40804 — Removal Foreign Body Mouth
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). REMOVAL FOREIGN BODY MOUTH (HCPCS 40804) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/40804?code_type=HCPCS
MLA (9th ed.)
“REMOVAL FOREIGN BODY MOUTH (HCPCS 40804) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/40804?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“REMOVAL FOREIGN BODY MOUTH (HCPCS 40804) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/40804?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $376–$1,573 (25th–75th percentile) across 2,046 hospitals · 5,817 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 40804 — 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 the surgeon's fee are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$376
$943 typical
$1,573
The middle 50% of negotiated facility rates for this procedure, measured across 2,046 hospitals. The the surgeon's fee 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. | $943 |
| Surgeon (professional fee) Estimate national typical Medicare $116 × 1.22 commercial. | $141 |
| Likely subtotal | $1,084 |
Surgical episode (typical)
~$1,084
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Surgeon (professional fee) (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $1,539.00 | $1,261.98 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | HMO | — | $1,539.00 | $1,261.98 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $1,539.00 | $1,261.98 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $1,539.00 | $1,261.98 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $1,539.00 | $1,261.98 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $1,539.00 | $1,261.98 | 2025-11-26 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $1.15 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $1.16 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $1.16 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $1.32 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $1.33 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $1.33 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $1.44 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $1.45 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $1.45 | — | — | 2026-03-18 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $2.12 | $44.00 | $33.00 | 2025-03-07 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.99 | $596.50 | $357.90 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.99 | $596.50 | $357.90 | 2025-08-11 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $6.78 | $210.00 | $210.00 | 2026-02-13 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $9.27 | $463.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $9.27 | $463.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $9.27 | $463.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $9.27 | $463.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $9.27 | $463.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $9.27 | $463.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $9.27 | $463.50 | — | 2026-03-31 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $9.33 | — | — | 2026-04-14 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $9.48 | $474.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $9.48 | $474.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $9.48 | $474.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $9.48 | $474.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $9.48 | $474.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $9.48 | $474.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $9.48 | $474.00 | — | 2026-03-31 | MRF ↗ |
| WASHINGTON COUNTY HOSPITAL Outpatient | Blue Cross Blue Shield AL | PPO | $10.81 | $66.27 | $26.51 | 2025-05-21 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $11.54 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $11.54 | — | — | 2026-04-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $11.71 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $13.72 | — | — | 2026-04-14 | MRF ↗ |
| DALLAS REGIONAL MEDICAL CENTER Outpatient | Non-Contracted Medicaid | Non-Contracted Medicaid 95 Percent | $13.80 | $336.29 | $1,077.00 | 2024-12-19 | MRF ↗ |
| DALLAS REGIONAL MEDICAL CENTER Outpatient | Traditional Medicaid | Traditional Medicaid | $14.53 | $336.29 | $1,077.00 | 2024-12-19 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Both | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $14.91 | $1,433.25 | $1,433.25 | 2026-04-24 | MRF ↗ |
| MAYERS MEMORIAL HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $15.00 | $1,031.00 | $1,031.00 | 2026-05-12 | MRF ↗ |
| MEDINA REGIONAL HOSPITAL OutpatientFacility | United Healthcare | Medicare Advantage | $18.00 | $75.00 | $67.50 | 2025-06-26 | MRF ↗ |
| Magee Rehabilitation Hospital OutpatientFacility | Magee Health Partners | Medicaid | $18.07 | — | — | 2026-03-18 | MRF ↗ |
| MEDINA REGIONAL HOSPITAL OutpatientFacility | Superior Health Plan | Medicare Advantage | $18.36 | $75.00 | $67.50 | 2025-06-26 | MRF ↗ |
| TRINITAS REGIONAL MEDICAL CENTER OutpatientFacility | Wellpoint | NJ Family Care | $19.72 | — | — | 2026-03-04 | MRF ↗ |
| NEWARK BETH ISRAEL MEDICAL CENTER OutpatientFacility | United Healthcare | Community Plan | $20.30 | — | — | 2026-03-04 | MRF ↗ |
| ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL - SOMERSET OutpatientFacility | Wellpoint | NJ Family Care | $20.88 | — | — | 2026-03-04 | MRF ↗ |
| VALLEY REGIONAL HOSPITAL Both | WELL SENSE HEALTH PLAN | WELL SENSE HEALTH PLAN | $21.32 | $290.00 | $159.50 | 2026-04-10 | MRF ↗ |
| VALLEY REGIONAL HOSPITAL Both | BEACON HEALTH | CARELON BEHAVIORAL HEALTH | $21.32 | $290.00 | $159.50 | 2026-04-10 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Partners | Managed Medicaid | $21.36 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Partners | Managed Medicaid | $21.36 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| ERLANGER BLEDSOE HOSPITAL OutpatientFacility | OccuNet | OccuNet WC | $21.49 | $174.00 | $50.29 | 2026-01-25 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $21.58 | $332.00 | $215.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $21.58 | $332.00 | $215.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $21.58 | $332.00 | $215.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $21.58 | $332.00 | $215.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $21.58 | $332.00 | $215.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $21.58 | $332.00 | $215.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $21.58 | $332.00 | $215.80 | 2026-03-12 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $21.68 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $21.89 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Alliance | Behavioral Health | $21.89 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| MCLAREN PORT HURON Both | McLaren Commercial Ins | McLaren Commercial Ins | $22.00 | $87.00 | $43.00 | 2025-02-03 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Carolina Complete Health | Managed Medicaid | $22.09 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Healthy Blue | Managed Medicaid | $22.09 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Wellcare | Managed Medicaid | $22.09 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Alliance | Behavioral Health | $22.11 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $22.26 | $596.50 | $357.90 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $22.26 | $596.50 | $357.90 | 2025-08-11 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Vaya | Managed Medicaid | $22.30 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Healthy Blue | Managed Medicaid | $22.30 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Carolina Complete Health | Managed Medicaid | $22.30 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Wellcare | Managed Medicaid | $22.30 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| VALLEY REGIONAL HOSPITAL Both | AMERIHEALTH CARITAS NH | AMERIHEALTH CARITAS NH | $22.42 | $290.00 | $159.50 | 2026-04-10 | MRF ↗ |
| MEDINA REGIONAL HOSPITAL OutpatientFacility | Community First Health Plan | HIE | $22.50 | $75.00 | $67.50 | 2025-06-26 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Vaya | Managed Medicaid | $22.51 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| ERLANGER BLEDSOE HOSPITAL OutpatientFacility | OPTUM VACCN | VA COMMUNITY CARE NETWORK | $22.62 | $174.00 | $50.29 | 2026-01-25 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Alliance | Managed Medicaid | $22.64 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| VALLEY REGIONAL HOSPITAL Both | NH MEDICAID | NH MEDICAID PENDING | $22.64 | $290.00 | $159.50 | 2026-04-10 | MRF ↗ |
| VALLEY REGIONAL HOSPITAL Both | NH MEDICAID | NH MEDICAID | $22.64 | $290.00 | $159.50 | 2026-04-10 | MRF ↗ |
| VALLEY REGIONAL HOSPITAL Both | NH MEDICAID | NH MEDICAID DISABILITY | $22.64 | $290.00 | $159.50 | 2026-04-10 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Alliance | Managed Medicaid | $22.75 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | Trillium | Managed Medicaid | $22.75 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| MERCY HOSPITAL LINCOLN OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $22.88 | $352.00 | $228.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL LINCOLN OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $22.88 | $352.00 | $228.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL LINCOLN OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $22.88 | $352.00 | $228.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL LINCOLN OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $22.88 | $352.00 | $228.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL LINCOLN OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $22.88 | $352.00 | $228.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL LINCOLN OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $22.88 | $352.00 | $228.80 | 2026-03-12 | MRF ↗ |
| ATRIUM HEALTH UNIVERSITY CITY OutpatientFacility | Trillium | Managed Medicaid | $22.96 | $213.60 | $106.80 | 2025-12-05 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $24.09 | $213.60 | $106.80 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Alliance | Behavioral Health | $24.33 | $213.60 | $106.80 | 2025-12-01 | MRF ↗ |
| ERLANGER BLEDSOE HOSPITAL OutpatientFacility | WELLPOINT | WELLPOINT TN MEDICARE | $24.36 | $174.00 | $50.29 | 2026-01-25 | MRF ↗ |
| ERLANGER BLEDSOE HOSPITAL OutpatientFacility | BLUECARE | DSNP | $24.36 | $174.00 | $50.29 | 2026-01-25 | MRF ↗ |
| ERLANGER BLEDSOE HOSPITAL OutpatientFacility | AMERICAN HEALTH | CAH ? BLEDSOE | $24.36 | $174.00 | $50.29 | 2026-01-25 | MRF ↗ |
| ERLANGER BLEDSOE HOSPITAL OutpatientFacility | BCBST | BLUE ADVANTAGE | $24.36 | $174.00 | $50.29 | 2026-01-25 | MRF ↗ |
| ERLANGER BLEDSOE HOSPITAL OutpatientFacility | NHC | Medicare Advantage | $24.36 | $174.00 | $50.29 | 2026-01-25 | MRF ↗ |
| ERLANGER BLEDSOE HOSPITAL OutpatientFacility | CLOVER | Medicare Advantage | $24.36 | $174.00 | $50.29 | 2026-01-25 | MRF ↗ |
| ERLANGER BLEDSOE HOSPITAL OutpatientFacility | HUMANA | MEDICARE ADVANTAGE | $24.36 | $174.00 | $50.29 | 2026-01-25 | MRF ↗ |
| ERLANGER BLEDSOE HOSPITAL OutpatientFacility | WELLPOINT | WELLPOINT TN -TENNCARE | $24.36 | $174.00 | $50.29 | 2026-01-25 | MRF ↗ |
| ERLANGER BLEDSOE HOSPITAL OutpatientFacility | AETNA | AETNA MEDICARE | $24.36 | $174.00 | $50.29 | 2026-01-25 | MRF ↗ |
| ERLANGER BLEDSOE HOSPITAL OutpatientFacility | UPMC | Medicare Advantage | $24.36 | $174.00 | $50.29 | 2026-01-25 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Wellcare | Managed Medicaid | $24.54 | $213.60 | $106.80 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Carolina Complete Health | Managed Medicaid | $24.54 | $213.60 | $106.80 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Healthy Blue | Managed Medicaid | $24.54 | $213.60 | $106.80 | 2025-12-01 | MRF ↗ |
| MEDINA REGIONAL HOSPITAL OutpatientFacility | Amerivantage | Medicare Advantage | $24.75 | $75.00 | $67.50 | 2025-06-26 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Vaya | Managed Medicaid | $24.78 | $213.60 | $106.80 | 2025-12-01 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Partners | Managed Medicaid | $24.78 | $213.60 | $106.80 | 2025-12-01 | MRF ↗ |
| POTOMAC VALLEY HOSPITAL Outpatient | Unitedhealthcare Medicare Advantage | All Plans | — | $2,271.00 | $1,135.50 | 2026-05-14 | MRF ↗ |
| POTOMAC VALLEY HOSPITAL Outpatient | Unitedhealthcare Medicare Advantage | All Plans | — | $2,271.00 | $1,135.50 | 2026-05-22 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Alliance | Managed Medicaid | $25.03 | $213.60 | $106.80 | 2025-12-01 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | JNE Health Partners | JNE001_JNE002_JNE003 Medicaid | $25.10 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | JNE Health Partners | JNE001_JNE002_JNE003 CHIP | $25.10 | — | — | 2026-03-18 | MRF ↗ |
| THOMAS JEFFERSON UNIVERSITY HOSPITAL OutpatientFacility | Health Partners Medicaid | JCC001 JCC002 Caid MCO | $25.10 | — | — | 2026-03-18 | MRF ↗ |
| Jefferson Methodist Hospital OutpatientFacility | Health Partners Medicaid | JCC001 JCC002 Caid MCO | $25.10 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | JNE Health Partners | JNE001_JNE002_JNE003 CHIP | $25.10 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON LANSDALE HOSPITAL OutpatientFacility | JAB Health Partners | JAB002 Medicaid | $25.10 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | JNE Health Partners | JNE001_JNE002_JNE003 Medicaid | $25.10 | — | — | 2026-03-18 | MRF ↗ |
| ATRIUM HEALTH LINCOLN OutpatientFacility | Trillium | Managed Medicaid | $25.27 | $213.60 | $106.80 | 2025-12-01 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $25.42 | $391.00 | $254.15 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $25.42 | $391.00 | $254.15 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $25.42 | $391.00 | $254.15 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $25.42 | $391.00 | $254.15 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $25.42 | $391.00 | $254.15 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $25.42 | $391.00 | $254.15 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $25.42 | $391.00 | $254.15 | 2026-03-12 | MRF ↗ |
| JERSEY CITY MEDICAL CENTER OutpatientFacility | Wellpoint | NJ Family Care | $25.52 | — | — | 2026-03-04 | MRF ↗ |
| STANLY REGIONAL MEDICAL CENTER OutpatientFacility | Partners | Managed Medicaid | $25.63 | $213.60 | $106.80 | 2025-12-01 | 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.