43239 — Egd Biopsy Single/multiple
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). EGD BIOPSY SINGLE/MULTIPLE (CPT 43239) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/43239?code_type=CPT
MLA (9th ed.)
“EGD BIOPSY SINGLE/MULTIPLE (CPT 43239) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/43239?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“EGD BIOPSY SINGLE/MULTIPLE (CPT 43239) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/43239?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $870–$2,415 (25th–75th percentile) across 3,353 hospitals · 7,910 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 43239 — 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
$870
$1,397 typical
$2,415
The middle 50% of negotiated facility rates for this procedure, measured across 3,353 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. | $1,397 |
| Endoscopist (professional fee) Estimate national typical Medicare $124 × 1.22 commercial. | $151 |
| Anesthesia Estimate national typical 00731, ~30 min typical. Medicare $143 × 3.14 commercial. | $451 |
| Likely subtotal | $1,998 |
Complete-episode estimate (typical)
~$1,998
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: whether a finding is treated during the same procedure, which converts a diagnostic exam to a therapeutic one and changes the cost-sharing.
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)
~$5,783
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
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 |
|---|---|---|---|---|---|---|---|
| MARION GENERAL HOSPITAL Inpatient | Umr Marion General Hospital | Umrmghun | — | $32,966.00 | $19,779.60 | 2026-07-15 | MRF ↗ |
| MARION GENERAL HOSPITAL Inpatient | Php Encore Not Exchange | Phpenc 1 | — | $32,966.00 | $19,779.60 | 2026-07-15 | MRF ↗ |
| MARION GENERAL HOSPITAL Inpatient | Php Encore Not Exchange | Phpenc | — | $32,717.92 | $19,630.75 | 2026-07-15 | MRF ↗ |
| MARION GENERAL HOSPITAL Inpatient | Php Encore Not Exchange | Phpenc | — | $32,966.00 | $19,779.60 | 2026-07-15 | MRF ↗ |
| MARION GENERAL HOSPITAL Inpatient | Php Encore Not Exchange | Phpenc 1 | — | $32,717.92 | $19,630.75 | 2026-07-15 | MRF ↗ |
| MARION GENERAL HOSPITAL Inpatient | Umr Marion General Hospital | Umrmghun | — | $32,717.92 | $19,630.75 | 2026-07-15 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $1,079.61 | $107.96 | 2026-07-18 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | United Healthcare | Compass | — | $1.00 | $0.60 | 2026-07-15 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Cigna | Commercial | — | $1.00 | $0.60 | 2026-07-15 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $1.00 | $0.60 | 2026-07-15 | MRF ↗ |
| SAVOY MEDICAL CENTER OutpatientFacility | Aetna | Commercial | — | — | — | 2026-03-15 | MRF ↗ |
| CANYON VISTA MEDICAL CENTER Outpatient | BLUECROSS BLUESHIELD OF ARIZONA, INC | HMO | $0.64 | $6,038.00 | $2,415.20 | 2025-07-01 | MRF ↗ |
| BARTON MEMORIAL HOSPITAL Outpatient | Aetna | Commercial | — | $3,569.98 | $2,498.99 | 2026-08-01 | MRF ↗ |
| COLUMBUS COMMUNITY HOSPITAL, INC Outpatient | United Healthcare | Commercial | — | $1.01 | $0.96 | 2026-07-15 | MRF ↗ |
| COLUMBUS COMMUNITY HOSPITAL, INC Outpatient | Ambetter Health | Commercial | — | $1.01 | $0.96 | 2026-07-15 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $591.00 | $484.62 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $591.00 | $484.62 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $591.00 | $484.62 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $591.00 | $484.62 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | HMO | — | $591.00 | $484.62 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $591.00 | $484.62 | 2025-11-26 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $1.42 | $699.00 | $524.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $1.42 | $699.00 | $524.25 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $1.42 | $1,271.00 | $953.25 | 2026-07-01 | MRF ↗ |
| PEMISCOT COUNTY MEMORIAL HOSPITAL Outpatient | Cigna | Commercial | $3.20 | $365.00 | $255.50 | 2026-07-15 | MRF ↗ |
| HANCOCK COUNTY HEALTH SYSTEM Outpatient | WELLMARK HMO-ALL OTHER PLANS | WELLMARK HMO-ALL OTHER PLANS | $3.24 | $1,161.00 | $870.75 | 2026-03-26 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $3.99 | $468.00 | $88.92 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $3.99 | $344.00 | $65.36 | 2026-01-25 | MRF ↗ |
| COMANCHE COUNTY MEDICAL CENTER Outpatient | MPI - ALL PLANS | MPI - ALL PLANS | $4.39 | $432.00 | $280.80 | 2026-05-07 | MRF ↗ |
| WALLOWA MEMORIAL HOSPITAL Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $5.80 | $1,082.00 | $1,082.00 | 2026-07-09 | MRF ↗ |
| MOBRIDGE REGIONAL HOSPITAL - CAH Outpatient | SANFORD HEALTHPLAN-ALL PLANS | SANFORD HEALTHPLAN-ALL PLANS | $6.08 | $1,888.00 | $1,888.00 | 2026-07-16 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $7.39 | $4,106.00 | $906.34 | 2024-12-31 | MRF ↗ |
| SPRINGHILL MEDICAL CENTER Outpatient | Unitedhealthcare Insurance Company (Contracting On Behalf Of Itself, Unitedhealthcare Of Alabama, Inc. And United'S Affiliates) | Commercial All Payer | — | $2,903.71 | $2,468.15 | 2026-07-15 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $7.98 | $286.00 | $286.00 | 2026-02-13 | MRF ↗ |
| STE GENEVIEVE COUNTY MEMORIAL HOSPITAL Outpatient | Cigna | Commercial | — | $518.00 | $259.00 | 2026-07-15 | MRF ↗ |
| SPRINGHILL MEDICAL CENTER Outpatient | Humana Inc. | Standard | — | $2,903.71 | $2,468.15 | 2026-07-15 | MRF ↗ |
| NORTHWEST FLORIDA COMMUNITY HOSPITAL Outpatient | Medicare | Medicare | — | $306.00 | $244.80 | 2026-07-15 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | KAISER MEDI-CAL | KAISER MEDI-CAL | $15.00 | $468.00 | $93.60 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $15.00 | $468.00 | $93.60 | 2026-05-24 | MRF ↗ |
| PEACEHEALTH PEACE ISLAND MEDICAL CENTER Outpatient | Humana Health Plan | Medicare Hmo/Ppo | — | $989.50 | $643.18 | 2026-08-01 | MRF ↗ |
| ABBEVILLE AREA MEDICAL CENTER Outpatient | Humana | Medicaid | — | $3,549.09 | $2,484.36 | 2026-07-15 | MRF ↗ |
| ABBEVILLE AREA MEDICAL CENTER Outpatient | Humana | Medicaid | — | $3,549.09 | $2,484.36 | 2026-08-03 | MRF ↗ |
| KERN VALLEY HEALTHCARE DISTRICT Outpatient | HEALTHNET (AIM) | HEALTHNET (AIM) | $20.00 | $608.00 | $125.06 | 2026-02-25 | MRF ↗ |
| KERN VALLEY HEALTHCARE DISTRICT Outpatient | MEDI-CAL | MEDI-CAL | $20.00 | $608.00 | $125.06 | 2026-02-25 | MRF ↗ |
| KERN VALLEY HEALTHCARE DISTRICT Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $20.00 | $608.00 | $125.06 | 2026-02-25 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | TRIWEST WELLMARK-ALL PLANS | TRIWEST WELLMARK-ALL PLANS | $21.10 | $58.61 | $52.75 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | VA CCN -ALL PLANS | VA CCN -ALL PLANS | $21.10 | $58.61 | $52.75 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MEDICAL ASSOCIATES-ALL PLANS | MEDICAL ASSOCIATES-ALL PLANS | $21.10 | $58.61 | $52.75 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | TRICARE- ALL PLANS | TRICARE- ALL PLANS | $21.10 | $58.61 | $52.75 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | WELLMARK MCR ADV- ALL PLANS | WELLMARK MCR ADV- ALL PLANS | $21.31 | $58.61 | $52.75 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | UHC MCR ADV | UHC MCR ADV | $21.73 | $58.61 | $52.75 | 2026-01-03 | MRF ↗ |
| ANTELOPE VALLEY HOSPITAL Outpatient | Health Net Of California - Medi | Cal | — | $8,272.00 | $8,272.00 | 2026-07-15 | MRF ↗ |
| PEMISCOT COUNTY MEMORIAL HOSPITAL Outpatient | Anthem Traditional | Commercial | $23.71 | $365.00 | $255.50 | 2026-07-15 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $24.88 | $2,392.45 | $2,392.45 | 2026-04-24 | MRF ↗ |
| ADVENTIST HEALTH CASTLE Outpatient | PACIFIC ADMIN PPO - ALL PLANS | PACIFIC ADMIN PPO - ALL PLANS | $29.27 | $342.00 | $109.44 | 2026-05-18 | MRF ↗ |
| DECATUR COUNTY MEMORIAL HOSPITAL Outpatient | UHC-ALL OTHER PLANS | UHC-ALL OTHER PLANS | $30.00 | $508.00 | $381.00 | 2026-03-18 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | $6,966.75 | 2024-12-08 | MRF ↗ |
| Vibra Hospital Of Western Mass - Central Campus | Multiplan Complimentary 737 Multiplan, Value Point | — | $31.00 | $39.00 | — | 2026-07-31 | MRF ↗ |
| Vibra Hospital Of Denver | Tricare West Healthnet 232 | — | $31.26 | $48.09 | — | 2026-07-31 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL AETNA CARE [700912] | $31.38 | $4,837.75 | $4,837.75 | 2026-03-23 | MRF ↗ |
| MERCYONE ELKADER MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $31.45 | — | $7,659.75 | 2026-03-31 | MRF ↗ |
| CHAN SOON- SHIONG MEDICAL CENTER AT WINDBER Outpatient | Highmark | Highmark Mcr Freedom Blue | $31.49 | $160.00 | $136.00 | 2026-07-15 | MRF ↗ |
| CHAN SOON- SHIONG MEDICAL CENTER AT WINDBER Outpatient | Highmark | Highmark Mcr Security Blue | $31.49 | $160.00 | $136.00 | 2026-07-15 | MRF ↗ |
| CHAN SOON- SHIONG MEDICAL CENTER AT WINDBER Outpatient | Highmark | Highmark Mcr Community/Complete Blue | $31.49 | $160.00 | $136.00 | 2026-07-15 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | OSCAR-ALL PLANS | OSCAR-ALL PLANS | $31.65 | $58.61 | $52.75 | 2026-01-03 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UCARE MEDICARE [16042] | UCARE MSHO [1604204] | $31.72 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UCARE MEDICARE [16042] | UCARE MEDICARE PLANS [1604203] | $31.72 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UCARE MEDICARE [16042] | UCARE CONNECT PLUS MEDICARE [1604201] | $31.72 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | PRIME WEST MEDICARE [16030] | PRIME WEST MSHO [1603001] | $31.72 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | MEDICA MEDICARE [16024] | MEDICA ACCESSABILITY SOLUTION ENHANCED [1602405] | $31.72 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | BLUE CROSS BLUE SHIELD MEDICARE [16008] | BCBS BLUE PLUS SECURE BLUE [1600804] | $31.72 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | BLUE CROSS BLUE SHIELD MEDICARE [16008] | BCBS PLATINUM BLUE [1600803] | $31.72 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | BLUE CROSS BLUE SHIELD MEDICARE [16008] | BCBS OUT OF STATE MEDICARE [1600802] | $31.72 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | MEDICA MEDICARE [16024] | MEDICA PRIME SOLUTION [1602403] | $31.72 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | MEDICA MEDICARE [16024] | MEDICA ADVANTAGE SOLUTION [1602401] | $31.72 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | MEDICA MEDICARE [16024] | MEDICA COMPLETE SOLUTION [1602404] | $31.72 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | BLUE CROSS BLUE SHIELD MEDICARE [16008] | BCBS MN MEDICARE ADVANTAGE [1600801] | $31.72 | $472.00 | — | 2026-01-01 | MRF ↗ |
| CHAN SOON- SHIONG MEDICAL CENTER AT WINDBER Outpatient | Highmark | Highmark Comm Managed/Indemnity | $31.80 | $160.00 | $136.00 | 2026-07-15 | MRF ↗ |
| CHAN SOON- SHIONG MEDICAL CENTER AT WINDBER Outpatient | Highmark | Highmark Aca / My Direct Blue / My Blue Access Ppo | $31.80 | $160.00 | $136.00 | 2026-07-15 | MRF ↗ |
| CHAN SOON- SHIONG MEDICAL CENTER AT WINDBER Outpatient | Highmark | Highmark Comm Community Blue | $31.80 | $160.00 | $136.00 | 2026-07-15 | MRF ↗ |
| CHAN SOON- SHIONG MEDICAL CENTER AT WINDBER Outpatient | Highmark | Highmark Comm Performance Blue | $31.80 | $160.00 | $136.00 | 2026-07-15 | MRF ↗ |
| Vibra Hospital Of Boise | United Healthcare | — | $31.88 | $40.35 | — | 2026-07-30 | MRF ↗ |
| USA HEALTH CHILDREN'S & WOMEN'S HOSPITAL OutpatientFacility | United Healthcare | All Payor/Commercial | — | $1,876.00 | $1,876.00 | 2026-04-30 | MRF ↗ |
| Vibra Hospital Of Boise | Multiplan Complimentary 737 Multiplan, Value Point | — | $32.28 | $40.35 | — | 2026-07-30 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UHC ALL SAVERS [1601011] | $32.50 | $1,298.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UNITEDHEALTH INTEGRATED SERVICES [1601007] | $32.50 | $1,298.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UNITEDHEALTH INTEGRATED SERVICES [1601007] | $32.50 | $1,298.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UNITED HEALTHCARE [1601005] | $32.50 | $1,298.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UNITED HEALTHCARE INDEMNITY [1601006] | $32.50 | $1,298.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UMR [1601009] | $32.50 | $1,298.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UHC ALL SAVERS [1601011] | $32.50 | $1,298.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | SUREST UNITED HEALTHCARE [1601008] | $32.50 | $1,298.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UMR LABOR CARE [1601010] | $32.50 | $1,298.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UMR [1601009] | $32.50 | $1,298.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UMR LABOR CARE [1601010] | $32.50 | $1,298.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | SUREST UNITED HEALTHCARE [1601008] | $32.50 | $1,298.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UNITED HEALTHCARE [1601005] | $32.50 | $1,298.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE [16010] | UNITED HEALTHCARE INDEMNITY [1601006] | $32.50 | $1,298.00 | — | 2026-01-01 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Humana | Humana Medicare Advantage | $32.60 | $105.00 | $105.00 | 2026-07-15 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UNITED HEALTHCARE MEDICARE [16044] | UNITED HEALTHCARE MEDICARE SOLUTIONS [1604402] | $32.68 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UNITED HEALTHCARE MEDICARE [16044] | UNITED HEALTHCARE MEDICARE ADVANTAGE [1604401] | $32.68 | $472.00 | — | 2026-01-01 | MRF ↗ |
| Vibra Hospital Of Western Mass - Central Campus | Multiplan Wc 54 Multiplan, Value Point | — | $33.00 | $39.00 | — | 2026-07-31 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | $7,179.00 | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | $7,179.00 | 2024-12-08 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | HEALTHPARTNERS MEDICARE [16019] | HEALTHPARTNERS FREEDOM [1601901] | $33.31 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | HEALTHPARTNERS MEDICARE [16019] | HEALTHPARTNERS MEDICARE ADVANTAGE [1601902] | $33.31 | $472.00 | — | 2026-01-01 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | $4,092.75 | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | $4,092.75 | 2024-12-08 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | HEALTHPARTNERS MEDICAID [16020] | HEALTHPARTNERS MN CARE [1602001] | $34.68 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | HEALTHPARTNERS MEDICAID [16020] | HEALTHPARTNERS CARE SNBC [1602003] | $34.68 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | HEALTHPARTNERS MEDICAID [16020] | HEALTHPARTNERS CARE [1602002] | $34.68 | $472.00 | — | 2026-01-01 | MRF ↗ |
| PIH HEALTH DOWNEY HOSPITAL Outpatient | La Care Health Plan | Hmo | $35.00 | $11,742.00 | $836.15 | 2026-07-19 | MRF ↗ |
| MAYERS MEMORIAL HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $35.00 | $1,472.00 | $1,472.00 | 2026-05-12 | MRF ↗ |
| CALIFORNIA HOSPITAL MEDICAL CENTER LA Outpatient | DHR | Medicaid|< 21 | — | — | — | 2026-02-28 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | MEDI-CAL | MEDI-CAL | $35.00 | $468.00 | $70.20 | 2026-07-29 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | BC MEDI-CAL | BC MEDI-CAL | $35.00 | $468.00 | $70.20 | 2026-07-29 | MRF ↗ |
| Vibra Hospital Of Western Mass - Central Campus | Multiplan Auto 618 Multiplan, Valuepoint | — | $35.00 | $39.00 | — | 2026-07-31 | MRF ↗ |
| ADVENTIST HEALTH BAKERSFIELD Outpatient | UNIVERSAL HC MCAL PROFEE ONLY | UNIVERSAL HC MCAL PROFEE ONLY | $35.00 | $468.00 | $70.20 | 2026-07-29 | MRF ↗ |
| ST MARY MEDICAL CENTER Outpatient | DHR | Medicaid|< 21 | — | — | — | 2026-02-28 | MRF ↗ |
| PIH HEALTH DOWNEY HOSPITAL Outpatient | Health Net Medi-Cal Managed Ca | Hmo | $35.00 | $11,742.00 | $836.15 | 2026-07-19 | MRF ↗ |
| CALIFORNIA HOSPITAL MEDICAL CENTER LA Outpatient | DHR | Medicaid|< 21 | — | — | — | 2026-02-28 | MRF ↗ |
| ST MARY MEDICAL CENTER Outpatient | DHR | Medicaid|< 21 | — | — | — | 2026-02-28 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Blue Cross | Blue Access & Small Group | $35.07 | — | — | 2026-07-18 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UCARE MEDICAID [16041] | UCARE MA [1604102] | $35.91 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UCARE MEDICAID [16041] | UCARE MN CARE [1604103] | $35.91 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UCARE MEDICAID [16041] | UCARE CONNECT [1604101] | $35.91 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | BLUE CROSS BLUE SHIELD MEDICAID [16007] | BCBS BLUE PLUS MN CARE [1600702] | $36.44 | $472.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | BLUE CROSS BLUE SHIELD MEDICAID [16007] | BCBS BLUE PLUS MA [1600701] | $36.44 | $472.00 | — | 2026-01-01 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Martins Point | Default | $37.08 | $103.00 | $77.25 | 2026-05-18 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Blue Cross | Epo/Ppo/Hmo/Indemnity | $37.40 | — | — | 2026-07-18 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Blue Cross Blue Shield Of Vt | Federal | $38.19 | $103.00 | $77.25 | 2026-05-18 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Blue Cross Blue Shield Of Vt | Default | $38.19 | $103.00 | $77.25 | 2026-05-18 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Blue Cross Blue Shield Of Vt | Ppo | $38.19 | $103.00 | $77.25 | 2026-05-18 | MRF ↗ |
| SATANTA DISTRICT HOSPITAL, CLINICS, & LTCU Outpatient | DIRECT BENEFIT-ALL PLANS | DIRECT BENEFIT-ALL PLANS | $38.40 | $160.00 | $144.00 | 2026-03-10 | MRF ↗ |
| SATANTA DISTRICT HOSPITAL, CLINICS, & LTCU Outpatient | DIRECT BENEFIT-ALL PLANS | DIRECT BENEFIT-ALL PLANS | $38.40 | $160.00 | $144.00 | 2026-03-10 | MRF ↗ |
| Vibra Hospital Of Denver | Tricare 765 | — | $38.47 | $48.09 | — | 2026-07-31 | MRF ↗ |
| Vibra Hospital Of Denver | Multiplan Complimentary 737 Multiplan, Value Point | — | $38.47 | $48.09 | — | 2026-07-31 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | MEDI-CAL | MEDI-CAL | $40.00 | $468.00 | $88.92 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | BC MCAL | BC MCAL | $40.00 | $468.00 | $88.92 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | UPN MCAL PROFEE ONLY-ALL OTHER PLANS | UPN MCAL PROFEE ONLY-ALL OTHER PLANS | $40.00 | $468.00 | $88.92 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CAL VIVA HLTH MCAL - ALL PLANS | CAL VIVA HLTH MCAL - ALL PLANS | $40.00 | $468.00 | $88.92 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE MCAL PROFEE ONLY | CENTRAL CA ALLIANCE MCAL PROFEE ONLY | $40.00 | $468.00 | $88.92 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS | DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS | $40.00 | $468.00 | $88.92 | 2026-05-20 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| FAIRCHILD MEDICAL CENTER Outpatient | MEDI-CAL | MEDI-CAL | $40.00 | $1,943.00 | $1,943.00 | 2025-12-03 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL AETNA BETTER HEALTH MEDICAID [300612] | $40.07 | $4,837.75 | $4,837.75 | 2026-03-23 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $40.24 | — | — | 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 RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $40.24 | — | — | 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 KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 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 ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM TRADITIONAL | 9233_ANTHEM TRADITIONAL VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Inpatient | SMARTHEALTH PPO | 8842_SMARTHEALTH PPO 20241001 | — | — | — | 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 CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 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 MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $40.24 | — | — | 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 WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $40.24 | — | — | 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 RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $40.24 | — | — | 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 RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | UNIFIED GROUP SERVICES | 8812_ANTHEM UNIFIED GROUPS VHIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PATHWAY X | 9231_ANTHEM PATHWAY X VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 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 ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PATHWAY | 9230_ANTHEM PATHWAY VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HMO/POS | 9229_ANTHEM HMO POS VCIN 20250101 | — | — | — | 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 RANDOLPH Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $40.24 | — | — | 2026-01-01 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.