42820 — Remove Tonsils And Adenoids
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). REMOVE TONSILS AND ADENOIDS (HCPCS 42820) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/42820?code_type=HCPCS
MLA (9th ed.)
“REMOVE TONSILS AND ADENOIDS (HCPCS 42820) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/42820?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“REMOVE TONSILS AND ADENOIDS (HCPCS 42820) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/42820?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,950–$7,516 (25th–75th percentile) across 2,019 hospitals · 4,521 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 42820 — 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
$1,950
$5,580 typical
$7,516
The middle 50% of negotiated facility rates for this procedure, measured across 2,019 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. | $5,580 |
| Surgeon (professional fee) Estimate national typical Medicare $261 × 1.22 commercial. | $318 |
| Anesthesia Estimate national typical 00170, ~55 min typical. Medicare $178 × 3.14 commercial. | $558 |
| Likely subtotal | $6,456 |
Surgical episode (typical)
~$6,456
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)
~$10,241
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
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 |
|---|---|---|---|---|---|---|---|
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $6,986.00 | $698.60 | 2026-05-14 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $6,986.00 | $698.60 | 2026-05-06 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $6,986.00 | $698.60 | 2026-05-22 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $0.36 | — | $11,382.01 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $0.36 | — | $11,382.01 | 2026-03-31 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $4.06 | $2,576.00 | $1,932.00 | 2025-03-07 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS DOMESTIC | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - SD (WELLMARK) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - CA | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WY | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MO (ANTHEM) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (CAPITAL) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CA (ANTHEM) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - TN | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - GA (ANTHEM) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | KAISER DOMESTIC | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NH (ANTHEM) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - WA (REGENCE) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CO (ANTHEM) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK NORTHEASTERN | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AR | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (ANTHEM) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WV (HIGHMARK) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WI (ANTHEM) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ID | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - UT (REGENCE) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CARE NETWORK | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK WESTERN | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MA | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MI | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (EXCELLUS) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OK | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (ANTHEM) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NV (ANTHEM) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (INDEPENDENCE) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - LA | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - PA (HIGHMARK) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MN | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NM | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AZ | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - TX | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - FL | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MT | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - FEDERAL | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AL | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - RI | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BCBS GENERIC | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MS | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - DE (HIGHMARK) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CT (ANTHEM) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WA (PREMERA) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OH (ANTHEM) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | PRE-EMPLOYMENT | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NC | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | WC DOMESTIC | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ME (ANTHEM) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VT | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NE | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - SC | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ND | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - KS | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BCN DOMESTIC | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IN (ANTHEM) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK HMO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (CAREFIRST) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AK (PREMERA) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL ALTERNATE | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - KY (ANTHEM) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE DISTINCTION TRANSPLANT | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - HI | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NJ (HORIZON) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - DC (CAREFIRST) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MD (CAREFIRST) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OR (REGENCE) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - ID (REGENCE) | WELLMARK PPO | $4.50 | — | $16,001.63 | 2026-03-31 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $8.26 | $750.00 | $142.50 | 2026-01-25 | MRF ↗ |
| UNIVERSITY OF VIRGINIA MEDICAL CENTER Outpatient | VETERANS [99909] | UVA HB VETERANS CHOICE | $13.45 | $14,171.90 | $8,503.14 | 2026-03-24 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $16.52 | $9,176.00 | $5,862.53 | 2024-12-31 | MRF ↗ |
| OAKDALE COMMUNITY HOSPITAL Both | HUMANA | HUMANA COMM IP | $18.15 | $33.00 | $6.60 | 2026-04-30 | MRF ↗ |
| OAKDALE COMMUNITY HOSPITAL Both | HUMANA | HUMANA COMM OP | $18.15 | $33.00 | $6.60 | 2026-04-30 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $21.60 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $24.00 | — | — | 2026-04-14 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL AETNA CARE [700912] | $25.98 | $14,072.83 | $14,072.83 | 2026-03-23 | MRF ↗ |
| LIFECARE MEDICAL CENTER Outpatient | BCBS MHCP | BCBS MHCP | $26.42 | $72.00 | $63.36 | 2026-02-03 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $26.96 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $26.96 | — | — | 2026-04-01 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $27.11 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $27.11 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $27.11 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $27.11 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $27.11 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $27.11 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $27.11 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $27.11 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $27.11 | — | — | 2026-04-14 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL AETNA BETTER HEALTH MEDICAID [300612] | $29.87 | $14,072.83 | $14,072.83 | 2026-03-23 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $29.95 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $29.95 | — | — | 2026-04-01 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $30.12 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $30.12 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $30.12 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $30.12 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $30.12 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $30.12 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $30.12 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $30.12 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $30.12 | — | — | 2026-04-14 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $31.76 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $31.76 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $31.76 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $31.76 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $31.76 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $31.76 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $31.76 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $31.76 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $31.76 | — | — | 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 ↗ |
| LIFECARE MEDICAL CENTER Outpatient | MEDICA MCAID | MEDICA MCAID | $33.26 | $72.00 | $63.36 | 2026-02-03 | MRF ↗ |
| LIFECARE MEDICAL CENTER Outpatient | MEDICA MCR ADV | MEDICA MCR ADV | $33.84 | $72.00 | $63.36 | 2026-02-03 | MRF ↗ |
| LIFECARE MEDICAL CENTER Outpatient | BCBS MCR ADV | BCBS MCR ADV | $33.84 | $72.00 | $63.36 | 2026-02-03 | MRF ↗ |
| LIFECARE MEDICAL CENTER Outpatient | UHC VA CCN | UHC VA CCN | $33.84 | $72.00 | $63.36 | 2026-02-03 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL UNITED HEALTHCARE LABS [106809] | $35.16 | $14,072.83 | $14,072.83 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL UNITED HEALTHCARE CARE [700909] | $35.16 | $14,072.83 | $14,072.83 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL UNITED HEALTHCARE CARE [300609] | $35.16 | $14,072.83 | $14,072.83 | 2026-03-23 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $35.29 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $35.29 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $35.29 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $35.29 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $35.29 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $35.29 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $35.29 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $35.29 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $35.29 | — | — | 2026-04-14 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | UNIVERSAL IPA MCAL OP/PROFEE ONLY | UNIVERSAL IPA MCAL OP/PROFEE ONLY | $36.00 | $1,026.00 | $277.02 | 2026-01-31 | MRF ↗ |
| LIFECARE MEDICAL CENTER Outpatient | UCARE MCR SELECT | UCARE MCR SELECT | $36.00 | $72.00 | $63.36 | 2026-02-03 | MRF ↗ |
| LIFECARE MEDICAL CENTER Outpatient | UCARE MCR ADV | UCARE MCR ADV | $36.00 | $72.00 | $63.36 | 2026-02-03 | MRF ↗ |
| LIFECARE MEDICAL CENTER Outpatient | UCARE SR HLTH OPTIONS (MSHO) | UCARE SR HLTH OPTIONS (MSHO) | $36.00 | $72.00 | $63.36 | 2026-02-03 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $36.00 | $1,026.00 | $277.02 | 2026-01-31 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA FSLH EMPLOYEE [70005901] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STRATEGIC COMP SERVICES [700061] | WC STRATEGIC COMP SERVICES [70006101] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | PROGRESSIVE AUTO INSURANCE [800005] | NF PROGRESSIVE AUTO INSURANCE [80000501] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | WC MISC. [709999] | WC MISC. [70999901] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UTICA NATIONAL NO FAULT [800007] | NF UTICA NATIONAL INS [80000701] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NF MISC. [809999] | NF MISC. [80999901] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NY CTRL MUTUAL NF [800004] | NF NY CTRL MUTUAL [80000401] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL AUTO INSURANCE [800008] | NF LIBERTY MUTUAL AUTO INS [80000801] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ALLSTATE AUTO INSURANCE [800001] | NF ALLSTATE [80000101] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ERIE INS NF [800002] | NF ERIE INS [80000201] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MET LIFE AUTO INSURANCE [800009] | NF MET LIFE AUTO INS [80000901] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NY CTRL MUTUAL NF [800004] | NF NY CTRL MUTUAL [80000401] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA SEMC EMPLOYEE [70005902] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC TRAVELER'S SEMC EMPLOYEE [70005904] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NYSIF [700058] | WC NY STATE INSURANCE FUND [70005801] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS NO FAULT [800006] | NF TRAVELERS [80000601] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STATE FARM AUTO INSURANCE NF [800026] | NF STATE FARM AUTO INSURANCE [80002601] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | CHARTIS WC [700029] | WC CHARTIS [70002901] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS NO FAULT [800006] | NF TRAVELERS [80000601] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | HARTFORD INS WC [700055] | WC HARTFORD INS [70005501] | $37.62 | $12,797.63 | $7,678.58 | 2025-01-17 | 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.