28103 — Remove/graft Foot Lesion
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Remove/graft foot lesion (OTHER 28103) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/28103?code_type=OTHER
MLA (9th ed.)
“Remove/graft foot lesion (OTHER 28103) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/28103?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“Remove/graft foot lesion (OTHER 28103) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/28103?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,057–$7,079 (25th–75th percentile) across 44 hospitals · 160 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 28103 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
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 |
|---|---|---|---|---|---|---|---|
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $35.94 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $35.94 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $55.01 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $55.01 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $55.01 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $55.01 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $55.49 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $55.49 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Complete Blue Mcr Adv | $55.49 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Complete Blue Mcr Adv | $55.49 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Coventry | $55.80 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Coventry | $55.80 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Freedom Blue Mcr Adv | $56.08 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Freedom Blue Mcr Adv | $56.08 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | $59.03 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | $59.03 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | $59.03 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | $59.03 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | $59.03 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | $59.03 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicare | Traditional Medicare | $59.03 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | $59.03 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicare | Traditional Medicare | $59.03 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | $59.03 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | $59.03 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | $59.03 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | $59.03 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | $59.03 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Aetna | Medicaid | $59.90 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid | Medicaid Illinois | $59.90 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Veteran Affairs | Traditional | $59.90 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Aetna | Medicare | $59.90 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicare | Medicare | $59.90 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Molina | Medicaid Illinois | $59.90 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Mutual Medical | Commercial | $59.90 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Medicare | $59.90 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Medicare | $59.90 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicare | Medicare | $59.90 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Mutual Medical | Commercial | $59.90 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Veteran Affairs | Traditional | $59.90 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Meridian | Medicaid Illinois | $59.90 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid | Medicaid Illinois | $59.90 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Humana | Medicare | $59.90 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Aetna | Medicaid | $59.90 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Aetna | Medicare | $59.90 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Medicare | $59.90 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Meridian | Medicaid Illinois | $59.90 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Molina | Medicaid Illinois | $59.90 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Humana | Medicare | $59.90 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Medicare | $59.90 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Mcr Advantage | $60.21 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Mcr Advantage | $60.21 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Hmo Epo | $60.21 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Hmo Epo | $60.21 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Geisinger | Mcr Advantage | $60.80 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Humana | Mcr Advantage | $60.80 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Geisinger | Mcr Advantage | $60.80 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Mcr Advantage | $60.80 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Humana | Mcr Advantage | $60.80 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Mcr Advantage | $60.80 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Mcr Advantage | $63.75 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Mcr Advantage | $63.75 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Security Blue Mcr Adv | $64.34 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Security Blue Mcr Adv | $64.34 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $83.58 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $83.58 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $91.48 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $91.48 | — | — | 2026-05-23 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $154.99 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $154.99 | — | — | 2026-05-24 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicaid | Traditional Medicaid | $195.00 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicaid | Traditional Medicaid | $195.00 | — | — | 2026-05-14 | MRF ↗ |
| Temple University Hospital - Transplant Center | Medicaid Managed Care Other | — | $195.00 | $52,022.00 | $6,679.35 | 2026-07-30 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Medicaid | Traditional Medicaid | $195.00 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Mcd Advantage | $195.00 | — | — | 2026-05-23 | MRF ↗ |
| Jeanes Hospital | Medicaid Managed Care Other | — | $195.00 | $52,022.00 | $6,679.35 | 2026-07-31 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Chip | $195.00 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Chip | $195.00 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Mcd Advantage | $195.00 | — | — | 2026-05-14 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Medicaid | Traditional Medicaid | $195.00 | — | — | 2026-05-13 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Mcd Advantage | $210.60 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Mcd Advantage | $210.60 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Jefferson Health | Mcd Advantage | $214.50 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Jefferson Health | Mcd Advantage | $214.50 | — | — | 2026-05-14 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Jefferson Health Plan | Mcd Advantage | $214.50 | — | — | 2026-05-23 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Amerihealth | Mcd Advantage | $214.50 | — | — | 2026-05-23 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Amerihealth | Mcd Advantage | $214.50 | — | — | 2026-05-13 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Jefferson Health Plan | Mcd Advantage | $214.50 | — | — | 2026-05-13 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Geisinger | Mcd Advantage | $214.50 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Geisinger | Mcd Advantage | $214.50 | — | — | 2026-05-23 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Geisinger | Mcd Advantage | $235.95 | — | — | 2026-05-23 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Geisinger | Mcd Advantage | $235.95 | — | — | 2026-05-13 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $237.22 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $237.22 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Commercial | $237.22 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Hfn | Commercial | $237.22 | — | — | 2026-05-24 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Complete Blue Mcr Adv | $239.29 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $239.29 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Complete Blue Mcr Adv | $239.29 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Community Blue Mcr Adv | $239.29 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Coventry | $240.63 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Coventry | $240.63 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Freedom Blue Mcr Adv | $241.84 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Freedom Blue Mcr Adv | $241.84 | — | — | 2026-05-23 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Upmc | Medicaid | $243.75 | — | — | 2026-05-23 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Upmc | Medicaid | $243.75 | — | — | 2026-05-13 | MRF ↗ |
| UNIVERSITY OF MICHIGAN HEALTH - SPARROW EATON Both | Medicaid | Professional Facility | $250.91 | $784.00 | $392.00 | 2026-05-09 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | $254.57 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | $254.57 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | $254.57 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | $254.57 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | $254.57 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | $254.57 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | $254.57 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicare | Traditional Medicare | $254.57 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Traditional Medicare | Traditional Medicare | $254.57 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | $254.57 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | $254.57 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | $254.57 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | $254.57 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | $254.57 | — | — | 2026-05-23 | MRF ↗ |
| O U MEDICAL CENTER | Healthchoice Ppo | — | $254.81 | $2,548.07 | $254.81 | 2026-07-31 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Molina | Medicaid Illinois | $258.32 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Veteran Affairs | Traditional | $258.32 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Medicare | $258.32 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Aetna | Medicaid | $258.32 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Medicare | $258.32 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Aetna | Medicare | $258.32 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid | Medicaid Illinois | $258.32 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Humana | Medicare | $258.32 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicare | Medicare | $258.32 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Meridian | Medicaid Illinois | $258.32 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | United Healthcare | Medicare | $258.32 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicaid | Medicaid Illinois | $258.32 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Meridian | Medicaid Illinois | $258.32 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Medicare | Medicare | $258.32 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Mutual Medical | Commercial | $258.32 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Molina | Medicaid Illinois | $258.32 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Veteran Affairs | Traditional | $258.32 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Aetna | Medicaid | $258.32 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Aetna | Medicare | $258.32 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Humana | Medicare | $258.32 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Mutual Medical | Commercial | $258.32 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Medicare | $258.32 | — | — | 2026-05-24 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Mcr Advantage | $259.66 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Hmo Epo | $259.66 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Mcr Advantage | $259.66 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Hmo Epo | $259.66 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Mcr Advantage | $262.21 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Humana | Mcr Advantage | $262.21 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Geisinger | Mcr Advantage | $262.21 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Geisinger | Mcr Advantage | $262.21 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Uhc | Mcr Advantage | $262.21 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Humana | Mcr Advantage | $262.21 | — | — | 2026-05-14 | MRF ↗ |
| NEW LONDON HOSPITAL Outpatient | Martin'S Point Health Care | Martin'S Point - Us Family Health Plan | $265.22 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Mcr Advantage | $274.93 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Aetna | Mcr Advantage | $274.93 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Security Blue Mcr Adv | $277.48 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Security Blue Mcr Adv | $277.48 | — | — | 2026-05-14 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $336.94 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $336.94 | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $360.44 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $360.44 | — | — | 2026-05-14 | MRF ↗ |
| UNIVERSITY OF MICHIGAN HEALTH - SPARROW EATON Both | Medicare | Professional | $370.74 | $784.00 | $392.00 | 2026-05-09 | MRF ↗ |
| NEW LONDON HOSPITAL Outpatient | Wellsense Health Plan | Wellsense - Nh Managed Medicaid | $375.54 | — | — | 2026-05-23 | MRF ↗ |
| NEW LONDON HOSPITAL Outpatient | Granite State Health Plan | New Hampshire Healthy Families - Nh Managed Medicaid | $375.54 | — | — | 2026-05-23 | MRF ↗ |
| NEW LONDON HOSPITAL Outpatient | Amerihealth Caritas Nh | Amerihealth Caritas - Nh Managed Medicaid | $379.18 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $394.51 | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Upmc | Commercial | $394.51 | — | — | 2026-05-14 | MRF ↗ |
| NEW LONDON HOSPITAL Outpatient | Anthem Health Plans Of Nh | Anthem Indiv Qhp - Exchange | $395.90 | — | — | 2026-05-23 | MRF ↗ |
| ST GABRIELS HOSPITAL | Medicaid|Bcbs - Mn|All Plans | — | $396.28 | $1,121.00 | $560.50 | 2026-07-31 | MRF ↗ |
| ST GABRIELS HOSPITAL | Medicaid|Medica|All Plans | — | $414.77 | $1,121.00 | $560.50 | 2026-07-31 | MRF ↗ |
| ST GABRIELS HOSPITAL | Medicaid|Health Partners|All Plans | — | $414.77 | $1,121.00 | $560.50 | 2026-07-31 | MRF ↗ |
| ST GABRIELS HOSPITAL | Medicaid|Ucare|All Plans | — | $414.77 | $1,121.00 | $560.50 | 2026-07-31 | MRF ↗ |
| CHI ST LUKES HEALTH MEMORIAL LIVINGSTON | Medicaid|Amerigroup|All Plans | — | $429.86 | — | — | 2026-07-31 | MRF ↗ |
| Jeanes Hospital | Jns Keystone First | — | $429.98 | $52,022.00 | $6,679.35 | 2026-07-31 | MRF ↗ |
| Temple University Hospital - Transplant Center | Keystone First | — | $429.98 | $52,022.00 | $6,679.35 | 2026-07-30 | MRF ↗ |
| CHI OAKES HOSPITAL | Medicare|Medica|All Plans | — | $430.66 | — | — | 2026-07-31 | MRF ↗ |
| ST GABRIELS HOSPITAL | Medicare|Bcbs - Mn|All Plans | — | $431.20 | $1,121.00 | $560.50 | 2026-07-31 | MRF ↗ |
| ST JOSEPHS AREA HEALTH SERVICES | Medicare|Prime West Health|All Plans | — | $431.20 | — | — | 2026-08-01 | MRF ↗ |
| ST GABRIELS HOSPITAL | Medicare|Humana|All Plans | — | $431.20 | $1,121.00 | $560.50 | 2026-07-31 | MRF ↗ |
| ST GABRIELS HOSPITAL | Medicare|Ucare|All Plans | — | $431.20 | $1,121.00 | $560.50 | 2026-07-31 | MRF ↗ |
| ST JOSEPHS AREA HEALTH SERVICES | Medicare|Humana|All Plans | — | $431.20 | — | — | 2026-08-01 | MRF ↗ |
| ST JOSEPHS AREA HEALTH SERVICES | Medicare|Medica|All Plans | — | $431.20 | — | — | 2026-08-01 | MRF ↗ |
| ST JOSEPHS AREA HEALTH SERVICES | Medicare|Ucare|All Plans | — | $431.20 | — | — | 2026-08-01 | MRF ↗ |
| ST GABRIELS HOSPITAL | Medicare|Medica|All Plans | — | $431.20 | $1,121.00 | $560.50 | 2026-07-31 | MRF ↗ |
| ST JOSEPHS AREA HEALTH SERVICES | Medicare|Bcbs - Mn|All Plans | — | $431.20 | — | — | 2026-08-01 | MRF ↗ |
| NEW LONDON HOSPITAL Outpatient | Harvard Pilgrim Health Care Of Ne | Hphc Fully Insured - Exchange | $453.58 | — | — | 2026-05-23 | MRF ↗ |
| NEW LONDON HOSPITAL Outpatient | Harvard Pilgrim Health Care Of Ne | Hphc Fully Insured - Elevatehealth Qhp - Exchange | $453.58 | — | — | 2026-05-23 | MRF ↗ |
| JOHN H STROGER JR HOSPITAL Both | Aetna | Hmo | $455.51 | $970.00 | $679.00 | 2026-05-14 | MRF ↗ |
| JOHN H STROGER JR HOSPITAL Both | Aetna | Ppo | $455.51 | $970.00 | $679.00 | 2026-05-14 | MRF ↗ |
| PROVIDENT HOSPITAL OF CHICAGO Both | Aetna | Hmo | $455.51 | $970.00 | $679.00 | 2026-05-22 | MRF ↗ |
| PROVIDENT HOSPITAL OF CHICAGO Both | Aetna | Ppo | $455.51 | $970.00 | $679.00 | 2026-05-22 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Upmc | Chip | $474.18 | — | — | 2026-05-13 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Upmc | Chip | $474.18 | — | — | 2026-05-23 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Upmc | Chip | $474.18 | — | — | 2026-05-13 | MRF ↗ |
| CLARION HOSPITAL Outpatient | Upmc | Chip | $474.18 | — | — | 2026-05-23 | MRF ↗ |
| NEW LONDON HOSPITAL Outpatient | Harvard Pilgrim Health Care Of Ne | Hphc Fully Insured - Hmo/Pos/Ppo | $497.02 | — | — | 2026-05-23 | MRF ↗ |
| JOHN H STROGER JR HOSPITAL Both | Uhc | Hmo | $498.40 | $970.00 | $679.00 | 2026-05-14 | MRF ↗ |
| JOHN H STROGER JR HOSPITAL Both | Uhc | Ppo | $498.40 | $970.00 | $679.00 | 2026-05-14 | 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.