31200 — Removal Of Ethmoid Sinus
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). REMOVAL OF ETHMOID SINUS (CPT 31200) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/31200?code_type=CPT
MLA (9th ed.)
“REMOVAL OF ETHMOID SINUS (CPT 31200) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/31200?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“REMOVAL OF ETHMOID SINUS (CPT 31200) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/31200?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $2,669–$7,614 (25th–75th percentile) across 1,510 hospitals · 2,286 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 31200 — 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
$2,669
$5,806 typical
$7,614
The middle 50% of negotiated facility rates for this procedure, measured across 1,510 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. | $5,806 |
| Surgeon (professional fee) Estimate national typical Medicare $584 × 1.22 commercial. | $713 |
| 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 | $7,226 |
Surgical episode (typical)
~$7,226
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge (see the recovery plan below)
- Complications, revisions, or readmissions
- Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)
The biggest swing: which insurer's rate applies — negotiated prices here run $2,669–$7,614.
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)
~$11,011
- 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 |
|---|---|---|---|---|---|---|---|
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $22.88 | $12,712.00 | $5,862.53 | 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 | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | 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 ↗ |
| 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 ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $51.21 | — | — | 2026-04-14 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $53.11 | — | — | 2025-12-31 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $63.20 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $63.20 | — | — | 2026-04-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $63.78 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $63.78 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $63.78 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $63.78 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $63.78 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $63.78 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $63.78 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $63.78 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $63.78 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $68.15 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $68.15 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $68.15 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $68.15 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $68.15 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $68.15 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $68.15 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $68.15 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $68.15 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $76.14 | $564.00 | $423.00 | 2026-01-16 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $85.80 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $85.80 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | GEISINGER | MANAGED MEDICAID | $85.80 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | GEISINGER | MANAGED MEDICAID | $85.80 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $85.80 | — | — | 2025-08-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $88.48 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $88.48 | — | — | 2026-04-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $89.30 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $89.30 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $89.30 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $89.30 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $89.30 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $89.30 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $89.30 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $89.30 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $89.30 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $89.70 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | CHIP | $89.70 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $89.70 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | CHIP | $89.70 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | CHIP | $89.70 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $89.70 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $89.70 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | GEISINGER | MANAGED MEDICAID | $92.82 | — | — | 2025-08-01 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $95.41 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $95.41 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $95.41 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $95.41 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $95.41 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $95.41 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $95.41 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $95.41 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $95.41 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $95.94 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MANAGED MEDICAID | $97.50 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | GEISINGER | MANAGED MEDICAID | $97.50 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MANAGED MEDICAID | $97.50 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $99.06 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $99.06 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $99.06 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $99.06 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $99.06 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $99.06 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AETNA | MANAGED MEDICAID | $101.40 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AETNA | MANAGED MEDICAID | $101.40 | — | — | 2025-08-01 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $105.30 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $105.30 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $105.30 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $105.30 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $105.30 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $105.30 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $105.30 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $105.30 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $105.30 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $105.30 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $105.30 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $105.30 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | AETNA | MANAGED MEDICAID | $113.08 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AETNA | MANAGED MEDICAID | $113.08 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | MANAGED MEDICAID | $113.08 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | MANAGED MEDICAID | $113.08 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $113.10 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $113.10 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | KEYSTONE FIRST | MANAGED MEDICAID | $113.10 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $113.10 | — | — | 2025-08-01 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $117.03 | $564.00 | $423.00 | 2026-01-16 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $122.56 | — | — | 2026-01-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UPMC | MANAGED MEDICAID | $128.36 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | UPMC | MANAGED MEDICAID | $128.36 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | UPMC | MANAGED MEDICAID | $128.36 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UPMC | MANAGED MEDICAID | $128.36 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UPMC | MANAGED MEDICAID | $128.36 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | UPMC | MANAGED MEDICAID | $128.36 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $140.40 | — | — | 2025-08-01 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP DUAL ACCESS|MVP DUAL ACCESS COMPLETE | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP GOLD PPO | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS CARE NEW YORK [112] | FIDELIS CARE NEW YORK|FIDELIS FHP|FIDELIS CHP | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | GENERIC CARRIER [107] | COMMERCIAL|HUMANA|CDPHP COMMERCIAL | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP GOLD HMO | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS(INCLUDING GOLD,SILVER,BRONZE AND PLATINUM) | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC MEDICARE COMPLETE | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS ESSENTIAL 1&2|FIDELIS ESSENTIAL 3&4 | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP|CIGNA|GWH CIGNA|NALC CIGNA | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 1&2 | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK MEDICARE | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC DUAL COMPLETE | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | MEDICARE HMO INDEPENDENT HLTH|NOVA HEALTHCARE MEDICARE | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UNITED HEALTHCARE|UHC - GENERIC|UHC EMPIRE PLAN (KINGSTON)|UNITEDHEALTHCARE OXFORD|UNITED MEDICAL RESOURCES (UMR)|UHC STUDENT RESOURCES|UHC SUREST|UNITED HEALTHCARE SHARED SERVICES | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | INDEPENDENT HEALTH ASSOC|NOVA HEALTHCARE-IHA | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA MEDICAID MANAGED CARE|MOLINA CHILD HEALTH PLUS | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MVP [109] | MVP DUAL ACCESS|MVP DUAL ACCESS COMPLETE | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE DUAL | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK|HIGHMARK INDEMNITY- OUT OF AREA|HIGHMARK HMO BLUE | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE MEDICARE HMO | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN|UHC COMMUNITY MEDICAID DENTAL|UHC ESSENTIAL 1&2|UHC CHPS|UHC ESSENTIAL 3&4 | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 3&4 | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 3&4 | — | $15,978.46 | $10,386.00 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE|TRICARE FOR LIFE|MARTINS POINT/US FAMILY | — | $15,978.46 | $10,386.00 | 2024-12-30 | 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.