43200 — Esophagoscopy Flexible Brush
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). ESOPHAGOSCOPY FLEXIBLE BRUSH (HCPCS 43200) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/43200?code_type=HCPCS
MLA (9th ed.)
“ESOPHAGOSCOPY FLEXIBLE BRUSH (HCPCS 43200) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/43200?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“ESOPHAGOSCOPY FLEXIBLE BRUSH (HCPCS 43200) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/43200?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $859–$2,240 (25th–75th percentile) across 2,057 hospitals · 6,333 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 43200 — 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 physician and sedation fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$859
$1,299 typical
$2,240
The middle 50% of negotiated facility rates for this procedure, measured across 2,057 hospitals. The physician and sedation 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. | $1,299 |
| Endoscopist (professional fee) Estimate national typical Medicare $79 × 1.22 commercial. | $97 |
| Anesthesia Estimate national typical Generic anesthesia (~30 min typical, median CMS base units). Medicare $123 × 3.14 commercial. Approximate — no procedure-specific anesthesia mapping for this code. | $386 |
| Likely subtotal | $1,782 |
Complete-episode estimate (typical)
~$1,782
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge (see the recovery plan below)
- Complications, revisions, or readmissions
- Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)
The biggest swing: which insurer's rate applies — negotiated prices here run $859–$2,240.
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)
~$5,567
- 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)
- Endoscopist (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 — 4 base units (typical CMS value) × ~30 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 |
|---|---|---|---|---|---|---|---|
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $0.99 | $1,415.00 | $1,061.25 | 2025-03-07 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $398.00 | $326.36 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $398.00 | $326.36 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $398.00 | $326.36 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | HMO | — | $398.00 | $326.36 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $398.00 | $326.36 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $398.00 | $326.36 | 2025-11-26 | MRF ↗ |
| GROSSMONT HOSPITAL Outpatient | Medicare | Medicare | $1.60 | $2,571.00 | $1,928.25 | 2026-04-01 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $2.38 | — | $5,522.69 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $2.38 | — | $5,522.69 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $2.38 | — | $5,522.69 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $2.38 | — | $5,522.69 | 2026-03-31 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $2.52 | $219.00 | $41.61 | 2026-01-25 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $7.03 | $3,903.00 | $906.34 | 2024-12-31 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $7.91 | $3,570.00 | $1,320.90 | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $8.26 | $413.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $8.26 | $413.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $8.26 | $413.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $8.26 | $413.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $8.26 | $413.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $8.26 | $413.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $8.26 | $413.00 | — | 2026-03-31 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $14.95 | — | — | 2026-03-18 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $15.00 | $461.00 | $461.00 | 2025-10-04 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $15.04 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $15.04 | — | — | 2026-03-18 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $16.35 | $2,639.85 | $1,583.91 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $16.35 | $2,639.85 | $1,583.91 | 2025-08-11 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $17.13 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $17.24 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $17.24 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $18.65 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $18.77 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $18.77 | — | — | 2026-03-18 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Health Net | Health Net Individual - EPO | $20.94 | $2,571.00 | $1,928.25 | 2026-04-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 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 KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 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 CARMEL Both | ANTHEM TRADITIONAL | 9233_ANTHEM TRADITIONAL VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 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 MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 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 FISHERS Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 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 ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 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 MERCY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 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 MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 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 SALEM Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 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 ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PATHWAY | 9230_ANTHEM PATHWAY VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 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 SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 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 RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 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 FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 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 | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 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 KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8813_ANTHEM UNIFIED GROUPS VKIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 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 ANDERSON Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 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 SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $24.67 | — | — | 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 CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $24.67 | — | — | 2026-01-01 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | UNITED HEALTH CARE COMMUNITY PLAN MEDICAID [9004] | UNITED HEALTH CARE MEDICAID [900401] | $27.91 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | KEY BENEFIT ADMINISTRATORS [1089] | KEY BENEFIT ADMINISTRATORS [108901] | $30.70 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | COUNTY HEALTH PLAN B [1022] | COUNTY HEALTH PLAN B NON GENESEE COUNTY [102202] | $30.70 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | COUNTY HEALTH PLAN B [1022] | GENESEE HEALTH PLAN B [102204] | $30.70 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UMR LABOR CARE [1601010] | $32.50 | $909.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | SUREST UNITED HEALTHCARE [1601008] | $32.50 | $909.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UNITED HEALTHCARE INDEMNITY [1601006] | $32.50 | $909.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UNITEDHEALTH INTEGRATED SERVICES [1601007] | $32.50 | $909.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UHC ALL SAVERS [1601011] | $32.50 | $909.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UNITED HEALTHCARE [1601005] | $32.50 | $909.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UMR [1601009] | $32.50 | $909.00 | — | 2026-01-01 | 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 | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | PACE MEDICARE HMO [7023] | GENESYS PACE MEDICARE HMO [702301] | $35.15 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $36.05 | $267.00 | $200.25 | 2026-01-16 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $36.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $36.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $36.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $36.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $36.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $36.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $36.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $36.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $36.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $36.11 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $36.11 | — | — | 2026-01-01 | MRF ↗ |
| Northern Montana Hospital Outpatient | Montana Medicaid | Medicaid | $37.21 | $139.00 | $97.30 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | Montana Medicaid | Medicaid | $37.21 | $139.00 | $97.30 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | Healthy Kids Medicaid | Medicaid | $37.21 | $139.00 | $97.30 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | Healthy Kids Medicaid | Medicaid | $37.21 | $139.00 | $97.30 | 2026-04-02 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | AMBETTER [1094] | AMBETTER MARKETPLACE [109401] | $39.05 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | VA MEDICAL CENTER [1061] | VA COMMUNITY CARE NETWORK [106104] | $39.05 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | AMBETTER [1094] | AMBETTER OUT OF STATE [109402] | $39.05 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | MOLINA MEDICARE [7006] | MOLINA MEDICARE COMPLETE CARE [700602] | $39.05 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | MOLINA [1071] | MOLINA MARKETPLACE [107102] | $39.05 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | BLUE CARE NETWORK ADVANTAGE [7001] | BLUE CARE NETWORK ADVANTAGE [700101] | $39.05 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| CHAMBERS MEMORIAL HOSPITAL Outpatient | AR TOTAL CARE MCAID - ALL PLANS | AR TOTAL CARE MCAID - ALL PLANS | $39.16 | $883.57 | $441.79 | 2026-05-05 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | HUMANA MILITARY [1098] | HUMANA MILITARY TRICARE EAST [109801] | $41.54 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | TRICARE [1056] | TRICARE WEST [105601] | $41.54 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | TRICARE [1056] | TRICARE FOR LIFE [105602] | $41.54 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | VHA OFFICE OF COMMUNITY CARE [1011] | CHAMPVA [101101] | $41.54 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| Northern Montana Hospital Outpatient | TriWest | PPO | $41.70 | $139.00 | $97.30 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | Humana Medicare Advantage | Medicare | $41.70 | $139.00 | $97.30 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | United Medicare Advantage | Medicare | $41.70 | $139.00 | $97.30 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | Humana Medicare Advantage | Medicare | $41.70 | $139.00 | $97.30 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | United Medicare Advantage | Medicare | $41.70 | $139.00 | $97.30 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | TriWest | PPO | $41.70 | $139.00 | $97.30 | 2026-04-02 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | MCLAREN HEALTH ADVANTAGE [1038] | MCLAREN HEALTH ADVANTAGE [103801] | $42.37 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | MCLAREN HEALTH ADVANTAGE [1038] | MCLAREN HEALTH PLAN COMMUNITY [103802] | $42.37 | $203.00 | $203.00 | 2026-03-23 | MRF ↗ |
| Northern Montana Hospital Outpatient | Aetna Medicare Advantage | Medicare | $43.09 | $139.00 | $97.30 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | Aetna Medicare Advantage | Medicare | $43.09 | $139.00 | $97.30 | 2026-04-02 | MRF ↗ |
| METRO NASHVILLE GENERAL HOSPITAL Both | UNITEDHEALTHCARE | MEDICARE ADVANTAGE SNP | $43.54 | $1,905.00 | $1,143.00 | 2024-07-01 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | McLaren | MEDICAID | $43.91 | $3,122.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Priority Health | MEDICAID | $43.91 | $3,122.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Blue Cross Complete | MEDICAID | $43.91 | $3,122.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | HAP CareSource | MEDICAID | $43.91 | $3,122.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $43.91 | $3,122.00 | — | 2025-06-28 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MOLINA MCAL HMO [20503] | MOLINA MCAL HMO [2050301] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | MEDICARE PART B [1000103] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | MEDICARE PART A [1000101] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | MEDICARE PART A & B [1000102] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | VETERANS ADMINISTRATION [80002] | VETERANS ADMINISTRATION [8000201] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDI-CAL- AFTER 10/01/21 [30505] | KAISER MEDI-CAL HMO [3050501] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | RAILROAD MEDICARE [1000104] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE WASHINGTON [3050609] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADV MID-ATLANTIC STATES [3050607] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE HAWAII [3050606] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE GEORGIA [3050605] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE SOUTHERN CA [3050602] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP [20502] | IEHP INLAND VALLEY IPA [2050203] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE NORTHERN CA [3050601] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE NORTHWEST [3050608] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP [20502] | INLAND EMPIRE HEALTH PLAN [2050201] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP [20502] | IEHP LASALLE MEDICAL ASSOCIATES [2050204] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER OUT OF AREA MEDICARE ADVANTAGE [3050603] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE COLORADO [3050604] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP CAL MEDI-CONNECT MEDICARE ADVANTAGE [10512] | IEHP INLAND VALLEY IPA MEDICARE ADV [1051203] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP CAL MEDI-CONNECT MEDICARE ADVANTAGE [10512] | IEHP LASALLE MED ASSOC MEDICARE ADV [1051204] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | GENERIC FIRST AID [30063] | FIRST AID WORK COMP [3006301] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | ASCEND HOSPICE [32000] | ASCEND HOSPICE [3200001] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | CHAMPVA [80001] | VHA OFFICE OF COMMUNITY CARE [8000101] | $44.33 | $231.00 | — | 2026-04-02 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Aetna Better Health | MEDICAID | $46.11 | $3,122.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Aetna Better Health | MEDICAID | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | HAP | HAP Caresource Medicaid | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna Better Health | MEDICAID | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | HAP | HAP Caresource Medicaid | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | McLaren | MEDICAID | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | McLaren | MEDICAID | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | HAP Caresource Medicaid | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Priority Health | MEDICAID | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Aetna Better Health | MEDICAID | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Blue Cross Complete | MEDICAID | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Priority Health | MEDICAID | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Aetna Better Health | MEDICAID | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Priority Health | MEDICAID | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | McLaren | MEDICAID | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | HAP Caresource Medicaid | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | McLaren | MEDICAID | $47.87 | $1,902.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Blue Cross Complete | MEDICAID | $47.87 | $1,902.00 | — | 2025-06-28 | 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.