27530 — Treat Knee Fracture
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). TREAT KNEE FRACTURE (HCPCS 27530) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/27530?code_type=HCPCS
MLA (9th ed.)
“TREAT KNEE FRACTURE (HCPCS 27530) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/27530?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“TREAT KNEE FRACTURE (HCPCS 27530) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/27530?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $268–$964 (25th–75th percentile) across 2,110 hospitals · 6,695 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 27530 — 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
$268
$465 typical
$964
The middle 50% of negotiated facility rates for this procedure, measured across 2,110 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. | $465 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $301 × 1.22 commercial. | $367 |
| Likely subtotal | $832 |
Surgical episode (typical)
~$832
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)
~$4,617
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 Inpatient | HealthNet of California, Inc. | HMO | — | $2,892.39 | $1,880.05 | 2025-11-26 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $2,892.39 | $1,880.05 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | SCAN Health Plan | Medicare Advantage | — | $2,892.39 | $1,880.05 | 2025-11-26 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $3.17 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $3.17 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $3.17 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $3.26 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $3.35 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $3.43 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $4.12 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $4.12 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $4.20 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $4.20 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $4.20 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $4.20 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $4.29 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $4.38 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $4.46 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $4.63 | $858.00 | $815.10 | 2026-02-20 | MRF ↗ |
| GROSSMONT HOSPITAL Outpatient | Indian Health Council | Indian Health Council | $4.79 | $836.00 | $627.00 | 2026-04-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $5.99 | $746.00 | $559.50 | 2025-03-07 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $7.00 | $840.00 | $184.80 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $7.00 | $840.00 | $218.40 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $7.00 | $840.00 | $218.40 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $7.00 | $840.00 | $193.20 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $7.00 | $840.00 | $201.60 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $7.00 | $840.00 | $184.80 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $7.00 | $840.00 | $184.80 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $7.00 | $840.00 | $159.60 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $7.00 | $840.00 | $201.60 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $7.00 | $840.00 | $151.20 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $7.00 | $840.00 | $193.20 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $7.00 | $840.00 | $184.80 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $7.00 | $840.00 | $193.20 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $7.00 | $840.00 | $184.80 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $7.00 | $840.00 | $184.80 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $7.00 | $840.00 | $159.60 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $7.00 | $840.00 | $193.20 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $7.00 | $840.00 | $226.80 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $7.00 | $840.00 | $151.20 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $7.00 | $840.00 | $226.80 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $7.00 | $840.00 | $184.80 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $7.00 | $840.00 | $184.80 | 2026-04-14 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $8.23 | $791.50 | $791.50 | 2026-04-24 | MRF ↗ |
| COMANCHE COUNTY MEDICAL CENTER Outpatient | MPI - ALL PLANS | MPI - ALL PLANS | $8.97 | $541.00 | $351.65 | 2026-05-07 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $9.45 | $651.00 | $240.87 | 2026-03-31 | MRF ↗ |
| WINDOM AREA HEALTH InpatientFacility | Aetna | Medicare Replacement | — | $29.00 | $19.72 | 2026-02-03 | MRF ↗ |
| WINDOM AREA HEALTH InpatientFacility | Medica Minnesota Senior Health Options (MSHO) | Medicare Replacement | — | $29.00 | $19.72 | 2026-02-03 | MRF ↗ |
| WINDOM AREA HEALTH InpatientFacility | United Healthcare | Medicare Replacement | — | $29.00 | $19.72 | 2026-02-03 | MRF ↗ |
| WINDOM AREA HEALTH InpatientFacility | Humana | Medicare Replacement | — | $29.00 | $19.72 | 2026-02-03 | MRF ↗ |
| WINDOM AREA HEALTH InpatientFacility | Primewest Minnesota Senior Health Options (MSHO) | Medicare Replacement | — | $29.00 | $19.72 | 2026-02-03 | MRF ↗ |
| WINDOM AREA HEALTH InpatientFacility | Blue Cross Blue Shield | Medicare Replacement | — | $29.00 | $19.72 | 2026-02-03 | MRF ↗ |
| WINDOM AREA HEALTH InpatientFacility | Ucare Minnesota Senior Health Options (MSHO) | Medicare Replacement | — | $29.00 | $19.72 | 2026-02-03 | MRF ↗ |
| WINDOM AREA HEALTH InpatientFacility | Blue Plus Minnesota Senior Health Options (MSHO) | Medicare Replacement | — | $29.00 | $19.72 | 2026-02-03 | MRF ↗ |
| WINDOM AREA HEALTH InpatientFacility | Medica | Medicare Replacement | — | $29.00 | $19.72 | 2026-02-03 | MRF ↗ |
| WINDOM AREA HEALTH InpatientFacility | UCare for Seniors | Medicare Replacement | — | $29.00 | $19.72 | 2026-02-03 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MEDI-CAL [2001] | MEDI-CAL | $12.00 | $46,273.78 | $25,450.58 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | COMMUNITY ELDERCARE [1027] | MEDI-CAL | $12.00 | $46,273.78 | $25,450.58 | 2026-04-01 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $12.00 | $1,229.00 | $1,229.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $12.00 | $1,229.00 | $1,229.00 | 2025-10-04 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | XIMED [2016] | MEDI-CAL | $12.00 | $46,273.78 | $25,450.58 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CAREMORE [2028] | MEDI-CAL | $12.00 | $46,273.78 | $25,450.58 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MEDI-CAL [1048] | MEDI-CAL | $12.00 | $46,273.78 | $25,450.58 | 2026-04-01 | MRF ↗ |
| Southwest Healthcare System-wildomar Both | Anthem Blue Cross Blue Shield | Medicaid | $12.00 | $905.00 | $362.00 | 2026-05-06 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | AETNA [1003] | AETNA MEDI-CAL | $12.00 | $46,273.78 | $25,450.58 | 2026-04-01 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $12.00 | $1,229.00 | $1,229.00 | 2025-10-04 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BRAND NEW DAY [1089] | MEDI-CAL | $12.00 | $46,273.78 | $25,450.58 | 2026-04-01 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $12.00 | $1,229.00 | $1,229.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $12.24 | $1,229.00 | $1,229.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $12.24 | $1,229.00 | $1,229.00 | 2025-10-04 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Healthy Blue | Medicaid | — | $1,053.00 | $789.75 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Hpk (Incl. Cigna) | Commercial | — | $1,053.00 | $789.75 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | United Healthcare | Commercial | — | $1,053.00 | $789.75 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Ks | Commercial | $12.53 | $1,053.00 | $789.75 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Wppa/Providrscare | Commercial | — | $1,053.00 | $789.75 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Phcs/Multiplan | Commercial | — | $1,053.00 | $789.75 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Sunflower | Medicaid | — | $1,053.00 | $789.75 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Aetna | Commercial | — | $1,053.00 | $789.75 | 2026-05-18 | MRF ↗ |
| TYLER COUNTY HOSPITAL Outpatient | Blue Cross and Blue Shield | Blue Advantage HMO | $14.00 | $27.00 | $20.00 | 2025-04-15 | MRF ↗ |
| ADAMS COUNTY REGIONAL MEDICAL CENTER Outpatient | AMERIHEALTH | MEDICAID | — | $52.00 | $41.60 | 2024-12-25 | MRF ↗ |
| ADAMS COUNTY REGIONAL MEDICAL CENTER Outpatient | HUMANA | MEDICARE | — | $52.00 | $41.60 | 2024-12-25 | MRF ↗ |
| ADAMS COUNTY REGIONAL MEDICAL CENTER Outpatient | CARESOURCE | MEDICAID | — | $52.00 | $41.60 | 2024-12-25 | MRF ↗ |
| ADAMS COUNTY REGIONAL MEDICAL CENTER Outpatient | MOLINA | MEDICARE | — | $52.00 | $41.60 | 2024-12-25 | MRF ↗ |
| ADAMS COUNTY REGIONAL MEDICAL CENTER Outpatient | UHC | MEDICARE | — | $52.00 | $41.60 | 2024-12-25 | MRF ↗ |
| ADAMS COUNTY REGIONAL MEDICAL CENTER Outpatient | MEDICARE | TRADITIONAL | — | $52.00 | $41.60 | 2024-12-25 | MRF ↗ |
| ADAMS COUNTY REGIONAL MEDICAL CENTER Outpatient | ANTHEM | INDIANA | — | $52.00 | $41.60 | 2024-12-25 | MRF ↗ |
| ADAMS COUNTY REGIONAL MEDICAL CENTER Outpatient | UHC | COMMERCIAL | — | $52.00 | $41.60 | 2024-12-25 | MRF ↗ |
| ADAMS COUNTY REGIONAL MEDICAL CENTER Outpatient | ANTHEM | OHIO | — | $52.00 | $41.60 | 2024-12-25 | MRF ↗ |
| ADAMS COUNTY REGIONAL MEDICAL CENTER Outpatient | ANTHEM | KENTUCKY | — | $52.00 | $41.60 | 2024-12-25 | MRF ↗ |
| ADAMS COUNTY REGIONAL MEDICAL CENTER Outpatient | AETNA | AETNA MEDICARE | — | $52.00 | $41.60 | 2024-12-25 | MRF ↗ |
| ADAMS COUNTY REGIONAL MEDICAL CENTER Outpatient | MERIGOLD | MEDICARE | — | $52.00 | $41.60 | 2024-12-25 | MRF ↗ |
| ADAMS COUNTY REGIONAL MEDICAL CENTER Outpatient | BUCKEYE | MEDICARE | — | $52.00 | $41.60 | 2024-12-25 | MRF ↗ |
| ADAMS COUNTY REGIONAL MEDICAL CENTER Outpatient | ANTHEM | MIDWEST | — | $52.00 | $41.60 | 2024-12-25 | MRF ↗ |
| ADAMS COUNTY REGIONAL MEDICAL CENTER Outpatient | ANTHEM | MEDICAID | — | $52.00 | $41.60 | 2024-12-25 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MOLINA [1055] | MOLINA MEDI-CAL COMMUNITY CARE [10550015] | $15.12 | $46,273.78 | $25,450.58 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MOLINA [1240] | MOLINA MEDI-CAL [12400001] | $15.12 | $46,273.78 | $25,450.58 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MOLINA [1240] | MOLINA MEDI-CAL | $15.12 | $46,273.78 | $25,450.58 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MOLINA [1055] | MOLINA MEDI-CAL | $15.12 | $46,273.78 | $25,450.58 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MOLINA [1055] | MOLINA MEDI-CAL [10550002] | $15.12 | $46,273.78 | $25,450.58 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | COMMUNITY HEALTH GROUP [1022] | COMMUNITY HEALTH GROUP (MEDI-CAL) | $15.48 | $46,273.78 | $25,450.58 | 2026-04-01 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $15.60 | $1,229.00 | $1,229.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $15.60 | $1,229.00 | $1,229.00 | 2025-10-04 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | HEALTH NET [1039] | HEALTH NET MEDI-CAL | $16.20 | $46,273.78 | $25,450.58 | 2026-04-01 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $16.30 | $281.00 | $281.00 | 2026-02-13 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $17.00 | $1,078.00 | $291.06 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | UNIVERSAL IPA MCAL OP/PROFEE ONLY | UNIVERSAL IPA MCAL OP/PROFEE ONLY | $17.00 | $1,078.00 | $291.06 | 2026-01-31 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | HEALTH CHOICE AZ | HEALTH CHOICE AZ | $20.23 | $982.00 | $343.70 | 2026-02-25 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | APIPA - AHCCCS-ALL OTHER PLANS | APIPA - AHCCCS-ALL OTHER PLANS | $20.23 | $982.00 | $343.70 | 2026-02-25 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $20.39 | — | — | 2026-04-16 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC LCD | ALL PRODUCTS | $20.39 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $20.39 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $20.39 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $20.39 | — | — | 2026-04-16 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC LCD | ALL PRODUCTS | $20.39 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $20.39 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $20.39 | — | — | 2026-04-16 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | CARE 1ST MCAID | CARE 1ST MCAID | $21.24 | $982.00 | $343.70 | 2026-02-25 | MRF ↗ |
| TYLER COUNTY HOSPITAL Outpatient | Blue Cross and Blue Shield | PPO/POS Network Participation | $22.00 | $27.00 | $20.00 | 2025-04-15 | MRF ↗ |
| TYLER COUNTY HOSPITAL Outpatient | Blue Cross and Blue Shield | Blue Essentials | $22.00 | $27.00 | $20.00 | 2025-04-15 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | MERCY CARE AHCCCS DDD | MERCY CARE AHCCCS DDD | $22.25 | $982.00 | $343.70 | 2026-02-25 | MRF ↗ |
| TYLER COUNTY HOSPITAL Outpatient | Blue Cross and Blue Shield | Traditional Indemnity | $23.00 | $27.00 | $20.00 | 2025-04-15 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.39 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.39 | — | — | 2026-04-14 | 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 ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | AETNA | MEDICARE | $29.04 | $257.00 | $38.55 | 2025-12-23 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| NORTHERN MAINE MEDICAL CENTER Outpatient | UHC_MCRADV | UNITED HEALTHCARE MEDICARE ADVANTAGE | $31.35 | $57.00 | $30.00 | 2026-03-25 | MRF ↗ |
| NORTHERN MAINE MEDICAL CENTER Outpatient | MICMAC HEALTH | MICMAC HEALTH | $31.35 | $57.00 | $30.00 | 2026-03-25 | MRF ↗ |
| NORTHERN MAINE MEDICAL CENTER Outpatient | HUMANA_MCRADV | HUMANA MEDICARE ADAVANTAGE | $31.35 | $57.00 | $30.00 | 2026-03-25 | MRF ↗ |
| NORTHERN MAINE MEDICAL CENTER Outpatient | AETNA_MCRADV | AETNA MEDICARE ADVANTAGE | $31.35 | $57.00 | $30.00 | 2026-03-25 | MRF ↗ |
| NORTHERN MAINE MEDICAL CENTER Outpatient | VACCN | VETERANS COMMUNITY CARE NETWORK | $31.35 | $57.00 | $30.00 | 2026-03-25 | MRF ↗ |
| NORTHERN MAINE MEDICAL CENTER Outpatient | GENERATIONS_MCRADV | GENERATIONS MEDICARE ADVANTAGE | $31.35 | $57.00 | $30.00 | 2026-03-25 | MRF ↗ |
| NORTHERN MAINE MEDICAL CENTER Outpatient | WELLCARE | WELLCARE | $31.35 | $57.00 | $30.00 | 2026-03-25 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $31.66 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $31.66 | — | — | 2026-04-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $31.94 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $31.94 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $31.94 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $31.94 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $31.94 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $31.94 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $31.94 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $31.94 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $31.94 | — | — | 2026-04-14 | MRF ↗ |
| NORTHERN MAINE MEDICAL CENTER Outpatient | ANTHEM_MCRADV | ANTHEM MEDICARE ADVANTAGE | $31.98 | $57.00 | $30.00 | 2026-03-25 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | BLUE CROSS-ALL PLANS | BLUE CROSS-ALL PLANS | $32.96 | $103.00 | $82.40 | 2026-03-04 | MRF ↗ |
| DECATUR COUNTY HOSPITAL Both | BLUE CROSS-ALL PLANS | BLUE CROSS-ALL PLANS | $32.96 | $103.00 | $82.40 | 2026-03-04 | 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 | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $35.87 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $35.87 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $35.87 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $35.87 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $35.87 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $35.87 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $35.87 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $35.87 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $35.87 | — | — | 2026-04-14 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | PENSACOLA | CHRISTIAN COLL | $36.00 | $240.00 | $36.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | PENSACOLA | CHRISTIAN COLL | $36.00 | $240.00 | $36.00 | 2025-12-23 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | W/O DAP | $36.29 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | W/O DAP | $36.29 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | PARTIAL | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CMDP | ALL PRODUCTS | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC IHS | ALL PRODUCTS | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | FULLY | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CARE FIRST | ALL PRODUCTS | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | PARTIAL | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC APIPA | ALL PRODUCTS | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CMDP | ALL PRODUCTS | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | ONLY | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC MERCY CARE | ALL PRODUCTS | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | WITH DAP | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | FULLY | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | ONLY | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC MERCY CARE | ALL PRODUCTS | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | BEHAVIORAL HEALTH | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC IHS | ALL PRODUCTS | $37.02 | $2,100.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | WITH DAP | $37.02 | $2,100.00 | — | 2026-01-01 | 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.