27428 — Reconstruction Knee
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). RECONSTRUCTION KNEE (HCPCS 27428) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/27428?code_type=HCPCS
MLA (9th ed.)
“RECONSTRUCTION KNEE (HCPCS 27428) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/27428?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“RECONSTRUCTION KNEE (HCPCS 27428) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/27428?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $4,595–$15,371 (25th–75th percentile) across 1,671 hospitals · 3,280 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 27428 — 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
$4,595
$11,736 typical
$15,371
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. | $11,736 |
| Surgeon (professional fee) Estimate national typical Medicare $1,040 × 1.22 commercial. | $1,269 |
| 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 | $13,714 |
Surgical episode (typical)
~$13,714
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)
~$17,499
- 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 |
|---|---|---|---|---|---|---|---|
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $9.70 | $3,163.00 | $822.38 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $9.70 | $3,163.00 | $695.86 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $9.70 | $3,163.00 | $569.34 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $9.70 | $3,163.00 | $727.49 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $9.70 | $3,163.00 | $727.49 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $9.70 | $3,163.00 | $727.49 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $9.70 | $3,163.00 | $569.34 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $9.70 | $3,163.00 | $759.12 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $9.70 | $3,163.00 | $759.12 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $9.70 | $3,163.00 | $695.86 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $9.70 | $3,163.00 | $600.97 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $9.70 | $3,163.00 | $695.86 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $9.70 | $3,163.00 | $695.86 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $9.70 | $3,163.00 | $600.97 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $9.70 | $3,163.00 | $727.49 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $9.70 | $3,163.00 | $854.01 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $9.70 | $3,163.00 | $695.86 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $9.70 | $3,163.00 | $695.86 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $9.70 | $3,163.00 | $822.38 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $9.70 | $3,163.00 | $695.86 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $9.70 | $3,163.00 | $695.86 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $9.70 | $3,163.00 | $854.01 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $11.42 | — | — | 2026-04-14 | MRF ↗ |
| CANTON-POTSDAM HOSPITAL Outpatient | FIDELIS CARE NEW YORK [112] | FIDELIS CARE NEW YORK|FIDELIS FHP|FIDELIS CHP | $13.37 | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| CANTON-POTSDAM 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 | $17.24 | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $26.96 | $14,980.00 | $14,325.75 | 2024-12-31 | 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 ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| 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 ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Medicare|Negotiated_Percentage | — | $49.00 | $2,134.00 | $1,280.40 | 2026-05-21 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Medicare|Negotiated_Percentage | — | $49.00 | $2,134.00 | $1,280.40 | 2026-05-18 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA MEDICAID MANAGED CARE|MOLINA CHILD HEALTH PLUS | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 1&2 | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 3&4 | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | INDEPENDENT HEALTH ASSOC|NOVA HEALTHCARE-IHA | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC MEDICARE COMPLETE | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | MEDICARE HMO INDEPENDENT HLTH|NOVA HEALTHCARE MEDICARE | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS MEDICARE [176] | FIDELIS MEDICARE|FIDELIS DUAL ADVANTAGE | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | AETNA [100] | AETNA MEDICARE ADVANTAGE | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 1&2|MVP ESSENTIAL 3&4 | $75.20 | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK ESSENTIALS | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 3&4 | $75.20 | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE DUAL | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE MEDICARE HMO | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN|UHC COMMUNITY MEDICAID DENTAL|UHC ESSENTIAL 1&2|UHC CHPS|UHC ESSENTIAL 3&4 | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED BEHAVORIAL HEALTH [120] | UNITED BEHAVORIAL HEALTH|MH OPTUM COMMERCIAL | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS ESSENTIAL 1&2|FIDELIS ESSENTIAL 3&4 | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC DUAL COMPLETE | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE|TRICARE FOR LIFE|MARTINS POINT/US FAMILY | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| St Anthony Regional Hospital & Nursing Home Outpatient | MIDLANDS CHOICE - ALL PLANS | MIDLANDS CHOICE - ALL PLANS | $76.98 | $3,180.00 | $3,180.00 | 2026-02-09 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Blue Cross Blue Shield Ip|Negotiated_Percentage | — | $91.00 | $2,134.00 | $1,280.40 | 2026-05-18 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Blue Cross Blue Shield Ip|Negotiated_Percentage | — | $91.00 | $2,134.00 | $1,280.40 | 2026-05-21 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $91.14 | — | — | 2026-04-14 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP EXCHANGE-INDIVIDUAL | $92.01 | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Blue Cross Blue Shield Op|Negotiated_Percentage | — | $93.00 | $2,134.00 | $1,280.40 | 2026-05-21 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Blue Cross Blue Shield Op|Negotiated_Percentage | — | $93.00 | $2,134.00 | $1,280.40 | 2026-05-18 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Multiplan|Negotiated_Percentage | — | $95.00 | $2,134.00 | $1,280.40 | 2026-05-18 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Aetna|Negotiated_Percentage | — | $95.00 | $2,134.00 | $1,280.40 | 2026-05-21 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Aetna|Negotiated_Percentage | — | $95.00 | $2,134.00 | $1,280.40 | 2026-05-18 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Multiplan|Negotiated_Percentage | — | $95.00 | $2,134.00 | $1,280.40 | 2026-05-21 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|United Healthcare|Negotiated_Percentage | — | $95.00 | $2,134.00 | $1,280.40 | 2026-05-18 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $95.00 | $530.00 | $143.10 | 2026-01-31 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MEDI-CAL [1048] | MEDI-CAL | $95.00 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | UNIVERSAL IPA MCAL OP/PROFEE ONLY | UNIVERSAL IPA MCAL OP/PROFEE ONLY | $95.00 | $530.00 | $143.10 | 2026-01-31 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE CROSS [1013] | BLUE CROSS MEDI-CAL UNLISTED IPA [10130011] | $95.00 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | COMMUNITY ELDERCARE [1027] | MEDI-CAL | $95.00 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MEDI-CAL [2001] | MEDI-CAL | $95.00 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CAREMORE [2028] | MEDI-CAL | $95.00 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | XIMED [2016] | MEDI-CAL | $95.00 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | AETNA [1003] | AETNA MEDI-CAL | $95.00 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BRAND NEW DAY [1089] | MEDI-CAL | $95.00 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE CROSS [1013] | MEDI-CAL | $95.00 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|United Healthcare|Negotiated_Percentage | — | $95.00 | $2,134.00 | $1,280.40 | 2026-05-21 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Cigna|Negotiated_Percentage | — | $95.00 | $2,134.00 | $1,280.40 | 2026-05-18 | MRF ↗ |
| Southwest Healthcare System-wildomar Both | Anthem Blue Cross Blue Shield | Medicaid | $95.00 | — | — | 2026-05-06 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Cigna|Negotiated_Percentage | — | $95.00 | $2,134.00 | $1,280.40 | 2026-05-21 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | VANTAGE [1092] | PROSPECT VANTAGE MEDICAL GROUP MEDI-CAL | $95.00 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | WELLCARE TODAY'S OPTIONS [12503] | — | $23,663.19 | $15,381.07 | 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 | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | GENERIC CARRIER [107] | ST REGIS MOHAWK [10724] | — | $23,663.19 | $15,381.07 | 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 | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | HUMANA MEDICARE HMO | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | FIDELIS CARE NEW YORK [112] | FIDELIS CARE NEW YORK|FIDELIS FHP|FIDELIS CHP | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | AETNA [100] | AETNA MEDICARE ADVANTAGE | — | $23,663.19 | $15,381.07 | 2024-12-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ALTAMED MEDI-CAL - ALL OTHER PLANS | ALTAMED MEDI-CAL - ALL OTHER PLANS | $100.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ACCESS MEDI-CAL | ACCESS MEDI-CAL | $100.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BLUE SHIELD MEDI-CAL | BLUE SHIELD MEDI-CAL | $100.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MEDI-CAL | MEDI-CAL | $100.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | MEDI-CAL | MEDI-CAL | $100.00 | $530.00 | $100.70 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC ALLIANCE MEDI-CAL | PACIFIC ALLIANCE MEDI-CAL | $100.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BC MEDI-CAL | BC MEDI-CAL | $100.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | HEALTHNET MEDI-CAL | HEALTHNET MEDI-CAL | $100.00 | $530.00 | $100.70 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PREFERRED MEDI-CAL | PREFERRED MEDI-CAL | $100.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $100.00 | $530.00 | $100.70 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | $100.00 | $530.00 | $100.70 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHCARE INC MEDI-CAL | HEALTHCARE INC MEDI-CAL | $100.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC IPA MEDI-CAL | PACIFIC IPA MEDI-CAL | $100.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | LASALLE MG MEDI-CAL | LASALLE MG MEDI-CAL | $100.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | CCIPA MEDI-CAL - ALL PLANS | CCIPA MEDI-CAL - ALL PLANS | $100.00 | $530.00 | $100.70 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | CARE FIRST MEDI-CAL | CARE FIRST MEDI-CAL | $100.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $119.10 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $119.36 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $119.36 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $119.36 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $119.36 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $119.36 | — | — | 2026-04-14 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $119.36 | — | — | 2026-04-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $119.36 | — | — | 2026-04-14 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $119.36 | — | — | 2026-04-01 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $119.36 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $119.36 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $119.36 | — | — | 2026-04-14 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MOLINA [1240] | MOLINA MEDI-CAL | $119.70 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MOLINA [1240] | MOLINA MEDI-CAL [12400001] | $119.70 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MOLINA [1055] | MOLINA MEDI-CAL COMMUNITY CARE [10550015] | $119.70 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MOLINA [1055] | MOLINA MEDI-CAL [10550002] | $119.70 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MOLINA [1055] | MOLINA MEDI-CAL | $119.70 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | FCS IPA MEDI-CAL OP/PROFEE ONLY | FCS IPA MEDI-CAL OP/PROFEE ONLY | $120.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | COMMUNITY HEALTH GROUP [1022] | COMMUNITY HEALTH GROUP (MEDI-CAL) | $122.55 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | HEALTH NET [1039] | HEALTH NET MEDI-CAL | $128.25 | $54,507.06 | $29,978.88 | 2026-04-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $134.03 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $134.03 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $134.03 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $134.03 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $134.03 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $134.03 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $134.03 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $134.03 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $134.03 | — | — | 2026-04-14 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Physicians Medical Group | MCD | $136.00 | — | — | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | Molina | MCD | $136.00 | — | — | 2024-10-01 | MRF ↗ |
| RIVERSIDE COMMUNITY HOSPITAL Outpatient | LA Care Health | Medi-cal | $136.00 | — | — | 2024-10-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | Molina | MCD | $136.27 | — | — | 2026-03-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | LA Care Health | Medi-cal | $136.27 | — | — | 2026-03-01 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HCLA MCAL PROFEE ONLY | HCLA MCAL PROFEE ONLY | $140.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | EL PROYECTO MCAL PROFEE ONLY | EL PROYECTO MCAL PROFEE ONLY | $140.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | GLOBAL CARE MCAL PROFEE ONLY | GLOBAL CARE MCAL PROFEE ONLY | $140.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ASSOC HISPANIC PHYSCNS MCAL | ASSOC HISPANIC PHYSCNS MCAL | $140.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | AHP MEDI-CAL | AHP MEDI-CAL | $140.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | BELLA VISTA MEDI-CAL OP/PROFEE ONLY | $140.00 | $567.00 | $102.06 | 2026-01-30 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Aetna | Aetna Better Health CHIP | $142.00 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $142.00 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $142.00 | — | — | 2026-04-14 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Healthy Kids | $146.44 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Medicaid HMO | $146.44 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Sunshine State Oncology | Medicaid HMO | $146.44 | — | — | 2025-08-01 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $149.10 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $149.10 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $149.10 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $149.10 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $149.10 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $149.10 | — | — | 2026-04-14 | 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.