42720 — Drainage Of Throat Abscess
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). DRAINAGE OF THROAT ABSCESS (HCPCS 42720) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/42720?code_type=HCPCS
MLA (9th ed.)
“DRAINAGE OF THROAT ABSCESS (HCPCS 42720) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/42720?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“DRAINAGE OF THROAT ABSCESS (HCPCS 42720) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/42720?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,299–$4,121 (25th–75th percentile) across 1,619 hospitals · 3,341 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 42720 — 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
$1,299
$3,120 typical
$4,121
The middle 50% of negotiated facility rates for this procedure, measured across 1,619 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. | $3,120 |
| Surgeon (professional fee) Estimate national typical Medicare $334 × 1.22 commercial. | $407 |
| Likely subtotal | $3,527 |
Surgical episode (typical)
~$3,527
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 |
|---|---|---|---|---|---|---|---|
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $3.15 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $3.15 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $3.15 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $3.23 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $3.32 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $3.40 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $4.08 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $4.08 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $4.17 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $4.17 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $4.17 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $4.17 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $4.25 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $4.34 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $4.43 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $4.60 | $851.00 | $808.45 | 2026-02-20 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $9.66 | $5,369.00 | $3,123.62 | 2024-12-31 | MRF ↗ |
| UNIVERSITY OF VIRGINIA MEDICAL CENTER Outpatient | VETERANS [99909] | UVA HB VETERANS CHOICE | $13.62 | $33,067.15 | $19,840.29 | 2026-03-24 | 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 ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $31.50 | — | — | 2026-04-14 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $39.53 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $39.53 | — | — | 2026-04-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $39.54 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $46.32 | — | — | 2026-04-14 | MRF ↗ |
| HILTON HEAD REGIONAL 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 ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | MEDICA MEDICAID [16023] | MEDICA CHOICE CARE [1602302] | $52.32 | $218.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | MEDICA MEDICAID [16023] | MEDICA ACCESSABILITY [1602301] | $52.32 | $218.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | MEDICA MEDICARE [16024] | MEDICA DUAL SOLUTION [1602402] | $57.04 | $218.00 | — | 2026-01-01 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $58.89 | — | — | 2025-12-31 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $62.24 | $461.00 | $345.75 | 2026-01-16 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC HEALTHCHOICE | ALL PRODUCTS | $62.51 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC HEALTHCHOICE | ALL PRODUCTS | $62.51 | — | — | 2026-01-01 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $65.80 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $65.80 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $65.80 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $65.80 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $65.80 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $65.80 | — | — | 2026-04-16 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $84.05 | $1,293.00 | $840.45 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $84.05 | $1,293.00 | $840.45 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $84.05 | $1,293.00 | $840.45 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $84.05 | $1,293.00 | $840.45 | 2026-03-12 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $84.14 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $84.14 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $84.14 | — | — | 2026-03-18 | MRF ↗ |
| CAREWELL HEALTH MEDICAL CENTER OutpatientFacility | Horizon New Jersey Health | Managed Medicaid | $85.62 | — | — | 2025-06-17 | MRF ↗ |
| YUMA REGIONAL MEDICAL CENTER OutpatientFacility | NAPHCARE | Managed Medicaid Peds | $89.28 | — | — | 2024-10-01 | MRF ↗ |
| YUMA REGIONAL MEDICAL CENTER OutpatientFacility | UHC | COMMUNITY CARE | $89.28 | — | — | 2024-10-01 | MRF ↗ |
| YUMA REGIONAL MEDICAL CENTER OutpatientFacility | UHC | COMMUNITY CARE PEDS | $89.28 | — | — | 2024-10-01 | MRF ↗ |
| YUMA REGIONAL MEDICAL CENTER OutpatientFacility | CENPATICO | Managed Medicaid | $89.28 | — | — | 2024-10-01 | MRF ↗ |
| YUMA REGIONAL MEDICAL CENTER OutpatientFacility | UAHP | FAMILY CARE PEDS | $89.28 | — | — | 2024-10-01 | MRF ↗ |
| YUMA REGIONAL MEDICAL CENTER OutpatientFacility | UAHP | FAMILY CARE | $89.28 | — | — | 2024-10-01 | MRF ↗ |
| YUMA REGIONAL MEDICAL CENTER OutpatientFacility | NAPHCARE | Managed Medicaid | $89.28 | — | — | 2024-10-01 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Amerihealth | F8102_Amerihealth | $89.50 | — | — | 2026-04-01 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Geisinger Health Plan | F8109_Geisinger Health Plan - Medicaid Chip | $89.50 | — | — | 2026-04-01 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Geisinger Health Plan | F8109_Geisinger Health Plan - Medicaid Chip | $89.50 | — | — | 2026-04-01 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Amerihealth | F8102_Amerihealth | $89.50 | — | — | 2026-04-01 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $89.50 | $1,085.00 | $238.70 | 2026-04-14 | MRF ↗ |
| ARNOT OGDEN MEDICAL CENTER OutpatientFacility | AmeriHealth | All Products | $89.50 | — | — | 2026-03-27 | MRF ↗ |
| SURGICAL INSTITUTE OF READING BothFacility | Unison | Med Plus | $89.50 | $2,691.00 | $4,783.07 | 2026-04-08 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $89.50 | $1,085.00 | $249.55 | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Aetna | Aetna Better Health CHIP | $89.50 | $1,085.00 | $249.55 | 2026-04-14 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $92.27 | — | — | 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 Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $92.27 | — | — | 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 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 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 PATHWAY X | 9231_ANTHEM PATHWAY X VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PPO PREFERRED | 9232_ANTHEM PREFERRED VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Inpatient | SMARTHEALTH PPO | 8842_SMARTHEALTH PPO 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY 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 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM TRADITIONAL | 9233_ANTHEM TRADITIONAL 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 KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 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 SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HMO/POS | 9229_ANTHEM HMO POS VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8813_ANTHEM UNIFIED GROUPS VKIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $92.27 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| UPMC COLE OutpatientFacility | Aetna | CHIP/Medicaid | $93.97 | $2,434.00 | $1,460.40 | 2026-03-06 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $93.98 | $1,085.00 | $238.70 | 2026-04-14 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.