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 $1,751–$5,120 (25th–75th percentile) across 2,302 hospitals · 5,030 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
$1,751
$3,310 typical
$5,120
The middle 50% of negotiated facility rates for this procedure, measured across 2,302 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. | $3,310 |
| Surgeon (professional fee) Estimate national typical Medicare $311 × 1.22 commercial. | $379 |
| Anesthesia Estimate national typical 01480, ~90 min typical. Medicare $184 × 3.14 commercial. | $579 |
| Likely subtotal | $4,268 |
Surgical episode (typical)
~$4,268
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge (see the recovery plan below)
- Complications, revisions, or readmissions
- Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)
The biggest swing: which insurer's rate applies — negotiated prices here run $1,751–$5,120.
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)
~$8,053
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
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 |
|---|---|---|---|---|---|---|---|
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | HEALTHSMART | HEALTHSMART WORKERS COMP | $0.17 | — | — | 2026-05-20 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Ohana Care | Medicaid | $0.18 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Hmsa | Medicaid | $0.19 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $0.20 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | HEALTHSMART | HEALTHSMART WORKERS COMP | $0.22 | — | — | 2026-09-02 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | Ohana Care | Medicaid | $0.28 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | Hmsa | Medicaid | $0.28 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | Ohana Care | Medicaid | $0.28 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | Hmsa | Medicaid | $0.28 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Carolina Complete Health | Managed Medicaid | $0.28 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | United Healthcare | Compass | $0.35 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Healthy Blue | Managed Medicaid | $0.37 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Wellcare | Managed Medicaid | $0.37 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | United Healthcare | Managed Medicaid | $0.37 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Aetna Nc State Health Plan | Commercial | $0.48 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Aetna | Commercial | $0.58 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Aetna New Business | Commerical | $0.58 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Cigna | Commercial | $0.60 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Medcost | Commercial | $0.60 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Nc | Commercial | $0.64 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Fidelis | Medicaid | $0.69 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Uhc | Medicaid | $0.69 | — | — | 2026-10-12 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | Multiplan | Commercial | $0.70 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | Multiplan | Commercial | $0.70 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Fidelis Exchange | Commercial | $0.72 | — | — | 2026-10-12 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Humana Choicecare | Commercial | $0.75 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Humana | Commercial | $0.75 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | United Healthcare | Commercial | $0.77 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | First Health | Commercial | $0.80 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | First Health | Commercial | $0.80 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| The Queen's Medical Center Outpatient | First Health | Commercial | $0.80 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Multiplan | Commercial | $0.82 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| The Queen's Medical Center Outpatient | Humana | Commercial | $0.90 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| Wahiawa General Hospital Outpatient | Humana | Commercial | $0.90 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| THE QUEENS MEDICAL CENTER Outpatient | Humana | Commercial | $0.90 | $1.00 | $0.70 | 2026-07-15 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | CARE1ST MEDICARE ADVANTAGE | CARE1ST MEDICARE ADVANTAGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE - OPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| CITIZENS BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Harvard Pilgrim Health Care | Medicare Advantage | $1.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| MUENSTER MEMORIAL HOSPITAL Outpatient | Aetna | Commercial | $1.00 | $1.00 | $1.00 | 2026-04-03 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Aetna Medicare | Aetna Medicare | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE SHIELD - MANTECA SURGERY CENTER MEDICARE ADVANTAGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR KIDS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | HUMANA | HUMANA MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Coventry Health Care | Coventry Health Care | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Aetna | Aetna | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Securehorizons Direct | Securehorizons Direct | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR PLUS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE SHIELD PROMISE MEDICARE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Anthem | Anthem Exchange | $1.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID NON UHRIP | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Anthem | Medicare Advantage | $1.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Midlands Choice | Midlands Choice | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HILL REGIONAL HOSPITAL Outpatient | United Healthcare of Texas | Commercial | $1.00 | $1.00 | $1.00 | 2025-11-06 | MRF ↗ |
| Carolinas Continuecare Hospital At Pineville Outpatient | MultiPlan | PPO | $1.00 | $1.00 | $1.00 | 2025-11-25 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE COMMERCIAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HILL REGIONAL HOSPITAL Outpatient | Cigna | PPO | $1.00 | $1.00 | $1.00 | 2025-11-06 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | United Medical Resources | United Medical Resources | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID STAR PLUS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE CHARTER | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| MUENSTER MEMORIAL HOSPITAL Outpatient | Blue Cross and Blue Shield of Texas | Commercial | $1.00 | $1.00 | $1.00 | 2026-04-03 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Umr Uhc | Umr Uhc | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE CHARTER | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Medicaid | Medicaid | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID STAR KIDS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Carolinas Continuecare Hospital At Pineville Outpatient | Primary Physician Care | Commercial | $1.00 | $1.00 | $1.00 | 2025-11-25 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | CARE1ST MEDICARE ADVANTAGE | CARE1ST MEDICARE ADVANTAGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE SHIELD PROMISE MEDICARE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| CITIZENS BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HILL REGIONAL HOSPITAL Outpatient | Aetna | Commercial | $1.00 | $1.00 | $1.00 | 2025-11-06 | MRF ↗ |
| HILL REGIONAL HOSPITAL Outpatient | Managed Care | PPO | $1.00 | $1.00 | $1.00 | 2025-11-06 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | United Healthcare | Medicare Advantage | $1.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| HILL REGIONAL HOSPITAL Outpatient | USA Managed Care Organization | PPO | $1.00 | $1.00 | $1.00 | 2025-11-06 | MRF ↗ |
| PRINCETON BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA HMO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NON OPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | United Healthcare | United Healthcare | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Uhc Medicare Solutions Ppo | Uhc Medicare Solutions Ppo | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE - MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Continuecare Hospital At Baptist Health Corbin Outpatient | Anthem | Healthlink | $1.00 | $1.00 | $1.00 | 2025-11-25 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER OutpatientFacility | Blue Cross of Blue Shield of Texas | Traditional Immidiate Bussiness | $1.00 | $1.00 | $1.00 | 2026-10-27 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA HMO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Humana | Humana | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER OutpatientFacility | Prime Health Services | Commercial | $1.00 | $1.00 | $1.00 | 2026-10-27 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Blue Cross Medicare Blue Ppo | Blue Cross Medicare Blue Ppo | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| SHELBY BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID STAR | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR KIDS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Health Partners Uph Self Funded | Health Partners Uph Self Funded | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Aetna - Coventry | Aetna - Coventry | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM NON UHRIP | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| PRINCETON BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Cigna | Cigna | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | MVP Health Plan | Medicare Advantage | $1.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| MUENSTER MEMORIAL HOSPITAL Outpatient | Superior HealthPlan | Commercial | $1.00 | $1.00 | $1.00 | 2026-04-03 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Wellsense | Medicare Advantage | $1.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE - OPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW BUSINESS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Health Partners | Health Partners | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | WellCare | Medicare Advantage | $1.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| Carolinas Continuecare Hospital At Pineville Outpatient | Blue Cross and Blue Shield of North Carolina | Medicare Advantage | $1.00 | $1.00 | $1.00 | 2025-11-25 | MRF ↗ |
| Continuecare Hospital At Medical Center Odessa Outpatient | Blue Cross Blue Shield of Texas | Commercial | $1.00 | $1.00 | $1.00 | 2025-11-25 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NON OPTIONS PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE COMMERCIAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| SHELBY BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Uhc Medicare Solutions Hmo | Uhc Medicare Solutions Hmo | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| MITCHELL COUNTY HOSPITAL DISTRICT Outpatient | Aetna | Commercial | $1.00 | $3.00 | $2.00 | 2026-06-02 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER OutpatientFacility | Cigna Health Springs | Commercial | $1.00 | $1.00 | $1.00 | 2026-10-27 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER OutpatientFacility | Friday Health Insurance Company | Commercial | $1.00 | $1.00 | $1.00 | 2026-10-27 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW BUSINESS | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Meritain | Meritain | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Great West | Great West | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Amerigroup Ia Medicaid | Amerigroup Ia Medicaid | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR PLUS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL Outpatient | Humana Choice | Humana Choice | $1.00 | $1.00 | — | 2026-07-15 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.06 | — | — | 2026-09-02 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.30 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.30 | — | — | 2026-09-01 | MRF ↗ |
| FRIO REGIONAL HOSPITAL Outpatient | United Healthcare | Commercial | $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 ↗ |
| 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 | Blue Cross Blue Shield of Texas | Blue Advantage | $2.00 | $2.00 | $1.00 | 2026-05-15 | MRF ↗ |
| FRIO REGIONAL HOSPITAL Outpatient | Blue Cross Blue Shield of Texas | Traditional | $2.00 | $2.00 | $1.00 | 2026-05-15 | MRF ↗ |
| FRIO REGIONAL HOSPITAL Outpatient | ChoiceCare | Medicare Advantage | $2.00 | $2.00 | $1.00 | 2026-05-15 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Anthem | Commercial | $2.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| MITCHELL COUNTY HOSPITAL DISTRICT Outpatient | Blue Cross and Blue Shield of Texas | Blue Advantage HMO | $2.00 | $3.00 | $2.00 | 2026-06-02 | MRF ↗ |
| FRIO REGIONAL HOSPITAL Outpatient | Humana | Commercial | $2.00 | $2.00 | $1.00 | 2026-05-15 | MRF ↗ |
| MITCHELL COUNTY HOSPITAL DISTRICT Outpatient | Blue Cross and Blue Shield of Texas | Commercial | $2.00 | $3.00 | $2.00 | 2026-06-02 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Harvard Pilgrim Health Care | Commercial | $2.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| FRIO REGIONAL HOSPITAL Outpatient | Aetna | Commercial | $2.00 | $2.00 | $1.00 | 2026-05-15 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Cigna | Commercial | $2.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| FRIO REGIONAL HOSPITAL Outpatient | Humana | Medicare Advantage | $2.00 | $2.00 | $1.00 | 2026-05-15 | MRF ↗ |
| MITCHELL COUNTY HOSPITAL DISTRICT Outpatient | Cigna | Commercial | $2.00 | $3.00 | $2.00 | 2026-06-02 | MRF ↗ |
| MITCHELL COUNTY HOSPITAL DISTRICT Outpatient | Blue Cross and Blue Shield of Texas | HMO | $2.00 | $3.00 | $2.00 | 2026-06-02 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Tufts Health Plan | Commercial | $2.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| MITCHELL COUNTY HOSPITAL DISTRICT Outpatient | Blue Cross and Blue Shield of Texas | PPO | $2.00 | $3.00 | $2.00 | 2026-06-02 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | MVP Health Plan | Commercial | $2.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| HUNTSVILLE MEMORIAL HOSPITAL Outpatient | Prime Health Services | Commercial | $2.00 | $3.00 | $1.00 | 2026-03-26 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | MultiPlan | Commercial | $2.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| HUNTSVILLE MEMORIAL HOSPITAL Outpatient | Three Rivers Provider Network | Commercial | $2.00 | $3.00 | $1.00 | 2026-03-26 | MRF ↗ |
| HUNTSVILLE MEMORIAL HOSPITAL Outpatient | Texas Children's Health Plan | HMO | $2.00 | $3.00 | $1.00 | 2026-03-26 | MRF ↗ |
| HUNTSVILLE MEMORIAL HOSPITAL Outpatient | Humana | Commercial | $2.00 | $3.00 | $1.00 | 2026-03-26 | 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 | Blue Cross and Blue Shield of Texas | PPO | $2.00 | $3.00 | $1.00 | 2026-03-26 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Aetna | Commercial | $3.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| HUNTSVILLE MEMORIAL HOSPITAL Outpatient | Scott and White | Commercial | $3.00 | $3.00 | $1.00 | 2026-03-26 | MRF ↗ |
| St Lawrence Rehabilitation Center Outpatient | Amerihealth | HMO | $3.00 | $4.00 | $4.00 | 2026-03-31 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Blue Cross Blue Shield | Medicare Advantage | $3.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Beacon Health | Commercial | $3.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Cigna | Medicare Advantage | $3.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Coventry | Commercial | $3.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | United Healthcare | Commercial | $3.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Manage Behavioral Health | Commercial | $3.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Martin's Point Healthcare | Tricare | $3.00 | $3.00 | $2.00 | 2026-08-27 | MRF ↗ |
| SPRINGFIELD HOSPITAL Outpatient | Wellsense | Commercial | $3.00 | $3.00 | $2.00 | 2026-08-27 | 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.