42104 — Excision Lesion Mouth Roof
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). EXCISION LESION MOUTH ROOF (HCPCS 42104) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/42104?code_type=HCPCS
MLA (9th ed.)
“EXCISION LESION MOUTH ROOF (HCPCS 42104) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/42104?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“EXCISION LESION MOUTH ROOF (HCPCS 42104) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/42104?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,040–$4,148 (25th–75th percentile) across 1,724 hospitals · 4,262 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 42104 — 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
$1,040
$3,138 typical
$4,148
The middle 50% of negotiated facility rates for this procedure, measured across 1,724 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. | $3,138 |
| Surgeon (professional fee) Estimate national typical Medicare $123 × 1.22 commercial. | $150 |
| Likely subtotal | $3,287 |
Surgical episode (typical)
~$3,287
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 ↗ |
| STEWART MEMORIAL COMMUNITY HOSPITAL OutpatientFacility | None | — | — | $1.00 | — | 2024-10-08 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.51 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.51 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $1.51 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.55 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.59 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $1.63 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.95 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.95 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $1.99 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.99 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.99 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.99 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $2.04 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $2.08 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $2.12 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $2.20 | $407.00 | $386.65 | 2026-02-20 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OK | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | WC DOMESTIC | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - LA | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NC | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | KAISER DOMESTIC | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - FEDERAL | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - WA (REGENCE) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (CAPITAL) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OR (REGENCE) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NH (ANTHEM) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - KS | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS DOMESTIC | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - FL | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OH (ANTHEM) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AR | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - DE (HIGHMARK) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AZ | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CA (ANTHEM) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ME (ANTHEM) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (EXCELLUS) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MN | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - SD (WELLMARK) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (ANTHEM) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - SC | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CO (ANTHEM) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AL | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AK (PREMERA) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NM | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MI | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WY | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - DC (CAREFIRST) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BCN DOMESTIC | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ND | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ID | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK HMO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - GA (ANTHEM) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - PA (HIGHMARK) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - HI | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MS | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WI (ANTHEM) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - RI | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NV (ANTHEM) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - CA | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WV (HIGHMARK) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MO (ANTHEM) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VT | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BCBS GENERIC | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (CAREFIRST) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NJ (HORIZON) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - UT (REGENCE) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MT | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MD (CAREFIRST) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE DISTINCTION TRANSPLANT | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - KY (ANTHEM) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - TX | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - ID (REGENCE) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK NORTHEASTERN | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK WESTERN | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CT (ANTHEM) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - TN | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WA (PREMERA) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | PRE-EMPLOYMENT | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IN (ANTHEM) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL ALTERNATE | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (INDEPENDENCE) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MA | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CARE NETWORK | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NE | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (ANTHEM) | WELLMARK PPO | $4.92 | — | $16,924.69 | 2026-03-31 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Outpatient | United Healthcare Medicare | Medicare Advantage | $5.90 | $340.00 | $204.00 | 2026-02-12 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Outpatient | United Healthcare Medicare | Medicare Advantage | $5.90 | $340.00 | $204.00 | 2026-02-12 | MRF ↗ |
| MERCY HOSPITAL PITTSBURG, INC OutpatientFacility | BLUE CROSS AND BLUE SHIELD [20053] | HB PITS BLUE CROSS CHOICE | $6.15 | $14,852.47 | $9,654.11 | 2026-05-15 | MRF ↗ |
| MERCY HOSPITAL PITTSBURG, INC OutpatientFacility | MC ANTHEM [20455] | HB PITS BLUE CROSS CHOICE | $6.15 | $14,852.47 | $9,654.11 | 2026-05-15 | MRF ↗ |
| MERCY HOSPITAL PITTSBURG, INC OutpatientFacility | MC GENERIC ANTHEM [20456] | HB PITS BLUE CROSS CHOICE | $6.15 | $14,852.47 | $9,654.11 | 2026-05-15 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $7.80 | $946.00 | $946.00 | 2026-02-13 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $10.74 | $5,964.00 | $3,123.62 | 2024-12-31 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $11.06 | — | — | 2026-04-14 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $13.81 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $13.81 | — | — | 2026-04-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $13.88 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $16.26 | — | — | 2026-04-14 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $20.40 | $652.00 | $652.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $20.40 | $652.00 | $652.00 | 2025-10-04 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - Meridian | Medicaid - Meridian | $23.00 | $227.00 | $113.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - United | Medicaid - United | $23.00 | $227.00 | $113.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - Molina | Medicaid - Molina | $25.00 | $227.00 | $113.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - Molina | Medicaid - Molina | $27.00 | $227.00 | $113.00 | 2025-02-03 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Medica | All Plans | $28.72 | $79.79 | $99.74 | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Medica | All Plans | $28.72 | $79.79 | $99.74 | 2026-03-05 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Medicaid - United | Medicaid - United | $29.00 | $227.00 | $113.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $29.00 | $227.00 | $113.00 | 2025-02-03 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $29.30 | $217.00 | $162.75 | 2026-01-16 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - United | Medicaid - United | $30.00 | $227.00 | $113.00 | 2025-02-03 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $30.78 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $30.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $30.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM SHORT TERM LIMITED DURATION | 9361_ANTHEM SHORT TERM LIMITED DURATION VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $30.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Inpatient | SMARTHEALTH PPO | 8842_SMARTHEALTH PPO 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HEALTHSYNC HMO | 9227_ANTHEM HEALTHSYNC HMO VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $30.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PATHWAY | 9230_ANTHEM PATHWAY VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PPO PREFERRED | 9232_ANTHEM PREFERRED VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HEALTHSYNC POS | 9228_ANTHEM HEALTHSYNC POS VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $30.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $30.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $30.78 | — | — | 2026-01-01 | 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.