29855 — Tibial Arthroscopy/surgery
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). TIBIAL ARTHROSCOPY/SURGERY (HCPCS 29855) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/29855?code_type=HCPCS
MLA (9th ed.)
“TIBIAL ARTHROSCOPY/SURGERY (HCPCS 29855) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/29855?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“TIBIAL ARTHROSCOPY/SURGERY (HCPCS 29855) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/29855?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $4,094–$10,038 (25th–75th percentile) across 1,642 hospitals · 3,120 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 29855 — 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
$4,094
$7,194 typical
$10,038
The middle 50% of negotiated facility rates for this procedure, measured across 1,642 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. | $7,194 |
| Surgeon (professional fee) Estimate national typical Medicare $730 × 1.22 commercial. | $890 |
| 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 | $8,792 |
Surgical episode (typical)
~$8,792
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)
~$12,577
- 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 NEWTON MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $2.88 | — | $22,202.51 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $2.88 | — | $22,202.51 | 2026-03-31 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | CIGNA MCR HMO/PPO [250525] | MEDICARE REPLACEMENT [25052501] | $6.79 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | BCBS MEDICARE [250503] | BCBS MEDICARE REPLACEMENT [25050301] | $6.79 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | BCBS MEDICARE [250503] | BCBS MEDICARE REPLACEMENT [25050301] | $6.79 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | WELLCARE HEALTH PLAN [250516] | MEDICARE REPLACEMENT [25051601] | $6.79 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | CIGNA MCR HMO/PPO [250525] | MEDICARE REPLACEMENT [25052501] | $6.79 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | WELLCARE HEALTH PLAN [250516] | MEDICARE REPLACEMENT [25051601] | $6.79 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | HUMANA GOLD [250508] | PFFS MEDICARE REPLACEMENT [25050801] | $6.91 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | UNITED HEALTH MCR HMO/PPO [250515] | UHC MEDICARE REPLACEMENT [25051501] | $6.91 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | AETNA COVENTRY MCR REPLACEMENT [250518] | AETNA MEDICARE [25051801] | $6.91 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | HUMANA GOLD [250508] | PFFS MEDICARE REPLACEMENT [25050801] | $6.91 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | UNITED HEALTH MCR HMO/PPO [250515] | UHC MEDICARE REPLACEMENT [25051501] | $6.91 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | AETNA COVENTRY MCR REPLACEMENT [250518] | AETNA MEDICARE [25051801] | $6.91 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | ALIGN SENIOR CARE [250524] | ALIGN MEDICARE REPLACEMENT [25052401] | $6.92 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | ALIGN SENIOR CARE [250524] | ALIGN MEDICARE REPLACEMENT [25052401] | $6.92 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | FREEDOM HEALTH [250505] | FREEDOM HLTH MEDICARE REPLACEMENT [25050501] | $6.92 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | FREEDOM HEALTH [250505] | FREEDOM HLTH MEDICARE REPLACEMENT [25050501] | $6.92 | $56,664.77 | $11,332.95 | 2026-03-26 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | UHC COMMUNITY MEDICAID [2175] | HB XR UHC INDIANA PATHWAYS MEDICAID | $15.48 | $36,016.97 | $21,801.38 | 2025-12-19 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $22.89 | $12,716.00 | $7,262.33 | 2024-12-31 | 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 ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | 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 ↗ |
| RUSH MEMORIAL HOSPITAL Both | HEALTH NET | HEALTH NET | $57.80 | $196.25 | $147.19 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Both | CARESOURCE MCR ADV | CARESOURCE MCR ADV | $60.84 | $196.25 | $147.19 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Both | MY TRUE ADVANTAGE - ALL PLANS | MY TRUE ADVANTAGE - ALL PLANS | $60.84 | $196.25 | $147.19 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Both | UHC MCR ADV | UHC MCR ADV | $60.84 | $196.25 | $147.19 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Both | HUMANA MCR ADV | HUMANA MCR ADV | $61.45 | $196.25 | $147.19 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Both | AETNA MCR ADV | AETNA MCR ADV | $61.45 | $196.25 | $147.19 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Both | VIANT BEECH ST MCR ADV | VIANT BEECH ST MCR ADV | $62.66 | $196.25 | $147.19 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Both | ANTHEM MCR ADV | ANTHEM MCR ADV | $62.66 | $196.25 | $147.19 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Both | TODAY'S OPTION MCR ADV-ALL PLANS | TODAY'S OPTION MCR ADV-ALL PLANS | $62.66 | $196.25 | $147.19 | 2026-04-27 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $63.76 | — | — | 2026-04-14 | MRF ↗ |
| St Anthony Regional Hospital & Nursing Home Outpatient | MIDLANDS CHOICE - ALL PLANS | MIDLANDS CHOICE - ALL PLANS | $76.98 | $2,146.00 | $2,146.00 | 2026-02-09 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $80.00 | $2,731.00 | $518.89 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | MEDI-CAL | MEDI-CAL | $80.00 | $2,731.00 | $518.89 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | HEALTHNET MEDI-CAL | HEALTHNET MEDI-CAL | $80.00 | $2,731.00 | $518.89 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | $80.00 | $2,731.00 | $518.89 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $80.00 | $2,731.00 | $737.37 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | UNIVERSAL IPA MCAL OP/PROFEE ONLY | UNIVERSAL IPA MCAL OP/PROFEE ONLY | $80.00 | $2,731.00 | $737.37 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | CCIPA MEDI-CAL - ALL PLANS | CCIPA MEDI-CAL - ALL PLANS | $80.00 | $2,731.00 | $518.89 | 2026-01-31 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $83.50 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $83.50 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $83.50 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $83.50 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $83.50 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $83.50 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $83.50 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $83.50 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $83.50 | — | — | 2026-04-14 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $83.65 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $83.65 | — | — | 2026-04-01 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Both | ANTHEM PATH ESSENTIALS | ANTHEM PATH ESSENTIALS | $92.24 | $196.25 | $147.19 | 2026-04-27 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $93.77 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $93.77 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $93.77 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $93.77 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $93.77 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $93.77 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $93.77 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $93.77 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $93.77 | — | — | 2026-04-14 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Both | CARESOURCE MARKETPLACE-ALL OTHER PLANS | CARESOURCE MARKETPLACE-ALL OTHER PLANS | $97.34 | $196.25 | $147.19 | 2026-04-27 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $100.85 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $101.48 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $101.48 | — | — | 2026-03-18 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Sunshine State Oncology | Medicaid HMO | $102.48 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Healthy Kids | $102.48 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Medicaid HMO | $102.48 | — | — | 2025-08-01 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Molina Oncology | Healthy Kids | $105.40 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Molina Oncology | Medicaid HMO | $105.40 | — | — | 2025-08-01 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $106.38 | $788.00 | $591.00 | 2026-01-16 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Community Care Plan Oncology | Medicaid HMO | $107.35 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Amerihealth Caritas Oncology | Medicaid HMO | $107.35 | — | — | 2025-08-01 | MRF ↗ |
| WITHAM HEALTH SERVICES Outpatient | ANTHEM EXCH | ANTHEM EXCH | $113.93 | $183.75 | $128.63 | 2026-03-31 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $114.03 | — | — | 2026-04-14 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Both | ANTHEM HMO | ANTHEM HMO | $115.00 | $196.25 | $147.19 | 2026-04-27 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $115.58 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $116.30 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $116.30 | — | — | 2026-03-18 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Peak Health | Medicare | $121.56 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Aetna | Medicare | $121.56 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | United Healthcare | Medicare | $121.56 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | United Healthcare | Medicare | $121.56 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Peia | Other Governmental | $121.56 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Highmark Blue Cross | Ppo/Pos | $121.56 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Highmark Blue Cross | Medicare | $121.56 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Humana | Medicare | $121.56 | — | — | 2026-05-06 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Blue Cross Oncology | Medicare Advantage | $123.65 | — | — | 2025-08-01 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $125.84 | — | — | 2026-03-18 | MRF ↗ |
| WITHAM HEALTH SERVICES Outpatient | ANTHEM PPO | ANTHEM PPO | $126.59 | $183.75 | $128.63 | 2026-03-31 | MRF ↗ |
| WITHAM HEALTH SERVICES Outpatient | ANTHEM HMO | ANTHEM HMO | $126.59 | $183.75 | $128.63 | 2026-03-31 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $126.63 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $126.63 | — | — | 2026-03-18 | MRF ↗ |
| Shepherd Center Outpatient | Medicare | Commercial | $127.43 | — | — | 2026-05-06 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Humana | Medicare Advantage (MMG) | $127.92 | — | — | 2025-10-24 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Devoted | Medicare Advantage Prevailing (MMG) | $127.92 | — | — | 2025-10-24 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Devoted | Medicare Advantage (MMG) | $127.92 | — | — | 2025-10-24 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Florida Community Care Oncology | Medicaid HMO | $128.82 | — | — | 2025-08-01 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Humana | HMO/PPO | $129.01 | — | — | 2025-10-24 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $129.40 | — | — | 2026-05-06 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | United Healthcare Oncology | Medicare Advantage | $130.30 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | United Healthcare Oncology | Commercial | $130.33 | — | — | 2025-08-01 | MRF ↗ |
| LIBERTY HOSPITAL Outpatient | Blue Cross Blue Shield | Freedom Network | $130.42 | — | — | 2026-05-26 | MRF ↗ |
| LIBERTY HOSPITAL Outpatient | Blue Cross Blue Shield | Freedom Network Select | $130.42 | — | — | 2026-05-26 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Both | ANTHEM PATH X | ANTHEM PATH X | $131.49 | $196.25 | $147.19 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Both | ANTHEM PPO | ANTHEM PPO | $131.49 | $196.25 | $147.19 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Both | ANTHEM PATH | ANTHEM PATH | $131.49 | $196.25 | $147.19 | 2026-04-27 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $132.52 | — | — | 2025-12-31 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $133.90 | — | — | 2026-04-14 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | CarePlus | Medicare Advantage (MMG) | $134.32 | — | — | 2025-10-24 | MRF ↗ |
| RIVER'S EDGE HOSPITAL & CLINIC Both | Medicare A Mn J6 | Default | $134.59 | $659.50 | $527.60 | 2026-05-08 | MRF ↗ |
| RIVER'S EDGE HOSPITAL & CLINIC Both | Bcbs Mn Secure Blue Mcr Adv Dos After 1/1/19 | Medicare Advantage | $134.59 | $659.50 | $527.60 | 2026-05-08 | MRF ↗ |
| RIVER'S EDGE HOSPITAL & CLINIC Both | Medica Government Plans Medicare Advantage | Medicare Advantage | $134.59 | $659.50 | $527.60 | 2026-05-08 | MRF ↗ |
| RIVER'S EDGE HOSPITAL & CLINIC Both | Medica Choice Care Dos Lt 01012022 Or Snbc | Medicare Advantage | $134.59 | $659.50 | $527.60 | 2026-05-08 | MRF ↗ |
| RIVER'S EDGE HOSPITAL & CLINIC Both | Humana Advantage Care Plans Med Advantage | Medicare Advantage | $134.59 | $659.50 | $527.60 | 2026-05-08 | MRF ↗ |
| RIVER'S EDGE HOSPITAL & CLINIC Both | Medicare Railroad Palmetto Gba | Default | $134.59 | $659.50 | $527.60 | 2026-05-08 | MRF ↗ |
| RIVER'S EDGE HOSPITAL & CLINIC Both | Cigna Medicare Advantage | Medicare Advantage | $134.59 | $659.50 | $527.60 | 2026-05-08 | MRF ↗ |
| RIVER'S EDGE HOSPITAL & CLINIC Both | Humana Gold Plus Integrated Plan Il Mcr Adv | Medicare Advantage | $134.59 | $659.50 | $527.60 | 2026-05-08 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | WellCare Oncology | Medicare Advantage | $135.60 | — | — | 2025-08-01 | MRF ↗ |
| WITHAM HEALTH SERVICES Outpatient | AETNA-ALL OTHER PLANS | AETNA-ALL OTHER PLANS | $135.98 | $183.75 | $128.63 | 2026-03-31 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Freedom Optimum Oncology | Medicare Advantage | $136.84 | — | — | 2025-08-01 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Baycare | Medicare Advantage (MMG) | $136.88 | — | — | 2025-10-24 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Aetna Oncology | Medicare Advantage | $138.35 | — | — | 2025-08-01 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Freedom Health | Medicare Advantage (MMG) | $140.72 | — | — | 2025-10-24 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Optimum | Medicare Advantage (MMG) | $140.72 | — | — | 2025-10-24 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Aetna | Exchange (MMG) | $142.58 | — | — | 2025-10-24 | MRF ↗ |
| WITHAM HEALTH SERVICES Outpatient | UHC-ALL PLANS | UHC-ALL PLANS | $143.33 | $183.75 | $128.63 | 2026-03-31 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $143.35 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $143.35 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $143.35 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $143.35 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $143.35 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $143.35 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $143.35 | — | — | 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.