42120 — Remove Palate/lesion
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). REMOVE PALATE/LESION (HCPCS 42120) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/42120?code_type=HCPCS
MLA (9th ed.)
“REMOVE PALATE/LESION (HCPCS 42120) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/42120?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“REMOVE PALATE/LESION (HCPCS 42120) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/42120?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $2,328–$7,614 (25th–75th percentile) across 1,559 hospitals · 2,883 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 42120 — 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
$2,328
$5,797 typical
$7,614
The middle 50% of negotiated facility rates for this procedure, measured across 1,559 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. | $5,797 |
| Surgeon (professional fee) Estimate national typical Medicare $912 × 1.22 commercial. | $1,113 |
| 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 | $7,618 |
Surgical episode (typical)
~$7,618
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)
~$11,403
- 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 |
|---|---|---|---|---|---|---|---|
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Aetna | Commercial | $0.89 | $16.50 | $5.78 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Oscar Health | Exchange | $2.69 | $16.50 | $5.78 | 2026-05-08 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - GA (ANTHEM) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (CAREFIRST) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NV (ANTHEM) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - ID (REGENCE) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL ALTERNATE | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MI | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WY | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NH (ANTHEM) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BCN DOMESTIC | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WV (HIGHMARK) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ID | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE DISTINCTION TRANSPLANT | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AL | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (ANTHEM) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NC | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - UT (REGENCE) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WI (ANTHEM) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NE | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - LA | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (CAPITAL) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MN | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CARE NETWORK | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (EXCELLUS) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - FL | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MO (ANTHEM) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WA (PREMERA) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - TN | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NM | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CA (ANTHEM) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK NORTHEASTERN | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS DOMESTIC | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NJ (HORIZON) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - DC (CAREFIRST) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (ANTHEM) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OK | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - SC | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VT | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK HMO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MA | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AZ | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AK (PREMERA) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK WESTERN | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | WC DOMESTIC | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MS | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - FEDERAL | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AR | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ND | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | KAISER DOMESTIC | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OH (ANTHEM) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CO (ANTHEM) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - SD (WELLMARK) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - TX | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - RI | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (INDEPENDENCE) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ME (ANTHEM) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - KS | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - CA | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MD (CAREFIRST) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - PA (HIGHMARK) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - WA (REGENCE) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MT | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - HI | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OR (REGENCE) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - DE (HIGHMARK) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | PRE-EMPLOYMENT | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IN (ANTHEM) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - KY (ANTHEM) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BCBS GENERIC | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CT (ANTHEM) | WELLMARK PPO | $3.33 | — | $16,493.22 | 2026-03-31 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $18.55 | $10,303.00 | $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 ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | MRF ↗ |
| ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL OutpatientFacility | Wellpoint | NJ Family Care | $44.51 | — | — | 2026-03-04 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER 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 ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $73.26 | — | — | 2026-04-14 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $75.58 | $4,675.00 | $4,675.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $75.58 | $4,675.00 | $4,675.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $77.09 | $4,675.00 | $4,675.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $77.09 | $4,675.00 | $4,675.00 | 2025-10-04 | MRF ↗ |
| GEORGE C GRAPE COMMUNITY HOSPITAL Outpatient | HUMANA - ALL PLANS | HUMANA - ALL PLANS | $81.00 | $162.00 | $145.80 | 2026-02-19 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $81.40 | — | — | 2026-04-14 | MRF ↗ |
| MASSAC MEMORIAL HOSPITAL Outpatient | MOLINA KY MCAID | MOLINA KY MCAID | $90.15 | $1,772.00 | $1,240.40 | 2026-02-20 | MRF ↗ |
| MASSAC MEMORIAL HOSPITAL Outpatient | ANTHEM BCBS MY MCAID | ANTHEM BCBS MY MCAID | $90.15 | $1,772.00 | $1,240.40 | 2026-02-20 | MRF ↗ |
| MASSAC MEMORIAL HOSPITAL Outpatient | AETNA BETTER HEALTH MCAID | AETNA BETTER HEALTH MCAID | $90.15 | $1,772.00 | $1,240.40 | 2026-02-20 | MRF ↗ |
| MASSAC MEMORIAL HOSPITAL Outpatient | BCBS MEDICAID | BCBS MEDICAID | $90.15 | $1,772.00 | $1,240.40 | 2026-02-20 | MRF ↗ |
| MASSAC MEMORIAL HOSPITAL Outpatient | MERIDIAN MEDICAID-ALL PLANS | MERIDIAN MEDICAID-ALL PLANS | $90.15 | $1,772.00 | $1,240.40 | 2026-02-20 | MRF ↗ |
| MASSAC MEMORIAL HOSPITAL Outpatient | MOLINA MEDICAID-ALL OTHER PLANS | MOLINA MEDICAID-ALL OTHER PLANS | $90.15 | $1,772.00 | $1,240.40 | 2026-02-20 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $91.95 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $91.95 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $91.95 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $91.95 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $91.95 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $91.95 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $91.95 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $91.95 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $91.95 | — | — | 2026-04-14 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $92.68 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $92.68 | — | — | 2026-04-01 | 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 ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $98.25 | $4,675.00 | $4,675.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $98.25 | $4,675.00 | $4,675.00 | 2025-10-04 | MRF ↗ |
| GENESIS HOSPITAL OutpatientFacility | NOBLE COUNTY HEALTH DEPARTMENT [10017599] | HB ODH BCCP PROJECT | $101.40 | $10,691.79 | $6,415.07 | 2026-03-27 | MRF ↗ |
| GENESIS HOSPITAL OutpatientFacility | FULTON COUNTY HEALTH DEPARTMENT [1013223] | HB ODH BCCP PROJECT | $101.40 | $10,691.79 | $6,415.07 | 2026-03-27 | MRF ↗ |
| GENESIS HOSPITAL OutpatientFacility | OU COMM HLTH PROG OUHCOM HAP BSP [101321] | HB ODH BCCP PROJECT | $101.40 | $10,691.79 | $6,415.07 | 2026-03-27 | MRF ↗ |
| GENESIS HOSPITAL OutpatientFacility | TRINITY BCCP [101328] | HB ODH BCCP PROJECT | $101.40 | $10,691.79 | $6,415.07 | 2026-03-27 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $102.16 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $102.16 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $102.16 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $102.16 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $102.16 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $102.16 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $102.16 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $102.16 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $102.16 | — | — | 2026-04-14 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $102.97 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $102.97 | — | — | 2026-04-01 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $107.73 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $107.73 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $107.73 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $107.73 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $107.73 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $107.73 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $107.73 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $107.73 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $107.73 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $119.70 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $119.70 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $119.70 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $119.70 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $119.70 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $119.70 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $119.70 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $119.70 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $119.70 | — | — | 2026-04-14 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $127.64 | — | — | 2025-12-31 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Sunshine State Oncology | Medicaid HMO | $129.33 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Healthy Kids | $129.33 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Medicaid HMO | $129.33 | — | — | 2025-08-01 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | UHC | Medicare Advantage | $131.97 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | First Health Network | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $131.97 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Pacific Source | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Interwest Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Prime Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $131.97 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | VA Health | All | $131.97 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Tricare | All | $131.97 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Montana Health CoOp | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Coventry | All | — | — | — | 2026-03-28 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Molina Oncology | Medicaid HMO | $133.02 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Molina Oncology | Healthy Kids | $133.02 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Community Care Plan Oncology | Medicaid HMO | $135.48 | — | — | 2025-08-01 | 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.