43241 — Egd Tube/cath Insertion
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). EGD TUBE/CATH INSERTION (CPT 43241) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/43241?code_type=CPT
MLA (9th ed.)
“EGD TUBE/CATH INSERTION (CPT 43241) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/43241?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“EGD TUBE/CATH INSERTION (CPT 43241) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/43241?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,296–$3,301 (25th–75th percentile) across 1,879 hospitals · 5,114 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 43241 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Estimated complete episode
What the whole episode might cost
Your hospital facility price plus the separately-billed professional fees a complete episode adds. The facility figure is an actual negotiated rate from our data; the surgeon and anesthesia figures are estimates from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$1,296
$2,180 typical
$3,301
The middle 50% of negotiated facility rates for this procedure, measured across 1,879 hospitals. Surgeon & anesthesia fees are modeled estimates added on top.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $2,180 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $127 × 1.22 commercial. | $155 |
| Likely subtotal | $2,335 |
Surgical episode (typical)
~$2,335
Your recovery plan — adjust to what your surgeon told you
After surgery, 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)
~$6,120
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Surgeon (professional fee) (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Oscar Health | Exchange | $3.41 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| JOHN MUIR MEDICAL CENTER - WALNUT CREEK CAMPUS Outpatient | CONTRA COSTA COUNTY JAIL [1012104] | CCC JAIL [101210401] | $3.84 | $65,839.13 | $29,627.61 | 2026-03-23 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $4.09 | $352.00 | $66.88 | 2026-01-25 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | United Healthcare | Medicare | $4.74 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Humana | Medicare | $4.74 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Blue Cross Blue Shield | Medicare | $4.74 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Essential Health Partners | Medicare | $4.74 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Aetna | Medicare | $4.74 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Devoted Healthcare | Medicare | $4.74 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Essential Health Partners | Hmo | $4.74 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Cigna | Medicare | $4.83 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Meridian | Medicare (Wellcare) | $4.88 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | PRIVATE HEALTH CARE SYSTEMS [20320] | HB FTSM PHCS | — | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | ARKANSAS DEPARTMENT OF HEALTH [20036] | HB FTSM ARK MEDICAID | $5.00 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | PRIVATE HEALTH CARE SYSTEMS CONTRACTED [320320] | HB FTSM PHCS | — | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | PRIVATE HEALTH CARE SYSTEMS CONTRACTED [320320] | HB FTSM PHCS | — | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | SUMMIT COMMUNITY CARE [20368] | HB FTSM ARK MEDICAID | $5.00 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | ARKANSAS DEPARTMENT OF HEALTH [20036] | HB FTSM ARK MEDICAID | $5.00 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | SUMMIT COMMUNITY CARE CONTRACTED [320368] | HB FTSM SUMMIT | $5.00 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | SUMMIT COMMUNITY CARE [20368] | HB FTSM ARK MEDICAID | $5.00 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | SUMMIT COMMUNITY CARE CONTRACTED [320368] | HB FTSM SUMMIT | $5.00 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | MEDICAID [20240] | HB FTSM ARK MEDICAID | $5.00 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | MEDICAID [20240] | HB FTSM ARK MEDICAID | $5.00 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | PRIVATE HEALTH CARE SYSTEMS [20320] | HB FTSM PHCS | — | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | CARESOURCE MEDICAID [20460] | HB FTSM CARESOURCE MEDICAID | $5.10 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | CARESOURCE MEDICAID [20460] | HB FTSM CARESOURCE MEDICAID | $5.10 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | CARESOURCE MEDICAID CONTRACTED [320460] | HB FTSM CARESOURCE MEDICAID | $5.10 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | CARESOURCE MEDICAID CONTRACTED [320460] | HB FTSM CARESOURCE MEDICAID | $5.10 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $5.19 | $2,882.00 | $1,912.13 | 2024-12-31 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Meridian | Exchange (Ambetter) | $5.69 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | EMPOWER HEALTHCARE SOLUTIONS MEDICAID [20118] | HB FTSM PASSE EMPOWER | $6.35 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | EMPOWER HEALTHCARE SOLUTIONS MEDICAID CONTRACTED [320118] | HB FTSM PASSE EMPOWER | $6.35 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | EMPOWER HEALTHCARE SOLUTIONS MEDICAID CONTRACTED [320118] | HB FTSM PASSE EMPOWER | $6.35 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | EMPOWER HEALTHCARE SOLUTIONS MEDICAID [20118] | HB FTSM PASSE EMPOWER | $6.35 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Aetna | Commercial | $7.68 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $8.18 | $582.00 | $582.00 | 2026-02-13 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Hst Technologies | Epo, Ppo | $9.10 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | ARKANSAS TOTAL CARE CONTRACTED [320039] | HB FTSM PASSE AR TOTAL CARE | $11.35 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | ARKANSAS TOTAL CARE [20039] | HB FTSM PASSE AR TOTAL CARE | $11.35 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | ARKANSAS TOTAL CARE [20039] | HB FTSM PASSE AR TOTAL CARE | $11.35 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | ARKANSAS TOTAL CARE CONTRACTED [320039] | HB FTSM PASSE AR TOTAL CARE | $11.35 | $596.00 | $387.40 | 2026-03-13 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | United Healthcare | Navigate, Core, Charter, Aco Tiered | $11.86 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | United Healthcare | All Other Plans | $13.18 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Cigna | Hmo, Ppo, Pos | $13.98 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Cigna | Local Plus | $13.98 | $21.00 | $7.35 | 2026-05-08 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $14.95 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $15.04 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $15.04 | — | — | 2026-03-18 | 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 Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $18.77 | — | — | 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 ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $21.06 | $156.00 | $117.00 | 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 ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $32.37 | $156.00 | $117.00 | 2026-01-16 | 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 ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Health Net | Health Net Individual - EPO | $33.40 | $4,126.00 | $3,094.50 | 2026-04-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Medicare | Medicare | $33.40 | $4,126.00 | $3,094.50 | 2026-04-01 | 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 ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $36.49 | — | — | 2026-01-01 | MRF ↗ |
| HERMANN AREA DISTRICT HOSPITAL Outpatient | UHC COMM/MARKETPLACE - ALL OTHER PLANS | UHC COMM/MARKETPLACE - ALL OTHER PLANS | $40.00 | $710.50 | $426.30 | 2026-01-24 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MERIDIAN HEALTH PLAN [9007] | MERIDIAN HEALTH PLAN [900701] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | AETNA BETTER HEALTH PLAN [9018] | AETNA BETTER HEALTH PLAN [901801] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH SHIAWASSEE COUNTY [901003] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH LAPEER COUNTY [901004] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH OAKLAND COUNTY [901005] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH SAGINAW COUNTY [901002] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | HARBOR HEALTH PLAN [9016] | HARBOR HEALTH PLAN [901601] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | OUT OF COUNTY CMH [901001] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID HEALTHY MICHIGAN [3007] | MEDICAID HEALTHY MICHIGAN [300701] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF STATE MEDICAID [3004] | OUT OF STATE MEDICAID GENERIC [300402] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF STATE MEDICAID [3004] | OUT OF STATE MEDICAID [300401] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | HEALTH ALLIANCE PLAN MEDICAID [9012] | HAP CARESOURCE [901202] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | UPPER PENINSULA HEALTH PLAN MEDICAID [9015] | UPPER PENINSULA HEALTH [901501] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MATERNITY OUT PATIENT MEDICAL (MOMS) [300002] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | PLAN FIRST FAMILY PLANNING [300003] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | ABW COVERAGE NO HMO LISTED [3003] | ABW COVERAGE NO HMO LISTED [300301] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | CHILDRENS SPECIAL HEALTH SERVICES ALT [3009] | CHILDRENS SPECIAL HEALTHCARE SERVICES [300901] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL MIDWEST HEALTH CAID [300607] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL MOLINA CAID [300603] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | HEALTH PARTNERS MEDICAID [9017] | HEALTH PARTNERS MEDICAID [901701] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | PACE MEDICAID HMO [9020] | GENESYS PACE [902001] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL PRIORITY HEALTH CAID [300611] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL OMNICARE CAID [300608] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | BCCCP/WISEWOMAN [300006] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL AETNA BETTER HEALTH MEDICAID [300612] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL MCLAREN CAID [300601] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID TEMPORARY PRESUMPTIVE [300005] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID QMB [300007] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MERIDIAN HEALTH PLAN [9007] | MERIDIAN MICHILD [900702] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | UNITED HEALTH CARE COMMUNITY PLAN MEDICAID [9004] | UNITED HEALTH CARE MEDICAID [900401] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL GREAT LAKES [300602] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID MICHILD [300008] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL BLUE CROSS COMPLETE [300610] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL HAP EMPOWERED [300613] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL TOTAL HEALTHCARE [300606] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL MERIDIAN CAID [300605] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | BLUE CROSS COMPLETE [9001] | BLUE CROSS COMPLETE [900102] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL HEALTH PLUS CAID [300604] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | EMERGENCY MEDICAID [300004] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID [300001] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | GENERIC MEDICAID HMO [9000] | GENERIC MEDICAID HMO [900001] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MOLINA [1071] | MOLINA MICHILD [107101] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MOLINA HEALTH CARE [9008] | MOLINA HEALTH CARE [900801] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID DEDUCTIBLE/SPENDDOWN [3001] | MEDICAID DEDUCTIBLE/SPENDDOWN [300101] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | PRIORITY HEALTH PLAN MEDICAID [9013] | PRIORITY HEALTH PLAN MEDICAID [901301] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | GENESEE COUNTY CMH [9003] | GENESEE COUNTY CMH [900301] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH CLINTON EATON & INGHAM COUNTY [901006] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | CHILDRENS SPECIAL HEALTHCARE SERVICES (CSHCS) [3002] | CHILDRENS SPECIAL HEALTHCARE SERVICES [300201] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | COVENTRY CARES MEDICAID [9009] | OMNICARE HEALTH PLAN MEDICAID [900901] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MICHIGAN COMPLETE HEALTH MEDICAID [9019] | MICHIGAN COMPLETE HEALTH MEDICAID [901901] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL UNITED HEALTHCARE CARE [300609] | $45.05 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| NORTH VALLEY HEALTH CENTER Outpatient | BCBS MHCP | BCBS MHCP | $48.76 | $293.00 | $293.00 | 2025-09-15 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Medicare|Negotiated_Percentage | — | $49.00 | $428.00 | $256.80 | 2026-05-18 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Medicare|Negotiated_Percentage | — | $49.00 | $428.00 | $256.80 | 2026-05-21 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | MOLINA MCR ADV | MOLINA MCR ADV | $49.20 | $164.00 | $98.40 | 2025-11-18 | MRF ↗ |
| MERCY MEDICAL CTR OutpatientFacility | CARELON HEALTH MEDICAID | CARELON MEDICAID | $49.48 | — | $5,254.79 | 2026-03-31 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | COUNTY HEALTH PLAN B [1022] | GENESEE HEALTH PLAN B [102204] | $49.56 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | COUNTY HEALTH PLAN B [1022] | COUNTY HEALTH PLAN B NON GENESEE COUNTY [102202] | $49.56 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | KEY BENEFIT ADMINISTRATORS [1089] | KEY BENEFIT ADMINISTRATORS [108901] | $49.56 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| S E LACKEY MEMORIAL HOSPITAL Outpatient | CIGNA COMM - ALL PLANS | CIGNA COMM - ALL PLANS | $50.00 | $323.00 | $323.00 | 2026-02-10 | 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 ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| MAINEHEALTH STEPHENS HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | $51.11 | $131.05 | $131.05 | 2025-09-09 | MRF ↗ |
| MAINEHEALTH STEPHENS HOSPITAL OutpatientFacility | United Healthcare | Medicare Advantage | $51.11 | $131.05 | $131.05 | 2025-09-09 | MRF ↗ |
| MAINEHEALTH STEPHENS HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $51.11 | $131.05 | $131.05 | 2025-09-09 | MRF ↗ |
| MAINEHEALTH STEPHENS HOSPITAL OutpatientFacility | Anthem | Medicare Advantage | $52.64 | $131.05 | $131.05 | 2025-09-09 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | MULTIPLAN [141] | MULTIPLAN [14101] | — | $253.14 | $253.14 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED BEHAVORIAL HEALTH [120] | UNITED BEHAVORIAL HEALTH [12001] | — | $253.14 | $253.14 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK MEDICARE [11402] | — | $253.14 | $253.14 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | GENERIC CARRIER [107] | COMMERCIAL [10701] | — | $253.14 | $253.14 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE [10301] | — | $253.14 | $253.14 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN [10104] | $53.06 | $253.14 | $253.14 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | EMBLEM GHI [113] | EMBLEM GHI [11301] | — | $253.14 | $253.14 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK [11401] | — | $253.14 | $253.14 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | GENERIC MEDICARE HMO [12505] | — | $253.14 | $253.14 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK ESSENTIALS [11404] | — | $253.14 | $253.14 | 2024-12-30 | MRF ↗ |
| MAINEHEALTH STEPHENS HOSPITAL OutpatientFacility | Wellcare | Medicare Advantage | $53.15 | $131.05 | $131.05 | 2025-09-09 | MRF ↗ |
| MERCY MEDICAL CTR OutpatientFacility | WELLSENSE HEALTH PLAN | WELLSENSE SILVER | $54.19 | — | $5,254.79 | 2026-03-31 | MRF ↗ |
| CHAMBERS MEMORIAL HOSPITAL Outpatient | AR TOTAL CARE MCAID - ALL PLANS | AR TOTAL CARE MCAID - ALL PLANS | $55.48 | $400.72 | $200.36 | 2026-05-05 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | PACE MEDICARE HMO [7023] | GENESYS PACE MEDICARE HMO [702301] | $56.30 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $57.63 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $57.63 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $57.63 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $57.63 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $57.63 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $57.63 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $57.63 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $57.63 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $57.63 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $57.63 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $57.63 | — | — | 2026-01-01 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | AETNA MEDICARE [7014] | AETNA MEDICARE [701401] | $62.56 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | AMERIVANTAGE MEDICARE HMO [7018] | AMERIVANTAGE MEDICARE HMO [701801] | $62.56 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | HEALTH ALLIANCE PLAN SENIOR [7003] | HENRY FORD HEALTH SELECT HMO MEDICARE [700311] | $62.56 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | UNIVERSITY OF MICHIGAN HEALTH MEDICARE [7031] | UNIVERSITY OF MICHIGAN HEALTH MEDICARE [703101] | $62.56 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | HEALTH ALLIANCE PLAN SENIOR [7003] | HAP MEDICARE DIABETES AND HEART HMO CSNP [700312] | $62.56 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | UPPER PENINSULA HEALTH PLAN MEDICARE [7019] | UPPER PENINSULA HEALTH PLAN MEDICARE [701901] | $62.56 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | HEALTH ALLIANCE PLAN SENIOR [7003] | HAP MEDICARE CONNECT HMO [700301] | $62.56 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | HEALTH PARTNERS MEDICARE HMO [7017] | HEALTH PARTNERS MEDICARE HMO [701701] | $62.56 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICARE PLUS BLUE/BCBS ADVANTAGE [7005] | MEDICARE PLUS BLUE U-M RETIREE ADVANTAGE [700502] | $62.56 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | GENERIC MEDICARE ADVANTAGE [7000] | GENERIC MEDICARE ADVANTAGE [700001] | $62.56 | $302.00 | $302.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICARE [2000] | RAIL ROAD MEDICARE [200004] | $62.56 | $302.00 | $302.00 | 2026-03-23 | 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.