28475 — Treat Metatarsal Fracture
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). TREAT METATARSAL FRACTURE (HCPCS 28475) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/28475?code_type=HCPCS
MLA (9th ed.)
“TREAT METATARSAL FRACTURE (HCPCS 28475) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/28475?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“TREAT METATARSAL FRACTURE (HCPCS 28475) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/28475?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $247–$870 (25th–75th percentile) across 2,125 hospitals · 6,591 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 28475 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Estimated complete episode
What the whole episode might cost
Your hospital facility price plus the separately-billed professional fees a complete episode adds. The facility figure is an actual negotiated rate from our data; the surgeon and anesthesia figures are estimates from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$247
$407 typical
$870
The middle 50% of negotiated facility rates for this procedure, measured across 2,125 hospitals. Surgeon & anesthesia fees are modeled estimates added on top.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $407 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $224 × 1.22 commercial. | $274 |
| Likely subtotal | $681 |
Surgical episode (typical)
~$681
Your recovery plan — adjust to what your surgeon told you
After surgery, recovery care is billed separately. We pre-fill the typical plan; change it to your situation.
Recovery cost modeled
~$3,785
With your recovery plan (typical)
~$4,466
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Surgeon (professional fee) (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| CEDARS-SINAI MEDICAL CENTER Outpatient | HealthNet of California, Inc. | HMO | — | $2,224.90 | $1,446.19 | 2025-11-26 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $2,224.90 | $1,446.19 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $1,340.00 | $1,098.80 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | HMO | — | $1,340.00 | $1,098.80 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $1,340.00 | $1,098.80 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $1,340.00 | $1,098.80 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $1,340.00 | $1,098.80 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | SCAN Health Plan | Medicare Advantage | — | $2,224.90 | $1,446.19 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $1,340.00 | $1,098.80 | 2025-11-26 | MRF ↗ |
| HANCOCK COUNTY HEALTH SYSTEM Outpatient | WELLMARK HMO-ALL OTHER PLANS | WELLMARK HMO-ALL OTHER PLANS | $2.57 | $194.00 | $145.50 | 2026-03-26 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $3.75 | $563.00 | $422.25 | 2025-03-07 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $7.90 | $336.00 | $124.32 | 2026-03-31 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $13.04 | $281.00 | $281.00 | 2026-02-13 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Aetna | First Health - Direct | $15.57 | $1,717.00 | $1,287.75 | 2026-04-01 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $18.26 | $660.00 | $145.20 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $18.26 | $660.00 | $145.20 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid HC | $18.26 | $660.00 | $145.20 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $18.26 | $660.00 | $118.80 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $18.26 | $660.00 | $171.60 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $18.26 | $660.00 | $145.20 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $18.26 | $660.00 | $158.40 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $18.26 | $660.00 | $145.20 | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $18.26 | $660.00 | $171.60 | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $18.26 | $660.00 | $118.80 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $18.26 | $660.00 | $178.20 | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $18.26 | $660.00 | $178.20 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $18.26 | $660.00 | $151.80 | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $18.26 | $660.00 | $158.40 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid CHC | $18.26 | $660.00 | $151.80 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $18.26 | $660.00 | $145.20 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $18.26 | $660.00 | $125.40 | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Medicaid CHC | $18.26 | $660.00 | $145.20 | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $18.26 | $660.00 | $125.40 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Amerihealth | Amerihealth Medicaid HC | $18.26 | $660.00 | $151.80 | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid CHC | $18.26 | $660.00 | $145.20 | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Amerihealth | Amerihealth Medicaid HC | $18.26 | $660.00 | $151.80 | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $19.22 | — | — | 2026-04-14 | MRF ↗ |
| FAIRCHILD MEDICAL CENTER Outpatient | MEDI-CAL | MEDI-CAL | $20.00 | $4,081.00 | $4,081.00 | 2025-12-03 | MRF ↗ |
| MAYERS MEMORIAL HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $20.00 | $1,516.00 | $1,516.00 | 2026-05-12 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Blue Shield | Blue Shield - Promise | $21.23 | $1,717.00 | $1,287.75 | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $24.68 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $24.68 | — | — | 2026-04-01 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $25.17 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $25.17 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $25.17 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $25.17 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $25.17 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $25.17 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $25.17 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $25.17 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $25.17 | — | — | 2026-04-14 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $26.00 | $950.00 | $950.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $26.00 | $950.00 | $950.00 | 2025-10-04 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | AETNA | MEDICARE | $27.12 | $240.00 | $36.00 | 2025-12-23 | MRF ↗ |
| The Hospitals of Providence Emergency Room Montwood OutpatientFacility | Imperial Health | Medicare Advantage | $28.00 | $823.56 | $658.85 | 2026-03-24 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $28.26 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $28.26 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $28.26 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $28.26 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $28.26 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $28.26 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $28.26 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $28.26 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $28.26 | — | — | 2026-04-14 | 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 ↗ |
| ERLANGER MURPHY MEDICAL CENTER OutpatientFacility | Peach State | All Products | $31.54 | $156.00 | $109.20 | 2026-01-25 | 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 ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $33.61 | — | — | 2026-04-16 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC LCD | ALL PRODUCTS | $33.61 | $3,031.00 | — | 2026-01-01 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $33.61 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $33.61 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $33.61 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $33.61 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $33.61 | — | — | 2026-04-16 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC LCD | ALL PRODUCTS | $33.61 | $3,031.00 | — | 2026-01-01 | 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 ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $34.70 | $257.00 | $192.75 | 2026-01-16 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | PGT | Medicare|All Plans | $35.29 | $277.00 | $48.48 | 2026-02-28 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | PENSACOLA | CHRISTIAN COLL | $36.00 | $240.00 | $36.00 | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | PENSACOLA | CHRISTIAN COLL | $36.00 | $240.00 | $36.00 | 2025-12-23 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | BCBS | Medicare|All Plans | $36.01 | $277.00 | $48.48 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AETNA | Medicare|All Plans | $36.01 | $277.00 | $48.48 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | UNITED | Medicare|All Plans | $36.74 | $277.00 | $48.48 | 2026-02-28 | MRF ↗ |
| The Hospitals of Providence Emergency Room Montwood OutpatientFacility | Imperial Health | Medicare Advantage | $37.06 | $823.56 | $658.85 | 2026-03-24 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AMERIVANTAGE | Medicare|All Plans | $37.10 | $277.00 | $48.48 | 2026-02-28 | MRF ↗ |
| CHRIST HOSPITAL Inpatient | ANTHEM [2024] | ANTHEM HMO/PPO [202416] | $37.22 | $564.00 | $338.40 | 2025-12-19 | MRF ↗ |
| CHRIST HOSPITAL Inpatient | BUCKEYE COMMUNITY HEALTH [2028] | BUCKEYE MEDICAID [202801] | $37.22 | $564.00 | $338.40 | 2025-12-19 | MRF ↗ |
| CHRIST HOSPITAL Inpatient | CARESOURCE [2031] | CARESOURCE OH MEDICAID [203102] | $37.22 | $564.00 | $338.40 | 2025-12-19 | MRF ↗ |
| METHODIST DALLAS MEDICAL CENTER Both | UNITED HEALTHCARE MEDICAID MANAGED CARE [5015] | MHS HB UNITED MEDICAID STAR PLUS MDMC | $38.09 | $464.00 | $232.00 | 2026-03-20 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | SCANHealth | Medicare|All Plans | $38.54 | $277.00 | $48.48 | 2026-02-28 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER OutpatientFacility | UNITEDHEALTHCARE | MEDICARE ADVANTAGE | $39.00 | $156.00 | $109.20 | 2026-01-25 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $39.00 | $156.00 | $109.20 | 2026-01-25 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | Aetna | Medicare Advantage | $39.84 | $166.00 | — | 2026-04-20 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | Aetna | Medicare Advantage | $39.84 | $166.00 | — | 2026-04-20 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $40.36 | — | — | 2026-04-14 | MRF ↗ |
| ERLANGER MURPHY MEDICAL CENTER OutpatientFacility | BCBSNC | MEDICARE ADVANTAGE | $40.56 | $156.00 | $109.20 | 2026-01-25 | MRF ↗ |
| METHODIST CHARLTON MEDICAL CENTER Both | UNITED HEALTHCARE MEDICAID MANAGED CARE [5015] | MHS HB UNITED MEDICAID STAR PLUS MCMC | $41.25 | $464.00 | $232.00 | 2026-03-21 | MRF ↗ |
| Magee Rehabilitation Hospital OutpatientFacility | Magee Health Partners | Medicaid | $41.62 | — | — | 2026-03-18 | MRF ↗ |
| MEDICAL ARTS HOSPITAL Both | STATE FARM AUTO | STATE FARM HEALTH | $41.80 | $209.00 | — | 2025-06-09 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - EAST CAMPUS OutpatientFacility | Imperial Health | Medicare Advantage | $42.82 | $823.56 | $658.85 | 2026-03-24 | MRF ↗ |
| MACNEAL HOSPITAL OutpatientFacility | BCBS IL | PPO | $43.01 | — | — | 2026-03-31 | MRF ↗ |
| METHODIST RICHARDSON MEDICAL CENTER Both | UNITED HEALTHCARE MEDICAID MANAGED CARE [5015] | MHS HB UNITED MEDICAID STAR PLUS MRMC | $44.45 | $464.00 | $232.00 | 2026-03-21 | MRF ↗ |
| METHODIST RICHARDSON MEDICAL CENTER Both | UNITED HEALTHCARE MEDICAID MANAGED CARE [5015] | MHS HB UNITED MEDICAID STAR PLUS MRMC | $44.45 | $464.00 | $232.00 | 2026-03-21 | MRF ↗ |
| RICHLAND HOSPITAL OutpatientFacility | Dean Health Plan | DHI/DHP Products and ASO Managed Care | $44.53 | $325.00 | $260.00 | 2026-04-24 | MRF ↗ |
| UNION GENERAL HOSPITAL Outpatient | CARESOURCE NETWORK PARTNERS, LLC. | CARE SOURCE MEDICAID | $44.81 | $293.00 | $146.50 | 2026-03-23 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $44.90 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $44.90 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $44.90 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $44.90 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $44.90 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $44.90 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $44.90 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $44.90 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $44.90 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $44.90 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $44.90 | — | — | 2026-01-01 | MRF ↗ |
| SAINT THOMAS RUTHERFORD HOSPITAL Outpatient | CIGNA LOCALPLUS | 3193_CIGNA LOCALPLUS (DEKALB) 20250601 | $45.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION SAINT THOMAS HOSPITAL Outpatient | CIGNA LOCALPLUS | 3193_CIGNA LOCALPLUS (DEKALB) 20250601 | $45.00 | — | — | 2026-01-01 | MRF ↗ |
| SAINT THOMAS RIVER PARK HOSPITAL Outpatient | CIGNA LOCALPLUS | 3193_CIGNA LOCALPLUS (DEKALB) 20250601 | $45.00 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT'S ST CLAIR OutpatientFacility | Aetna | Medicare Advantage | $46.37 | $389.00 | — | 2026-04-20 | MRF ↗ |
| ST VINCENT'S ST CLAIR OutpatientFacility | Aetna | Medicare Advantage | $46.37 | $389.00 | — | 2026-04-20 | MRF ↗ |
| RAINY LAKE MEDICAL CENTER InpatientFacility | Blue Cross of Minnesota | Minnesota Health Care Programs | $47.64 | $217.95 | $167.83 | 2026-05-06 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $49.60 | $763.00 | $495.95 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $49.60 | $763.00 | $495.95 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $49.60 | $763.00 | $495.95 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $49.60 | $763.00 | $495.95 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $49.60 | $763.00 | $495.95 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $49.60 | $763.00 | $495.95 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $49.60 | $763.00 | $495.95 | 2026-03-12 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | Optum | VACCN | $49.80 | $166.00 | — | 2026-04-20 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | Centene | Medicare Advantage | $49.80 | $166.00 | — | 2026-04-20 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | BlueCross BlueShield of Alabama | Medicare Advantage | $49.80 | $166.00 | — | 2026-04-20 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | Optum | VACCN | $49.80 | $166.00 | — | 2026-04-20 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | BlueCross BlueShield of Alabama | Medicare Advantage | $49.80 | $166.00 | — | 2026-04-20 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | Centene | Medicare Advantage | $49.80 | $166.00 | — | 2026-04-20 | MRF ↗ |
| FALLS COMMUNITY HOSPITAL AND CLINIC Outpatient | Blue Cross | PPO | $50.00 | $1,278.00 | $1,022.40 | 2026-02-03 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | 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 ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | Humana | Medicare Advantage | $50.30 | $166.00 | — | 2026-04-20 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | Humana | Medicare Advantage | $50.30 | $166.00 | — | 2026-04-20 | MRF ↗ |
| SKYLINE HOSPITAL Outpatient | REGENCE BS PAR | REGENCE BS PAR | $51.00 | $1,702.50 | $1,225.80 | 2026-05-04 | MRF ↗ |
| SKYLINE HOSPITAL Outpatient | REGENCE BS PPO/POS - ALL OTHER PLANS | REGENCE BS PPO/POS - ALL OTHER PLANS | $51.00 | $1,702.50 | $1,225.80 | 2026-05-04 | MRF ↗ |
| SOUTHWEST MEMORIAL HOSPITAL Outpatient | Medicare | Part B | $51.00 | $472.00 | $236.00 | 2025-06-12 | MRF ↗ |
| BAPTIST MEMORIAL HOSPITAL JONESBORO, INC. OutpatientFacility | Home State Health Plan | Medicaid | $51.00 | $314.00 | $59.66 | 2026-02-27 | MRF ↗ |
| BAPTIST MEMORIAL HOSPITAL JONESBORO, INC. OutpatientFacility | Tricare | Tricare | — | $314.00 | $59.66 | 2026-02-27 | MRF ↗ |
| SKYLINE HOSPITAL Outpatient | REGENCE BS CARE | REGENCE BS CARE | $51.00 | $1,702.50 | $1,225.80 | 2026-05-04 | MRF ↗ |
| WESTERLY HOSPITAL Outpatient | Great West Network | All Plans | $51.31 | $571.33 | $205.68 | 2026-01-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $51.83 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $51.83 | — | — | 2026-04-01 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $52.20 | $180.00 | $144.00 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | MA-BEHAVIORAL HEALTH | $52.20 | $180.00 | $144.00 | 2026-01-31 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | Ambetter | Commercial|All Plans | $52.22 | $277.00 | $48.48 | 2026-02-28 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | United Healthcare | Medicare Advantage | $52.29 | $166.00 | — | 2026-04-20 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | Prime Health Services | Medicare Advantage | $52.29 | $166.00 | — | 2026-04-20 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | Prime Health Services | Medicare Advantage | $52.29 | $166.00 | — | 2026-04-20 | MRF ↗ |
| ST VINCENTS BLOUNT OutpatientFacility | United Healthcare | Medicare Advantage | $52.29 | $166.00 | — | 2026-04-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Priority Health | PriorityHealthSEMIPartnersNet | $52.40 | — | — | 2025-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $52.72 | $180.00 | $144.00 | 2026-01-31 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $52.85 | — | — | 2026-04-14 | 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.