43212 — Esophagoscop Stent Placement
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). ESOPHAGOSCOP STENT PLACEMENT (CPT 43212) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/43212?code_type=CPT
MLA (9th ed.)
“ESOPHAGOSCOP STENT PLACEMENT (CPT 43212) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/43212?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“ESOPHAGOSCOP STENT PLACEMENT (CPT 43212) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/43212?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $2,729–$7,759 (25th–75th percentile) across 1,642 hospitals · 4,021 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 43212 — 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
$2,729
$5,910 typical
$7,759
The middle 50% of negotiated facility rates for this procedure, measured across 1,642 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. | $5,910 |
| Endoscopist (professional fee) Estimate national typical Medicare $170 × 1.22 commercial. | $207 |
| 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 | $6,503 |
Complete-episode estimate (typical)
~$6,503
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)
~$10,288
- 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 |
|---|---|---|---|---|---|---|---|
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Multiplan | Multiplan | $0.52 | $5,476.00 | $4,107.00 | 2026-04-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | County Medical Services | County of San Diego | $0.65 | $5,476.00 | $4,107.00 | 2026-04-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Inpatient | California Health and Wellness | California Health and Wellness | $0.65 | $5,476.00 | $4,107.00 | 2026-04-01 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Community Health Group | Community Health Group - Medi-Cal | $0.65 | $5,476.00 | $4,107.00 | 2026-04-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $1,783.00 | $1,462.06 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | Health Net of California, Inc. | HMO | — | $1,783.00 | $1,462.06 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $1,783.00 | $1,462.06 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $1,783.00 | $1,462.06 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $1,783.00 | $1,462.06 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $1,783.00 | $1,462.06 | 2025-11-26 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $5.48 | $461.00 | $87.59 | 2026-01-25 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $16.62 | $9,233.00 | $5,753.89 | 2024-12-31 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $27.54 | $204.00 | $153.00 | 2026-01-16 | 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 | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $42.33 | $204.00 | $153.00 | 2026-01-16 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - United | Medicaid - United | $43.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - Meridian | Medicaid - Meridian | $43.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - Molina | Medicaid - Molina | $48.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER 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 ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - Molina | Medicaid - Molina | $51.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | POS | — | $1,783.00 | $1,462.06 | 2025-11-26 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Medicaid - United | Medicaid - United | $54.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $54.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $54.07 | — | — | 2026-01-01 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - United | Medicaid - United | $57.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $60.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - Meridian | Medicaid - Meridian | $61.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - Meridian | Medicaid - Meridian | $61.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $61.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - United | Medicaid - United | $62.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $66.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| LAKESIDE MEDICAL CENTER OutpatientFacility | UHC | CHIP | $66.88 | $4,450.00 | $5,975.31 | 2025-12-02 | MRF ↗ |
| LAKESIDE MEDICAL CENTER OutpatientFacility | UHC | Managed Medicaid | $66.88 | $4,450.00 | $5,975.31 | 2025-12-02 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - Meridian | Medicaid - Meridian | $69.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | EMBLEM GHI [113] | EMBLEM GHI [11301] | — | $333.07 | $333.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK ESSENTIALS [11404] | — | $333.07 | $333.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | GENERIC MEDICARE HMO [125] | GENERIC MEDICARE HMO [12505] | — | $333.07 | $333.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN [10104] | $70.06 | $333.07 | $333.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | GENERIC CARRIER [107] | COMMERCIAL [10701] | — | $333.07 | $333.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MULTIPLAN [141] | MULTIPLAN [14101] | — | $333.07 | $333.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE [10301] | — | $333.07 | $333.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED BEHAVORIAL HEALTH [120] | UNITED BEHAVORIAL HEALTH [12001] | — | $333.07 | $333.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK MEDICARE [11402] | — | $333.07 | $333.07 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK [11401] | — | $333.07 | $333.07 | 2024-12-30 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $71.76 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $71.76 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $71.76 | — | — | 2026-03-18 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $73.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - United | Medicaid - United | $74.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Medicaid - Molina | Medicaid - Molina | $75.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $75.64 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $75.64 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $75.64 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $75.64 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $75.64 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $75.64 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $75.64 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $75.64 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $75.64 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $75.64 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $75.64 | — | — | 2026-01-01 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Tricare | Tricare | $76.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - Molina | Medicaid - Molina | $79.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - Molina | Medicaid - Molina | $80.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicare - United | Medicare - United | $81.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| HIGHLAND HOSPITAL Both | HIGHMARK BC/BS OF WESTERN NY MEDICAID [1702], AMERIGROUP (BSWNY ALTERNATE) [1720], HIGHMARK BC/BS OF WESTERN NY [5143] | HIGHMARK BC/BS OF WESTERN NY MEDICAID [170201], AMERIGROUP (BSWNY ALTERNATE) [172001], COMMUNITY BLUE CHILD HEALTH PLUS [514306], BC/BS OF WNY ESSENTIAL (NO MEDICAID) [514307] | $81.54 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Both | HIGHMARK BC/BS OF WESTERN NY MEDICAID [1702], AMERIGROUP (BSWNY ALTERNATE) [1720], HIGHMARK BC/BS OF WESTERN NY [5143] | HIGHMARK BC/BS OF WESTERN NY MEDICAID [170201], AMERIGROUP (BSWNY ALTERNATE) [172001], COMMUNITY BLUE CHILD HEALTH PLUS [514306], BC/BS OF WNY ESSENTIAL (NO MEDICAID) [514307] | $81.54 | — | — | 2026-04-01 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $82.23 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $82.23 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $82.23 | — | — | 2026-03-18 | MRF ↗ |
| MCLAREN MACOMB Outpatient | WC - Workers Compensation | WC - Workers Compensation | $83.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Traditional Medicare HMO PPO | Traditional Medicare HMO PPO | $84.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Medicaid - Meridian | Medicaid - Meridian | $84.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicare - Molina | Medicare - Molina | $86.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Tricare | Tricare | $86.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | HAP - HMO | HAP - HMO | $86.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicare - Humana | Medicare - Humana | $87.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicare - Priority Health | Medicare - Priority Health | $89.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $89.54 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $89.54 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $89.54 | — | — | 2026-03-18 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicare - United | Medicare - United | $90.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| HIGHLAND HOSPITAL Both | EXCELLUS BC/BS MEDICAID [1706], EXCELLUS BC/BS [2201] | BLUE CHOICE OPTION MEDICAID [170601], EXCELLUS CHILD HEALTH PLUS [220108],EXCELLUS HEALTHY NY [220110], EXCELLUS ESSENTIAL (NO MEDICAID) [220109], EXCELLUS ESSENTIAL (W/ MEDICAID) [170604], UNIVERA HEALTHY NY [220112], UNIVERA ESSENTIAL (NO MEDICAID) [220 | $90.38 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Both | EXCELLUS BC/BS MEDICAID [1706], EXCELLUS BC/BS [2201] | BLUE CHOICE OPTION MEDICAID [170601], EXCELLUS CHILD HEALTH PLUS [220108],EXCELLUS HEALTHY NY [220110], EXCELLUS ESSENTIAL (NO MEDICAID) [220109], EXCELLUS ESSENTIAL (W/ MEDICAID) [170604], UNIVERA HEALTHY NY [220112], UNIVERA ESSENTIAL (NO MEDICAID) [220 | $90.38 | — | — | 2026-04-01 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | CIGNA-ALL PLANS | CIGNA-ALL PLANS | $91.80 | $204.00 | $153.00 | 2026-01-16 | 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 ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | RAILROAD MEDICARE [1000104] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP [20502] | IEHP INLAND VALLEY IPA [2050203] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | MEDICARE PART A & B [1000102] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP [20502] | INLAND EMPIRE HEALTH PLAN [2050201] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE SOUTHERN CA [3050602] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | MEDICARE PART B [1000103] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | MEDICARE PART A [1000101] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | CHAMPVA [80001] | VHA OFFICE OF COMMUNITY CARE [8000101] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE WASHINGTON [3050609] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | GENERIC FIRST AID [30063] | FIRST AID WORK COMP [3006301] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER OUT OF AREA MEDICARE ADVANTAGE [3050603] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | VETERANS ADMINISTRATION [80002] | VETERANS ADMINISTRATION [8000201] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDI-CAL- AFTER 10/01/21 [30505] | KAISER MEDI-CAL HMO [3050501] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE GEORGIA [3050605] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE NORTHERN CA [3050601] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP CAL MEDI-CONNECT MEDICARE ADVANTAGE [10512] | IEHP LASALLE MED ASSOC MEDICARE ADV [1051204] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP CAL MEDI-CONNECT MEDICARE ADVANTAGE [10512] | IEHP INLAND VALLEY IPA MEDICARE ADV [1051203] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADV MID-ATLANTIC STATES [3050607] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE HAWAII [3050606] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE COLORADO [3050604] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MOLINA MCAL HMO [20503] | MOLINA MCAL HMO [2050301] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | ASCEND HOSPICE [32000] | ASCEND HOSPICE [3200001] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP [20502] | IEHP LASALLE MEDICAL ASSOCIATES [2050204] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE NORTHWEST [3050608] | $93.65 | $486.00 | — | 2026-04-02 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | United Healthcare | United Healthcare | $94.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| TRINITAS REGIONAL MEDICAL CENTER OutpatientFacility | Wellpoint | NJ Family Care | $94.14 | — | — | 2026-03-04 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | HAP CareSource | MEDICAID | $95.33 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $95.33 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | McLaren | MEDICAID | $95.33 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Priority Health | MEDICAID | $95.33 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Blue Cross Complete | MEDICAID | $95.33 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Bcbs - Western Ny | Medicaid Managed Care Plan | $95.93 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Both | HIGHMARK BC/BS OF WESTERN NY MEDICAID [1702], AMERIGROUP (BSWNY ALTERNATE) [1720], HIGHMARK BC/BS OF WESTERN NY [5143] | HIGHMARK BC/BS OF WESTERN NY MEDICAID [170201], AMERIGROUP (BSWNY ALTERNATE) [172001], COMMUNITY BLUE CHILD HEALTH PLUS [514306], BC/BS OF WNY ESSENTIAL (NO MEDICAID) [514307] | $95.93 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Both | HIGHMARK BC/BS OF WESTERN NY MEDICAID [1702], AMERIGROUP (BSWNY ALTERNATE) [1720], HIGHMARK BC/BS OF WESTERN NY [5143] | HIGHMARK BC/BS OF WESTERN NY MEDICAID [170201], AMERIGROUP (BSWNY ALTERNATE) [172001], COMMUNITY BLUE CHILD HEALTH PLUS [514306], BC/BS OF WNY ESSENTIAL (NO MEDICAID) [514307] | $95.93 | — | — | 2026-04-01 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $96.24 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $96.24 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $96.24 | — | — | 2026-03-18 | MRF ↗ |
| NEWARK BETH ISRAEL MEDICAL CENTER OutpatientFacility | United Healthcare | Community Plan | $96.90 | — | — | 2026-03-04 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Tricare | Tricare | $97.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Tricare | Tricare | $98.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL - SOMERSET OutpatientFacility | Wellpoint | NJ Family Care | $99.67 | — | — | 2026-03-04 | MRF ↗ |
| MCLAREN MACOMB Outpatient | United Healthcare | United Healthcare | $100.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicare - United | Medicare - United | $100.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicare - Humana | Medicare - Humana | $100.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Aetna Better Health | MEDICAID | $100.10 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicare - Humana | Medicare - Humana | $102.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Aetna | Aetna | $103.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Traditional Medicare HMO PPO | Traditional Medicare HMO PPO | $104.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Priority Health | MEDICAID | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Aetna Better Health | MEDICAID | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | HAP | HAP Caresource Medicaid | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Blue Cross Complete | MEDICAID | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | McLaren | MEDICAID | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | HAP Caresource Medicaid | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Aetna Better Health | MEDICAID | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Priority Health | MEDICAID | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | McLaren | MEDICAID | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | McLaren | MEDICAID | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna Better Health | MEDICAID | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Priority Health | MEDICAID | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | HAP | HAP Caresource Medicaid | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Aetna Better Health | MEDICAID | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | McLaren | MEDICAID | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Blue Cross Complete | MEDICAID | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | HAP Caresource Medicaid | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Priority Health | MEDICAID | $104.61 | $4,256.00 | — | 2025-06-28 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | United Healthcare | United Healthcare | $105.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Aetna | Aetna | $105.00 | $425.00 | $212.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Traditional Medicare HMO PPO | Traditional Medicare HMO PPO | $105.00 | $425.00 | $212.00 | 2025-02-03 | 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.