28315 — Removal Of Sesamoid Bone
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). REMOVAL OF SESAMOID BONE (CPT 28315) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/28315?code_type=CPT
MLA (9th ed.)
“REMOVAL OF SESAMOID BONE (CPT 28315) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/28315?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“REMOVAL OF SESAMOID BONE (CPT 28315) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/28315?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,797–$5,132 (25th–75th percentile) across 1,894 hospitals · 4,428 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 28315 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Estimated complete episode
What the whole episode might cost
Your hospital facility price plus the separately-billed professional fees a complete episode adds. The facility figure is an actual negotiated rate from our data; the surgeon and anesthesia fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$1,797
$3,355 typical
$5,132
The middle 50% of negotiated facility rates for this procedure, measured across 1,894 hospitals. The surgeon and anesthesia fees are modeled estimates added on top.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $3,355 |
| Surgeon (professional fee) Estimate national typical Medicare $311 × 1.22 commercial. | $379 |
| Anesthesia Estimate national typical Generic anesthesia (~90 min typical, median CMS base units). Medicare $225 × 3.14 commercial. Approximate — no procedure-specific anesthesia mapping for this code. | $708 |
| Likely subtotal | $4,443 |
Surgical episode (typical)
~$4,443
Your recovery plan — adjust to what your doctor told you
After your procedure, recovery care is billed separately. We pre-fill the typical plan; change it to your situation.
Recovery cost modeled
~$3,785
With your recovery plan (typical)
~$8,228
- 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 |
|---|---|---|---|---|---|---|---|
| CRESCENT MEDICAL CENTER LANCASTER Outpatient | Prime Health Services | Commercial | $1.00 | $1.00 | $1.00 | 2026-05-27 | MRF ↗ |
| MUENSTER MEMORIAL HOSPITAL Outpatient | Superior HealthPlan | Commercial | $1.00 | $1.00 | $1.00 | 2026-04-03 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER Outpatient | Cigna Health Springs | Commercial | $1.00 | $1.00 | $1.00 | 2026-05-27 | MRF ↗ |
| MUENSTER MEMORIAL HOSPITAL Outpatient | Aetna | Commercial | $1.00 | $1.00 | $1.00 | 2026-04-03 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER Outpatient | Friday Health Insurance Company | Commercial | $1.00 | $1.00 | $1.00 | 2026-05-27 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL OutpatientFacility | — | — | — | $1.00 | — | 2024-10-08 | MRF ↗ |
| MUENSTER MEMORIAL HOSPITAL Outpatient | Blue Cross and Blue Shield of Texas | Commercial | $1.00 | $1.00 | $1.00 | 2026-04-03 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER Outpatient | Blue Cross of Blue Shield of Texas | Traditional Immidiate Bussiness | $1.00 | $1.00 | $1.00 | 2026-05-27 | MRF ↗ |
| MITCHELL COUNTY HOSPITAL DISTRICT Outpatient | Aetna | Commercial | $1.00 | $3.00 | $2.00 | 2026-05-22 | MRF ↗ |
| FRIO REGIONAL HOSPITAL Outpatient | Blue Cross Blue Shield of Texas | HMO | $2.00 | $2.00 | $1.00 | 2026-05-15 | MRF ↗ |
| FRIO REGIONAL HOSPITAL Outpatient | Aetna | Commercial | $2.00 | $2.00 | $1.00 | 2026-05-15 | MRF ↗ |
| HUNTSVILLE MEMORIAL HOSPITAL Outpatient | Three Rivers Provider Network | Commercial | $2.00 | $3.00 | $1.00 | 2026-03-26 | MRF ↗ |
| CLAY COUNTY MEMORIAL HOSPITAL Outpatient | Healthsmart | Commercial | $2.00 | $11.00 | $8.00 | 2025-06-30 | MRF ↗ |
| HUNTSVILLE MEMORIAL HOSPITAL Outpatient | Blue Cross and Blue Shield of Texas | Blue Advantage HMO | $2.00 | $3.00 | $1.00 | 2026-03-26 | MRF ↗ |
| HUNTSVILLE MEMORIAL HOSPITAL Outpatient | Prime Health Services | Commercial | $2.00 | $3.00 | $1.00 | 2026-03-26 | MRF ↗ |
| FRIO REGIONAL HOSPITAL Outpatient | Blue Cross Blue Shield of Texas | Traditional | $2.00 | $2.00 | $1.00 | 2026-05-15 | MRF ↗ |
| CLAY COUNTY MEMORIAL HOSPITAL Outpatient | Muti-Plan | Commercial | $2.00 | $11.00 | $8.00 | 2025-06-30 | MRF ↗ |
| FRIO REGIONAL HOSPITAL Outpatient | Blue Cross Blue Shield of Texas | Blue Advantage | $2.00 | $2.00 | $1.00 | 2026-05-15 | MRF ↗ |
| FRIO REGIONAL HOSPITAL Outpatient | ChoiceCare | Commercial | $2.00 | $2.00 | $1.00 | 2026-05-15 | MRF ↗ |
| MITCHELL COUNTY HOSPITAL DISTRICT Outpatient | Blue Cross and Blue Shield of Texas | HMO | $2.00 | $3.00 | $2.00 | 2026-05-22 | MRF ↗ |
| MITCHELL COUNTY HOSPITAL DISTRICT Outpatient | Blue Cross and Blue Shield of Texas | Blue Advantage HMO | $2.00 | $3.00 | $2.00 | 2026-05-22 | MRF ↗ |
| HUNTSVILLE MEMORIAL HOSPITAL Outpatient | Humana | Commercial | $2.00 | $3.00 | $1.00 | 2026-03-26 | MRF ↗ |
| FRIO REGIONAL HOSPITAL Outpatient | ChoiceCare | Medicare Advantage | $2.00 | $2.00 | $1.00 | 2026-05-15 | MRF ↗ |
| MITCHELL COUNTY HOSPITAL DISTRICT Outpatient | Blue Cross and Blue Shield of Texas | PPO | $2.00 | $3.00 | $2.00 | 2026-05-22 | MRF ↗ |
| FRIO REGIONAL HOSPITAL Outpatient | United Healthcare | Commercial | $2.00 | $2.00 | $1.00 | 2026-05-15 | MRF ↗ |
| HUNTSVILLE MEMORIAL HOSPITAL Outpatient | Texas Children's Health Plan | HMO | $2.00 | $3.00 | $1.00 | 2026-03-26 | MRF ↗ |
| MITCHELL COUNTY HOSPITAL DISTRICT Outpatient | Blue Cross and Blue Shield of Texas | Commercial | $2.00 | $3.00 | $2.00 | 2026-05-22 | MRF ↗ |
| FRIO REGIONAL HOSPITAL Outpatient | Humana | Commercial | $2.00 | $2.00 | $1.00 | 2026-05-15 | MRF ↗ |
| MITCHELL COUNTY HOSPITAL DISTRICT Outpatient | Cigna | Commercial | $2.00 | $3.00 | $2.00 | 2026-05-22 | MRF ↗ |
| HUNTSVILLE MEMORIAL HOSPITAL Outpatient | Blue Cross and Blue Shield of Texas | PPO | $2.00 | $3.00 | $1.00 | 2026-03-26 | MRF ↗ |
| FRIO REGIONAL HOSPITAL Outpatient | Humana | Medicare Advantage | $2.00 | $2.00 | $1.00 | 2026-05-15 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Independence Keystone Health Plan | Commercial | $3.00 | $4.00 | $4.00 | 2026-03-31 | MRF ↗ |
| HUNTSVILLE MEMORIAL HOSPITAL Outpatient | Scott and White | Commercial | $3.00 | $3.00 | $1.00 | 2026-03-26 | MRF ↗ |
| HUNTSVILLE MEMORIAL HOSPITAL Outpatient | Multiplan | Commercial | $3.00 | $3.00 | $1.00 | 2026-03-26 | MRF ↗ |
| HUNTSVILLE MEMORIAL HOSPITAL Outpatient | Rockport | Commercial | $3.00 | $3.00 | $1.00 | 2026-03-26 | MRF ↗ |
| CLAY COUNTY MEMORIAL HOSPITAL Outpatient | Cigna | Commercial | $3.00 | $11.00 | $8.00 | 2025-06-30 | MRF ↗ |
| CLAY COUNTY MEMORIAL HOSPITAL Outpatient | Aetna | Commercial | $3.00 | $11.00 | $8.00 | 2025-06-30 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Amerihealth | HMO | $3.00 | $4.00 | $4.00 | 2026-03-31 | MRF ↗ |
| CLAY COUNTY MEMORIAL HOSPITAL Outpatient | Blue Cross Blue Shield | Commercial | $4.00 | $11.00 | $8.00 | 2025-06-30 | MRF ↗ |
| HUNTSVILLE MEMORIAL HOSPITAL Outpatient | Cigna | Medicare Advantage | $4.00 | $3.00 | $1.00 | 2026-03-26 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Aetna | Commercial | $4.00 | $4.00 | $4.00 | 2026-03-31 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $4.47 | $1,470.00 | $1,102.50 | 2025-03-07 | MRF ↗ |
| PACIFICA HOSPITAL OF THE VALLEY Outpatient | Aetna | Commercial | $9.00 | $18.00 | $18.00 | 2025-11-19 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $11.75 | $6,529.00 | $3,268.13 | 2024-12-31 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $927.00 | $203.94 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $927.00 | $222.48 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $927.00 | $250.29 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $927.00 | $203.94 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $927.00 | $166.86 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $927.00 | $222.48 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $927.00 | $203.94 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $927.00 | $250.29 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $927.00 | $176.13 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $927.00 | $203.94 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $927.00 | $213.21 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $927.00 | $203.94 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $927.00 | $213.21 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $927.00 | $213.21 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $927.00 | $203.94 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $927.00 | $203.94 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $927.00 | $241.02 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $927.00 | $213.21 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $927.00 | $166.86 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $16.00 | $927.00 | $176.13 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $927.00 | $241.02 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $16.00 | $927.00 | $203.94 | 2026-04-14 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Outpatient | Tricare | Commercial | $17.00 | $107.00 | $107.00 | 2025-11-07 | MRF ↗ |
| PACIFICA HOSPITAL OF THE VALLEY Outpatient | Heritage Provider Network | Medi-Cal | $18.00 | $18.00 | $18.00 | 2025-11-19 | MRF ↗ |
| PACIFICA HOSPITAL OF THE VALLEY Outpatient | Altamed | Commercial | $18.00 | $18.00 | $18.00 | 2025-11-19 | MRF ↗ |
| PACIFICA HOSPITAL OF THE VALLEY Outpatient | Molina | Medi-Cal | $18.00 | $18.00 | $18.00 | 2025-11-19 | MRF ↗ |
| PACIFICA HOSPITAL OF THE VALLEY Outpatient | Blue Cross Blue Shield - CA | Medi-Cal | $18.00 | $18.00 | $18.00 | 2025-11-19 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $18.76 | $11,074.00 | $11,074.00 | 2026-02-13 | MRF ↗ |
| MERCY MEDICAL CTR OutpatientFacility | CARELON HEALTH MEDICAID | CARELON MEDICAID | $23.37 | — | $6,940.05 | 2026-03-31 | MRF ↗ |
| GORDON MEMORIAL HOSPITAL DISTRICT Outpatient | United Healthcare | Medicare Advantage | $25.00 | $54.00 | $54.00 | 2025-07-09 | MRF ↗ |
| MERCY MEDICAL CTR OutpatientFacility | WELLSENSE HEALTH PLAN | WELLSENSE SILVER | $25.60 | — | $6,940.05 | 2026-03-31 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE DUAL | — | $6,793.89 | $4,416.03 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE MEDICARE HMO | — | $6,793.89 | $4,416.03 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC DUAL COMPLETE | — | $6,793.89 | $4,416.03 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | AETNA [100] | AETNA MEDICARE ADVANTAGE | — | $6,793.89 | $4,416.03 | 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 | — | $6,793.89 | $4,416.03 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 3&4 | — | $6,793.89 | $4,416.03 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS ESSENTIAL 1&2|FIDELIS ESSENTIAL 3&4 | — | $6,793.89 | $4,416.03 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | INDEPENDENT HEALTH ASSOC|NOVA HEALTHCARE-IHA | — | $6,793.89 | $4,416.03 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED BEHAVORIAL HEALTH [120] | UNITED BEHAVORIAL HEALTH|MH OPTUM COMMERCIAL | — | $6,793.89 | $4,416.03 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 1&2 | — | $6,793.89 | $4,416.03 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK ESSENTIALS | — | $6,793.89 | $4,416.03 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE|TRICARE FOR LIFE|MARTINS POINT/US FAMILY | — | $6,793.89 | $4,416.03 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS MEDICARE [176] | FIDELIS MEDICARE|FIDELIS DUAL ADVANTAGE | — | $6,793.89 | $4,416.03 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA MEDICAID MANAGED CARE|MOLINA CHILD HEALTH PLUS | — | $6,793.89 | $4,416.03 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | MEDICARE HMO INDEPENDENT HLTH|NOVA HEALTHCARE MEDICARE | — | $6,793.89 | $4,416.03 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC MEDICARE COMPLETE | — | $6,793.89 | $4,416.03 | 2024-12-30 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $26.91 | — | — | 2026-04-14 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | MASSHEALTH [20302] | All MASSHEALTH MH [90] Plans | $30.40 | $36,456.80 | $36,456.83 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER MH [123] Plans | $30.40 | $36,456.80 | $36,456.83 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | MGB MEDICAID [10906] | All MGB (FORMERLY AHP) ACO MH [202] Plans | $30.40 | $36,456.80 | $36,456.83 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | FALLON MEDICAID [10904] | All FALLON ACO MH [80] Plans | $30.40 | $36,456.80 | $36,456.83 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | INSTITUTION [10406] | All WORCESTER RECOVERY MH [234] Plans | $30.40 | $36,456.80 | $36,456.83 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | FALLON MEDICAID [10904] | All FALLON MCO MH [225] Plans | $30.40 | $36,456.80 | $36,456.83 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | HNE MEDICAID [10905] | All HEALTH NEW ENGLAND/MINUTEMAN MCO MH [221] Plans | $30.40 | $36,456.80 | $36,456.83 | 2025-12-08 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) MH [8] Plans | $30.40 | $36,456.80 | $36,456.83 | 2025-12-08 | 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 ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $35.09 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $35.09 | — | — | 2026-04-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $35.24 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $35.24 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $35.24 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $35.24 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $35.24 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $35.24 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $35.24 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $35.24 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $35.24 | — | — | 2026-04-14 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Amerihealth | HMO | $36.00 | $45.00 | $45.00 | 2026-03-31 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Independence Keystone Health Plan | Commercial | $36.00 | $45.00 | $45.00 | 2026-03-31 | MRF ↗ |
| COOSA VALLEY MEDICAL CENTER Outpatient | Health Spring | Commercial | $37.00 | $105.00 | $25.00 | 2026-01-28 | MRF ↗ |
| UMASS MEMORIAL HEALTHCARE-MARLBOROUGH HOSPITAL Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE SPECIAL KIDS (FORMERLY BMC) MH [256] Plans | $38.00 | $36,456.80 | $36,456.83 | 2025-12-08 | MRF ↗ |
| COOSA VALLEY MEDICAL CENTER Outpatient | Health Spring | Commercial | $39.00 | $110.00 | $26.00 | 2026-01-28 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $39.57 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $39.57 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $39.57 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $39.57 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $39.57 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $39.57 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $39.57 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $39.57 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $39.57 | — | — | 2026-04-14 | MRF ↗ |
| GORDON MEMORIAL HOSPITAL DISTRICT Outpatient | Midlands Choice | Commercial | $43.00 | $54.00 | $54.00 | 2025-07-09 | MRF ↗ |
| LIFECARE MEDICAL CENTER Outpatient | BCBS MHCP | BCBS MHCP | $43.29 | $118.00 | $103.84 | 2026-02-03 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Hpk (Incl. Cigna) | Commercial | — | $1,032.00 | $774.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Wppa/Providrscare | Commercial | — | $1,032.00 | $774.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | United Healthcare | Commercial | — | $1,032.00 | $774.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Healthy Blue | Medicaid | — | $1,032.00 | $774.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Ks | Commercial | $44.34 | $1,032.00 | $774.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Aetna | Commercial | — | $1,032.00 | $774.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Phcs/Multiplan | Commercial | — | $1,032.00 | $774.00 | 2026-05-18 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Sunflower | Medicaid | — | $1,032.00 | $774.00 | 2026-05-18 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Aetna | Commercial | $45.00 | $45.00 | $45.00 | 2026-03-31 | MRF ↗ |
| COOSA VALLEY MEDICAL CENTER Outpatient | Aetna | Commercial | $48.00 | $105.00 | $25.00 | 2026-01-28 | MRF ↗ |
| COLUMBUS COMMUNITY HOSPITAL OutpatientFacility | ICARE | MEDICARE ADVANTAGE | $48.72 | $168.00 | $92.40 | 2026-04-01 | MRF ↗ |
| EAST COOPER 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 ↗ |
| FAIRCHILD MEDICAL CENTER Outpatient | MEDI-CAL | MEDI-CAL | $50.00 | $788.00 | $788.00 | 2025-12-03 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| COOSA VALLEY MEDICAL CENTER Outpatient | Aetna | Commercial | $51.00 | $110.00 | $26.00 | 2026-01-28 | MRF ↗ |
| GORDON MEMORIAL HOSPITAL DISTRICT Outpatient | Medica | Commercial | $51.00 | $54.00 | $54.00 | 2025-07-09 | MRF ↗ |
| GORDON MEMORIAL HOSPITAL DISTRICT Outpatient | Blue Cross Blue Shield | Commercial | $51.00 | $54.00 | $54.00 | 2025-07-09 | MRF ↗ |
| GORDON MEMORIAL HOSPITAL DISTRICT Outpatient | United Healthcare | Commercial | $51.00 | $54.00 | $54.00 | 2025-07-09 | MRF ↗ |
| LIFECARE MEDICAL CENTER Outpatient | MEDICA MCAID | MEDICA MCAID | $54.52 | $118.00 | $103.84 | 2026-02-03 | MRF ↗ |
| CALAIS COMMUNITY HOSPITAL Outpatient | Anthem | Medicare Advantage | $55.00 | $265.00 | $199.00 | 2025-10-01 | MRF ↗ |
| CALAIS COMMUNITY HOSPITAL Outpatient | United Healthcare | Medicare Advantage | $55.00 | $265.00 | $199.00 | 2025-10-01 | MRF ↗ |
| EDGERTON HOSPITAL AND HEALTH SERVICES Both | Aetna | Default | $55.00 | $911.00 | $665.03 | 2026-05-09 | MRF ↗ |
| EDGERTON HOSPITAL AND HEALTH SERVICES Both | United Healthcare | Default | — | $911.00 | $665.03 | 2026-05-09 | MRF ↗ |
| LIFECARE MEDICAL CENTER Outpatient | MEDICA MCR ADV | MEDICA MCR ADV | $55.46 | $118.00 | $103.84 | 2026-02-03 | MRF ↗ |
| LIFECARE MEDICAL CENTER Outpatient | UHC VA CCN | UHC VA CCN | $55.46 | $118.00 | $103.84 | 2026-02-03 | MRF ↗ |
| LIFECARE MEDICAL CENTER Outpatient | BCBS MCR ADV | BCBS MCR ADV | $55.46 | $118.00 | $103.84 | 2026-02-03 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $56.51 | — | — | 2026-04-14 | MRF ↗ |
| LIFECARE MEDICAL CENTER Outpatient | UCARE MCR ADV | UCARE MCR ADV | $59.00 | $118.00 | $103.84 | 2026-02-03 | MRF ↗ |
| LIFECARE MEDICAL CENTER Outpatient | UCARE SR HLTH OPTIONS (MSHO) | UCARE SR HLTH OPTIONS (MSHO) | $59.00 | $118.00 | $103.84 | 2026-02-03 | MRF ↗ |
| LIFECARE MEDICAL CENTER Outpatient | UCARE MCR SELECT | UCARE MCR SELECT | $59.00 | $118.00 | $103.84 | 2026-02-03 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $64.79 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $64.79 | — | — | 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.