOSPITAL OutpatientFacility | PA Health_Wellness CHC | JAB002 CHC | $44.85 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | PA Health_Wellness CHC | JNE001_JNE002_JNE003 CHC | $44.85 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | PA Health_Wellness CHC | JNJ001_JNJ002_JNJ003 CHC | $44.85 | — | — | 2026-03-18 | 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.