28485 — Optx Metatarsal Fx Each
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). OPTX METATARSAL FX EACH (HCPCS 28485) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/28485?code_type=HCPCS
MLA (9th ed.)
“OPTX METATARSAL FX EACH (HCPCS 28485) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/28485?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“OPTX METATARSAL FX EACH (HCPCS 28485) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/28485?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,543–$9,993 (25th–75th percentile) across 2,108 hospitals · 4,884 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 28485 — 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
$3,543
$7,113 typical
$9,993
The middle 50% of negotiated facility rates for this procedure, measured across 2,108 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. | $7,113 |
| Surgeon (professional fee) Estimate national typical Medicare $542 × 1.22 commercial. | $661 |
| 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 | $8,483 |
Surgical episode (typical)
~$8,483
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)
~$12,267
- 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 |
|---|---|---|---|---|---|---|---|
| MERCYONE CLINTON MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $2.88 | — | $23,417.36 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $3.84 | — | $16,279.50 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $3.84 | — | $16,279.50 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $4.54 | — | $9,481.64 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $4.54 | — | $9,481.64 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $4.54 | — | $9,481.64 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $4.54 | — | $9,481.64 | 2026-03-31 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB MEDICAID-STANDARD | $6.63 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OOS MEDICAID [70002] | CHA HB MEDICAID-STANDARD | $6.63 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB MEDICAID-STANDARD | $6.63 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS TOGETHER W CHA [75001] | CHA HB MEDICAID-STANDARD | $6.63 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS GENERAL BRIGHAM [50021] | CHA HB MEDICAID-STANDARD | $6.63 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | UNITED HEALTH [40002] | CHA HB MEDICAID-STANDARD | $6.63 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS HEALTH [70001] | CHA HB MEDICAID-STANDARD | $6.63 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BOSTON MEDICAL CENTER - WELLSENSE [50003] | CHA HB MEDICAID-STANDARD | $6.63 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | AARP [40001] | CHA HB MEDICARE MANAGED CARE - UHC | $6.77 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | UNITED HEALTH [40002] | CHA HB MEDICARE MANAGED CARE - UHC | $6.77 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TRICARE [85002] | CHA HB TRICARE | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BCBS - MA [10001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | RR MEDICARE [60002] | CHA HB MEDICARE | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER COMMERCIAL PAYOR [50015] | CHA HB MEDICARE MANAGED CARE 100 PCT | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | ELDER SERVICE PLAN [65002] | CHA HB ELDER SERVICE PLAN | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | COMMONWEALTH CARE ALLIANCE [65001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB MEDICARE MANAGED CARE 100 PCT | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB FALLON CAREPLUS | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BCBS - OUT OF STATE [10002] | CHA HB MEDICARE MANAGED CARE 100 PCT | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER GOV'T PAYOR [85003] | CHA HB TRICARE | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | CIGNA [50005] | CHA HB MEDICARE MANAGED CARE 100 PCT | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | CHAMPVA [85001] | CHA HB TRICARE | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | SENIOR WHOLE HEALTH [65003] | CHA HB MEDICARE MANAGED CARE 100 PCT | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB FALLON | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS HEALTH PLAN [30001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MEDICARE [60001] | CHA HB MEDICARE | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HEALTH SAFETY NET [80001] | CHA HB HEALTH SAFETY NET | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS HEALTH PLAN [30001] | CHA HB Tufts Health Plan Medicare Preferred | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS GENERAL BRIGHAM [50021] | CHA HB MEDICARE MANAGED CARE 100 PCT | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BOSTON MEDICAL CENTER - WELLSENSE [50003] | CHA HB MEDICARE MANAGED CARE 100 PCT | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HUMANA [50008] | CHA HB MEDICARE MANAGED CARE 100 PCT | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HPHC [20001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | AETNA [50001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HEALTH SAFETY NET [80001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $7.52 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER HR [124] Plans | $7.59 | $29,032.40 | $29,032.40 | 2026-04-03 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | GEHA Multiplan Network | Default | — | $1,473.00 | $1,104.75 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $8.78 | $1,473.00 | $1,104.75 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Multiplan Inc. for American Family | Default | — | $1,473.00 | $1,104.75 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Private Healthcare Systems PHCS | Default | — | $1,473.00 | $1,104.75 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Mississippi Physicians Care Network | Default | — | $1,473.00 | $1,104.75 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Advanced Health | Default | — | $1,473.00 | $1,104.75 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | First Choice Health Network | Default | — | $1,473.00 | $1,104.75 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Magnolia Health Plan MCD Rep | Default | — | $1,473.00 | $1,104.75 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | UHC Community Plan MS | Default | — | $1,473.00 | $1,104.75 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Mississippi Select Health Care | Default | — | $1,473.00 | $1,104.75 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicare B MS JH | Default | — | $1,473.00 | $1,104.75 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicare A MS JH | Default | — | $1,473.00 | $1,104.75 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Primewell Vantage Health Plan | Default | — | $1,473.00 | $1,104.75 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Connecticut General Cigna | Default | — | $1,473.00 | $1,104.75 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicaid Mississippi | Default | — | $1,473.00 | $1,104.75 | 2025-03-07 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UNITED HEALTHCARE ALTERNATE [100260] | UHC EMPIRE ALTERNATE [10026001] | $9.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UNITED HEALTHCARE ALTERNATE [100260] | UHC EMPIRE ALTERNATE [10026001] | $9.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB TUFTS HEALTH PUBLIC PLANS QHP NON-SUBSIDIZED | $12.14 | $6,322.38 | $6,322.38 | 2026-03-20 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA SEMC EMPLOYEE [70005902] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ESIS WORK COMP [700010] | WC ESIS [70001001] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | CORVEL CORP WC [700054] | WC CORVEL CORP [70005401] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA FSLH EMPLOYEE [70005901] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL WORK COMP [700016] | WC LIBERTY MUTUAL [70001601] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STRATEGIC COMP SERVICES [700061] | WC STRATEGIC COMP SERVICES [70006101] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC TRAVELER'S SEMC EMPLOYEE [70005904] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | PMA WORK COMP [700031] | WC PMA [70003101] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UTICA NATIONAL WORKER'S COMP [700062] | WC UTICA NATIONAL INS [70006201] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ERIE INS NF [800002] | NF ERIE INS [80000201] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NY CTRL MUTUAL NF [800004] | NF NY CTRL MUTUAL [80000401] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | PROGRESSIVE AUTO INSURANCE [800005] | NF PROGRESSIVE AUTO INSURANCE [80000501] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS NO FAULT [800006] | NF TRAVELERS [80000601] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL AUTO INSURANCE [800008] | NF LIBERTY MUTUAL AUTO INS [80000801] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | CORVEL CORP WC [700054] | WC CORVEL CORP [70005401] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ERIE INS NF [800002] | NF ERIE INS [80000201] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UTICA NATIONAL NO FAULT [800007] | NF UTICA NATIONAL INS [80000701] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NYSIF [700058] | WC NY STATE INSURANCE FUND [70005801] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | GEICO AUTO INSURANCE [800003] | NF GEICO AUTO INSURANCE [80000301] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | WC MISC. [709999] | WC MISC. [70999901] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NY CTRL MUTUAL NF [800004] | NF NY CTRL MUTUAL [80000401] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC TRAVELER'S MVHS EMPLOYEE [70005903] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA FSLH EMPLOYEE [70005901] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA SEMC EMPLOYEE [70005902] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NCA WC [700057] | WC NCA [70005701] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS WORK COMP [700028] | WC TRAVELERS [70002801] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MADISON ONEIDA HERK WC [700056] | WC MADISON ONEIDA HERK [70005601] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | CHARTIS WC [700029] | WC CHARTIS [70002901] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | PMA WORK COMP [700031] | WC PMA [70003101] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | GALLAGHER BASSETT WORK COMP [700013] | WC GALLAGHER BASSETT [70001301] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | HARTFORD INS WC [700055] | WC HARTFORD INS [70005501] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | SEDGWICK [700027] | WC SEDGWICK [70002701] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STATE FARM AUTO INSURANCE NF [800026] | NF STATE FARM AUTO INSURANCE [80002601] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NYSIF [700058] | WC NY STATE INSURANCE FUND [70005801] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC TRAVELER'S MVHS EMPLOYEE [70005903] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UTICA NATIONAL NO FAULT [800007] | NF UTICA NATIONAL INS [80000701] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NF MISC. [809999] | NF MISC. [80999901] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL WORK COMP [700016] | WC LIBERTY MUTUAL [70001601] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL AUTO INSURANCE [800008] | NF LIBERTY MUTUAL AUTO INS [80000801] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UTICA NATIONAL WORKER'S COMP [700062] | WC UTICA NATIONAL INS [70006201] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ALLSTATE AUTO INSURANCE [800001] | NF ALLSTATE [80000101] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | WC MISC. [709999] | WC MISC. [70999901] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS WORK COMP [700028] | WC TRAVELERS [70002801] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | SEDGWICK [700027] | WC SEDGWICK [70002701] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC TRAVELER'S SEMC EMPLOYEE [70005904] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | PROGRESSIVE AUTO INSURANCE [800005] | NF PROGRESSIVE AUTO INSURANCE [80000501] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MET LIFE AUTO INSURANCE [800009] | NF MET LIFE AUTO INS [80000901] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ALLSTATE AUTO INSURANCE [800001] | NF ALLSTATE [80000101] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | GALLAGHER BASSETT WORK COMP [700013] | WC GALLAGHER BASSETT [70001301] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | GEICO AUTO INSURANCE [800003] | NF GEICO AUTO INSURANCE [80000301] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STATE FARM AUTO INSURANCE NF [800026] | NF STATE FARM AUTO INSURANCE [80002601] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NF MISC. [809999] | NF MISC. [80999901] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MET LIFE AUTO INSURANCE [800009] | NF MET LIFE AUTO INS [80000901] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | CHARTIS WC [700029] | WC CHARTIS [70002901] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS NO FAULT [800006] | NF TRAVELERS [80000601] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ESIS WORK COMP [700010] | WC ESIS [70001001] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NCA WC [700057] | WC NCA [70005701] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STRATEGIC COMP SERVICES [700061] | WC STRATEGIC COMP SERVICES [70006101] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MADISON ONEIDA HERK WC [700056] | WC MADISON ONEIDA HERK [70005601] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | HARTFORD INS WC [700055] | WC HARTFORD INS [70005501] | $15.02 | $37,027.51 | $22,216.51 | 2025-01-17 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Aetna | Aetna Better Health CHIP | $30.70 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $30.70 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $30.70 | — | — | 2026-04-14 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $32.24 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $32.24 | — | — | 2026-04-14 | 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 ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | GEISINGER | MANAGED MEDICAID | $33.77 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $33.77 | — | — | 2025-08-01 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $33.77 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $33.77 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | GEISINGER | MANAGED MEDICAID | $33.77 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $33.77 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $33.77 | — | — | 2025-08-01 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $33.77 | — | — | 2026-04-14 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $35.31 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $35.31 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $35.31 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | CHIP | $35.31 | — | — | 2025-08-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $35.31 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $35.31 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $35.31 | — | — | 2025-08-01 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $35.31 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $35.31 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | CHIP | $35.31 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $35.31 | — | — | 2025-08-01 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $35.31 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | CHIP | $35.31 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $35.31 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $35.31 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | GEISINGER | MANAGED MEDICAID | $36.53 | — | — | 2025-08-01 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $36.84 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $36.84 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $36.84 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $36.84 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $37.76 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MANAGED MEDICAID | $38.38 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MANAGED MEDICAID | $38.38 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | GEISINGER | MANAGED MEDICAID | $38.38 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $38.99 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $38.99 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $38.99 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $38.99 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $38.99 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $38.99 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AETNA | MANAGED MEDICAID | $39.91 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AETNA | MANAGED MEDICAID | $39.91 | — | — | 2025-08-01 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $40.52 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $40.52 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $40.52 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $40.52 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $40.52 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $40.52 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $40.52 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $40.52 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $40.52 | — | — | 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.