27870 — Fusion Of Ankle Joint Open
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). FUSION OF ANKLE JOINT OPEN (HCPCS 27870) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/27870?code_type=HCPCS
MLA (9th ed.)
“FUSION OF ANKLE JOINT OPEN (HCPCS 27870) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/27870?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“FUSION OF ANKLE JOINT OPEN (HCPCS 27870) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/27870?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $5,253–$14,930 (25th–75th percentile) across 1,869 hospitals · 4,195 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 27870 — 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
$5,253
$10,942 typical
$14,930
The middle 50% of negotiated facility rates for this procedure, measured across 1,869 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. | $10,942 |
| Surgeon (professional fee) Estimate national typical Medicare $928 × 1.22 commercial. | $1,132 |
| 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 | $12,782 |
Surgical episode (typical)
~$12,782
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)
~$16,567
- 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 |
|---|---|---|---|---|---|---|---|
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL UNITED HEALTHCARE LABS [106809] | $7.25 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL UNITED HEALTHCARE CARE [300609] | $7.25 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL UNITED HEALTHCARE CARE [700909] | $7.25 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | ALBANY COUNTY CORRECTIONAL FACILITY | ALBANY CORRECTIONAL FACILITY | $7.32 | — | $16,055.28 | 2026-03-31 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL AETNA BETTER HEALTH MEDICAID [300612] | $8.15 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL PRIORITY HEALTH PLAN [106814] | $9.50 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL CIGNA PRIORITY HEALTH [106826] | $9.50 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $9.88 | — | $16,055.28 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $9.88 | — | $16,055.28 | 2026-03-31 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL HUMANA CARE LABS [700905] | $10.36 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL HUMANA LABS [106813] | $10.36 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL MERIDIAN CAID [300605] | $11.30 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL BLUE CROSS COMPLETE [300610] | $13.59 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL MERIDIAN HEALTH ADVANTAGE [700910] | $13.82 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL MED PLUS BLUE CARE [700903] | $13.82 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL WELLCARE CARE [700920] | $13.82 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL MIDWEST HEALTH CAID [300607] | $13.87 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL HAP EMPOWERED [300613] | $13.87 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL AETNA LABS [106802] | $14.92 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL BCN CARE LABS [700902] | $16.06 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $16.48 | — | $16,055.28 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $16.48 | — | $16,055.28 | 2026-03-31 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL CIGNA LABS [106804] | $16.58 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL HAP LABS [106805] | $16.58 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL HAP PPO PLAN [106821] | $16.58 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL PRIORITY HEALTH CARE [700911] | $17.27 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | OMNICARE CARE [700906] | $17.27 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL VACCN [106827] | $17.27 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL MIDWEST HEALTHCARE CARE [700907] | $17.27 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL HAP CARE [700904] | $17.27 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL GENERIC MEDICARE [700914] | $17.27 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL AMERIHEALTH CARITAS VIP [700921] | $17.27 | $52,719.47 | $52,719.47 | 2026-03-23 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | UHC COMMUNITY MEDICAID [2175] | HB XR UHC INDIANA PATHWAYS MEDICAID | $18.04 | $85,155.87 | $52,007.26 | 2025-12-19 | MRF ↗ |
| HOSPITAL FOR SPECIAL SURGERY OutpatientFacility | BLUE CROSS BLUE SHIELD NY [1022] | BCBS INDIVIDUAL NETWORK [102218] | $27.78 | — | $23,694.95 | 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 ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $32.73 | $18,185.00 | $14,325.75 | 2024-12-31 | 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 ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | BCBS MEDICARE [250503] | BCBS MEDICARE REPLACEMENT [25050301] | $36.84 | $177,376.40 | $35,475.28 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | WELLCARE HEALTH PLAN [250516] | MEDICARE REPLACEMENT [25051601] | $36.84 | $177,376.40 | $35,475.28 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | CIGNA MCR HMO/PPO [250525] | MEDICARE REPLACEMENT [25052501] | $36.84 | $177,376.40 | $35,475.28 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | UNITED HEALTH MCR HMO/PPO [250515] | UHC MEDICARE REPLACEMENT [25051501] | $37.49 | $177,376.40 | $35,475.28 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | HUMANA GOLD [250508] | PFFS MEDICARE REPLACEMENT [25050801] | $37.49 | $177,376.40 | $35,475.28 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | AETNA COVENTRY MCR REPLACEMENT [250518] | AETNA MEDICARE [25051801] | $37.49 | $177,376.40 | $35,475.28 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | ALIGN SENIOR CARE [250524] | ALIGN MEDICARE REPLACEMENT [25052401] | $37.55 | $177,376.40 | $35,475.28 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | FREEDOM HEALTH [250505] | FREEDOM HLTH MEDICARE REPLACEMENT [25050501] | $37.55 | $177,376.40 | $35,475.28 | 2026-03-26 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $39.65 | $2,845.00 | $512.10 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $39.65 | $2,845.00 | $654.35 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $39.65 | $2,845.00 | $625.90 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $39.65 | $2,845.00 | $625.90 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $39.65 | $2,845.00 | $768.15 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $39.65 | $2,845.00 | $625.90 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $39.65 | $2,845.00 | $625.90 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $39.65 | $2,845.00 | $739.70 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $39.65 | $2,845.00 | $540.55 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $39.65 | $2,845.00 | $625.90 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $39.65 | $2,845.00 | $512.10 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $39.65 | $2,845.00 | $625.90 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $39.65 | $2,845.00 | $739.70 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $39.65 | $2,845.00 | $654.35 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $39.65 | $2,845.00 | $625.90 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $39.65 | $2,845.00 | $625.90 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $39.65 | $2,845.00 | $682.80 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $39.65 | $2,845.00 | $540.55 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $39.65 | $2,845.00 | $654.35 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $39.65 | $2,845.00 | $654.35 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $39.65 | $2,845.00 | $768.15 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $39.65 | $2,845.00 | $682.80 | 2026-04-14 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EDGERTON HOSPITAL AND HEALTH SERVICES Both | Aetna | Default | $55.00 | $2,869.00 | $2,094.37 | 2026-05-09 | 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 | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 1&2|MVP ESSENTIAL 3&4 | $75.49 | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | INDEPENDENT HEALTH ASSOC|NOVA HEALTHCARE-IHA | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | MEDICARE HMO INDEPENDENT HLTH|NOVA HEALTHCARE MEDICARE | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS ESSENTIAL 1&2|FIDELIS ESSENTIAL 3&4 | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 3&4 | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | AETNA [100] | AETNA MEDICARE ADVANTAGE | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA MEDICAID MANAGED CARE|MOLINA CHILD HEALTH PLUS | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC MEDICARE COMPLETE | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 1&2 | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED BEHAVORIAL HEALTH [120] | UNITED BEHAVORIAL HEALTH|MH OPTUM COMMERCIAL | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC DUAL COMPLETE | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP OPTION|MVP CHILD HEALTH PLUS | $75.49 | $39,000.36 | $31,200.29 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP OPTION|MVP CHILD HEALTH PLUS | $75.49 | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK ESSENTIALS | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS MEDICARE [176] | FIDELIS MEDICARE|FIDELIS DUAL ADVANTAGE | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE DUAL | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 1&2|MVP ESSENTIAL 3&4 | $75.49 | $39,000.36 | $31,200.29 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE MEDICARE HMO | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 3&4 | $75.49 | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE|TRICARE FOR LIFE|MARTINS POINT/US FAMILY | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $82.29 | — | — | 2026-04-14 | MRF ↗ |
| EDGERTON HOSPITAL AND HEALTH SERVICES Both | Quartz | Default | $88.00 | $2,869.00 | $2,094.37 | 2026-05-09 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MVP [109] | MVP EXCHANGE-INDIVIDUAL | $92.36 | $39,000.36 | $31,200.29 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP EXCHANGE-INDIVIDUAL | $92.36 | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | HUMANA MEDICARE HMO | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | WELLCARE TODAY'S OPTIONS [12503] | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | AETNA [100] | AETNA MEDICARE ADVANTAGE | — | $39,000.36 | $25,350.23 | 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 | — | $39,000.36 | $25,350.23 | 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 | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | GENERIC CARRIER [107] | ST REGIS MOHAWK [10724] | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS(INCLUDING GOLD,SILVER,BRONZE AND PLATINUM) | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | FIDELIS CARE NEW YORK [112] | FIDELIS CARE NEW YORK|FIDELIS FHP|FIDELIS CHP | — | $39,000.36 | $25,350.23 | 2024-12-30 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $107.76 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $107.76 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $107.76 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $107.76 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $107.76 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $107.76 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $107.76 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $107.76 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $107.76 | — | — | 2026-04-14 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $108.00 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $108.00 | — | — | 2026-04-01 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $116.00 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Aetna | Aetna Better Health CHIP | $116.00 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $116.00 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $116.09 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $121.01 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $121.01 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $121.01 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $121.01 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $121.01 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $121.01 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $121.01 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $121.01 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $121.01 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $121.80 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $127.60 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | GEISINGER | MANAGED MEDICAID | $127.60 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $127.60 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | GEISINGER | MANAGED MEDICAID | $127.60 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $127.60 | — | — | 2025-08-01 | 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.