Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

Export CSV

43242 — Egd US Fine Needle Bx/aspir

Per-row negotiated rates, exactly as filed by each hospital. Aggregated views below summarize across hospitals; the bottom table shows the underlying rows.

Typical negotiated price $2,344

Usually $1,637–$3,729 (25th–75th percentile) across 2,186 hospitals · 5,029 payers.

“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 43242 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.

Also priced as a different code

The same procedure is billed under different code systems depending on the setting. These facilities price it under a code you won’t see in the CPT/HCPCS 43242 table above — including hospitals that only publish the bundled version.

MS_DRG 435 — Endoscopic ultrasound (EUS) with fine-needle aspiration/biopsy Inpatient stay bundle
2,997 facilities · 1,037 not in the CPT/HCPCS table
MS_DRG 436 — Endoscopic ultrasound (EUS) with fine-needle aspiration/biopsy Inpatient stay bundle
2,956 facilities · 1,013 not in the CPT/HCPCS table
MS_DRG 437 — Endoscopic ultrasound (EUS) with fine-needle aspiration/biopsy Inpatient stay bundle
2,711 facilities · 869 not in the CPT/HCPCS table

An MS-DRG / APR-DRG price is the hospital’s single bundled charge for the entire inpatient stay — operating room, room & board, recovery, imaging, anesthesia (facility), implants and supplies — so it’s a broader, usually higher figure than the CPT/HCPCS 43242 line above, which prices the procedure alone. Neither includes the surgeon’s or anesthesiologist’s professional fees, which are billed separately.

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.

Pick your insurer to anchor on your plan’s negotiated rate.
Measured
$1,637 $2,344 typical $3,729

The middle 50% of negotiated facility rates for this procedure, measured across 2,186 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. $2,344
Endoscopist (professional fee) Estimate national typical Medicare $230 × 1.22 commercial. $280
Anesthesia Estimate national typical 00731, ~30 min typical. Medicare $143 × 3.14 commercial. $451
Likely subtotal $3,075
Complete-episode estimate (typical) ~$3,075

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.

After discharge
Recovery cost ~$3,785
With your recovery plan (typical) ~$6,860
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
RARITAN BAY MEDICAL CENTER OutpatientFacility Clover Managed Medicare $6.93 $3,850.00 $1,912.13 2024-12-31 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient DIGNITY MCR ADV OP/PROFEE ONLY DIGNITY MCR ADV OP/PROFEE ONLY $7.58 $649.00 $123.31 2026-01-25 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient DIGNITY MCR ADV OP/PROFEE ONLY DIGNITY MCR ADV OP/PROFEE ONLY $7.58 $884.00 $167.96 2026-08-02 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient CAL VIVA HLTH MCAL - ALL PLANS CAL VIVA HLTH MCAL - ALL PLANS $15.00 $884.00 $167.96 2026-08-02 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient BC MCAL BC MCAL $15.00 $884.00 $167.96 2026-08-02 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient CENTRAL CA ALLIANCE MCAL PROFEE ONLY CENTRAL CA ALLIANCE MCAL PROFEE ONLY $15.00 $884.00 $167.96 2026-08-02 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient MEDI-CAL MEDI-CAL $15.00 $884.00 $167.96 2026-08-02 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient UPN MCAL PROFEE ONLY-ALL OTHER PLANS UPN MCAL PROFEE ONLY-ALL OTHER PLANS $15.00 $884.00 $167.96 2026-08-02 MRF ↗
ADVENTIST HEALTH UKIAH VALLEY Outpatient KAISER MEDI-CAL KAISER MEDI-CAL $15.00 $884.00 $176.80 2026-05-24 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS $15.00 $884.00 $167.96 2026-08-02 MRF ↗
ADVENTIST HEALTH UKIAH VALLEY Outpatient MEDI-CAL MEDI-CAL $15.00 $884.00 $176.80 2026-05-24 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient KERN HEALTH SYSTEMS MCAL-ALL PLANS KERN HEALTH SYSTEMS MCAL-ALL PLANS $18.75 $884.00 $167.96 2026-08-02 MRF ↗
ADVENTIST HEALTH LODI MEMORIAL Outpatient MEDI-CAL MEDI-CAL $20.00 $884.00 $61.88 2026-08-02 MRF ↗
TAHOE FOREST HOSPITAL Outpatient BLUE CROSS MCAL BLUE CROSS MCAL $20.00 $1,185.00 $1,185.00 2025-10-04 MRF ↗
ADVENTIST HEALTH LODI MEMORIAL Outpatient CELTIC INS COMPANY - ALL PLANS CELTIC INS COMPANY - ALL PLANS $20.00 $884.00 $61.88 2026-08-02 MRF ↗
ADVENTIST HEALTH LODI MEMORIAL Outpatient KAISER MCAL KAISER MCAL $20.00 $884.00 $61.88 2026-08-02 MRF ↗
ADVENTIST HEALTH LODI MEMORIAL Outpatient BC MCAL BC MCAL $20.00 $884.00 $61.88 2026-08-02 MRF ↗
TAHOE FOREST HOSPITAL Outpatient CA HEALTH AND WELLNESS-ALL PLANS CA HEALTH AND WELLNESS-ALL PLANS $20.40 $1,185.00 $1,185.00 2025-10-04 MRF ↗
ADVENTIST HEALTH LODI MEMORIAL Outpatient HP MCAL PRO FEE HP MCAL PRO FEE $22.00 $884.00 $61.88 2026-08-02 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient CENTRAL CA ALLIANCE CCS PROFEE ONLY CENTRAL CA ALLIANCE CCS PROFEE ONLY $22.50 $884.00 $167.96 2026-08-02 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P $22.50 $884.00 $167.96 2026-08-02 MRF ↗
ADVENTIST HEALTH LODI MEMORIAL Outpatient HP OF SAN JOAQUIN MCAL HP OF SAN JOAQUIN MCAL $24.00 $884.00 $61.88 2026-08-02 MRF ↗
ADVENTIST HEALTH LODI MEMORIAL Outpatient HEALTHNET MCAL HEALTHNET MCAL $24.00 $884.00 $61.88 2026-08-02 MRF ↗
TAHOE FOREST HOSPITAL Outpatient PARTNERSHIP HEALTH PLAN- ALL PLANS PARTNERSHIP HEALTH PLAN- ALL PLANS $26.00 $1,185.00 $1,185.00 2025-10-04 MRF ↗
ADVENTIST HEALTH REEDLEY Outpatient CENTRAL CA ALLIANCE CHDP PROFEE ONLY CENTRAL CA ALLIANCE CHDP PROFEE ONLY $30.00 $884.00 $167.96 2026-08-02 MRF ↗
EAST CARROLL PARISH HOSPITAL Outpatient UNITED CHICAGO TEACHER FUND-ALL PLANS UNITED CHICAGO TEACHER FUND-ALL PLANS $38.48 $285.00 $213.75 2026-01-16 MRF ↗
ADVENTIST HEALTH BAKERSFIELD Outpatient UNIVERSAL HC MCAL PROFEE ONLY UNIVERSAL HC MCAL PROFEE ONLY $40.00 $884.00 $132.60 2026-10-05 MRF ↗
ADVENTIST HEALTH HANFORD Outpatient KAISER MCAL KAISER MCAL $40.00 $884.00 $167.96 2026-05-19 MRF ↗
ADVENTIST HEALTH HANFORD Outpatient UNIVERSAL HC MCAL PROFEE UNIVERSAL HC MCAL PROFEE $40.00 $884.00 $167.96 2026-05-19 MRF ↗
ADVENTIST HEALTH HANFORD Outpatient BC MCAL BC MCAL $40.00 $884.00 $167.96 2026-05-19 MRF ↗
ADVENTIST HEALTH HANFORD Outpatient MEDI-CAL MEDI-CAL $40.00 $884.00 $167.96 2026-05-19 MRF ↗
ADVENTIST HEALTH BAKERSFIELD Outpatient MEDI-CAL MEDI-CAL $40.00 $884.00 $132.60 2026-10-05 MRF ↗
ADVENTIST HEALTH BAKERSFIELD Outpatient BC MEDI-CAL BC MEDI-CAL $40.00 $884.00 $132.60 2026-10-05 MRF ↗
ADVENTIST HEALTH HANFORD Outpatient HEALTHNET MCAL HEALTHNET MCAL $40.00 $884.00 $167.96 2026-05-19 MRF ↗
INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient Ccbh - Behavioral Health Behavioral — — — 2026-07-19 MRF ↗
ADVENTIST HEALTH BAKERSFIELD Outpatient KERN HEALTH SYSTEMS MCAL KERN HEALTH SYSTEMS MCAL $56.40 $884.00 $132.60 2026-10-05 MRF ↗
EAST CARROLL PARISH HOSPITAL Outpatient UNITED AT&T-ALL PLANS UNITED AT&T-ALL PLANS $59.14 $285.00 $213.75 2026-01-16 MRF ↗
WYNN HOSPITAL Outpatient BLUE CROSS NY EXCELLUS MEDICAID [350081] EXCELLUS ESSENTIAL PLAN [35008102] $61.50 $13,728.81 $8,237.29 2025-01-17 MRF ↗
WYNN HOSPITAL Outpatient EXCELLUS HMO MEDICAID APG [350082] EXCELLUS HMO MEDICAID APG [35008201] $61.50 $13,728.81 $8,237.29 2025-01-17 MRF ↗
WYNN HOSPITAL Outpatient BLUE CROSS NY EXCELLUS MEDICAID [350081] EXCELLUS HMO MEDICAID [35008103] $61.50 $13,728.81 $8,237.29 2025-01-17 MRF ↗
WYNN HOSPITAL Outpatient BLUE CROSS NY EXCELLUS [200041] EXCELLUS HEALTHY NY EPO [20004107] $61.50 $13,728.81 $8,237.29 2025-01-17 MRF ↗
WYNN HOSPITAL Outpatient EXCELLUS HMO MEDICAID APG [350082] EXCELLUS ESSENTIAL PLAN APG [35008202] $61.50 $13,728.81 $8,237.29 2025-01-17 MRF ↗
WYNN HOSPITAL Outpatient EXCELLUS HMO MEDICAID APG [350082] EXCELLUS CHILD HEALTH PLUS APG [35008203] $61.50 $13,728.81 $8,237.29 2025-01-17 MRF ↗
WYNN HOSPITAL Outpatient BLUE CROSS NY EXCELLUS MEDICAID [350081] EXCELLUS CHILD HEALTH PLUS [35008101] $61.50 $13,728.81 $8,237.29 2025-01-17 MRF ↗
ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient Arkansas Total Care Medicaid $64.60 — — 2026-07-15 MRF ↗
ADVENTIST HEALTH UKIAH VALLEY Outpatient BLUE CROSS NON-MCS BLUE CROSS NON-MCS $66.41 $884.00 $176.80 2026-05-24 MRF ↗
ADVENTIST HEALTH UKIAH VALLEY Outpatient BLUE CROSS MCS-ALL OTHER PLANS BLUE CROSS MCS-ALL OTHER PLANS $66.41 $884.00 $176.80 2026-05-24 MRF ↗
ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient Caresource Medicaid $67.18 — — 2026-07-15 MRF ↗
ADVENTIST HEALTH HANFORD Outpatient VALLEY CHILDRENS - ALL PLANS VALLEY CHILDRENS - ALL PLANS $67.20 $884.00 $167.96 2026-05-19 MRF ↗
SEARHC WRANGELL MEDICAL CENTER & LTC Outpatient UHC-ALL PLANS UHC-ALL PLANS $72.00 $1,353.14 $1,353.14 2024-12-09 MRF ↗
MON HEALTH MARION Outpatient The Health Plan Commercial Plan Commercial $76.69 $547.79 $273.89 2026-07-15 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient UNITED HEALTHCARE [101] UNITED HEALTHCARE|UHC - GENERIC|UHC EMPIRE PLAN (KINGSTON)|UNITEDHEALTHCARE OXFORD|UNITED MEDICAL RESOURCES (UMR)|UHC CHPS|UHC STUDENT RESOURCES|UHC SUREST|UNITED HEALTHCARE SHARED SERVICES — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient UNITED HEALTHCARE [101] UHC MEDICARE COMPLETE — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient FIDELIS EXCHANGE [157] FIDELIS(INCLUDING GOLD,SILVER,BRONZE AND PLATINUM) — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient VETERANS ADMINISTRATION [178] VA VETERAN'S CHOICE VACAA [17803] — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient INDEPENDENT HEALTH ASSOCIATION,IN [138] INDEPENDENT HEALTH ASSOC|NOVA HEALTHCARE-IHA — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient CHAMPUS/TRICARE [103] CHAMPUS/TRICARE|TRICARE FOR LIFE|MARTINS POINT/US FAMILY — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient UNITED HEALTHCARE [101] UHC COMMUNITY PLAN|UHC COMMUNITY MEDICAID DENTAL|UHC ESSENTIAL 1&2|UHC CHPS|UHC ESSENTIAL 3&4 — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient MOLINA HEALTHCARE OF NY [188] MOLINA ESSENTIALS 3&4 — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient FIDELIS CARE NEW YORK [112] FIDELIS CARE NEW YORK|FIDELIS FHP|FIDELIS CHP — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient GENERIC CARRIER [107] COMMERCIAL|HUMANA|CDPHP COMMERCIAL — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient FIDELIS MEDICARE [176] FIDELIS MEDICARE|FIDELIS DUAL ADVANTAGE — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient MH OPTUM [170] MH OPTUM COMMUNITY — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient MOLINA HEALTHCARE OF NY [188] YOURCARE BEACON MEDICAID|MOLINA MEDICAID MANAGED CARE|MOLINA CHILD HEALTH PLUS — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient WELLCARE MEDICARE HMO [122] WELLCARE DUAL — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient EXCELLUS HMO [104] MEDICARE BLUE CHOICE|MEDICARE BLUE DUAL|UNIVERA SENIOR|MEDICARE BLUE PPO — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient MVP [109] MVP DUAL ACCESS|MVP DUAL ACCESS COMPLETE — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient MVP [109] MVP|CIGNA|GWH CIGNA|NALC CIGNA — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient EXCELLUS INDEMNITY [127] BLUE CHOICE|RGHS EMPLOYEE MEDICAL PLAN|EXCELLUS UNITY EMPLOYEE PLAN|RRH CDHP|EMPIRE BLUE CROSS (NYC)|BLUE CROSS & BLUE SHIELD|UNIVERA|EMPIRE PLAN B/C (KINGSTON)|EXCELLUS BCBS RIT|FEDERAL BLUE CROSS & BLUE SHIELD — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient HIGHMARK [114] HIGHMARK MEDICARE — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient GENERIC MEDICARE HMO [125] HUMANA MEDICARE HMO|GENERIC MEDICARE HMO|ELDERPLAN|CDPHP MEDICARE HMO — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient AETNA [100] AETNA MEDICARE ADVANTAGE — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient EXCELLUS HMO [104] BLUE CHOICE OPTION|CHILD HEALTH PLUS|UNIVERA MYHEALTH PLUS|EXCELLUS ESSENTIAL 1&2|EXCELLUS ESSENTIAL 3&4|UNIVERA MYHEALTH|UNIVERA ESSENTIAL 1&2|HEALTHY NY|UNIVERA ESSENTIAL 1&2 — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient FIDELIS EXCHANGE [157] FIDELIS ESSENTIAL 1&2|FIDELIS ESSENTIAL 3&4 — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient EMBLEM GHI [113] EMBLEM GHI — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient INDEPENDENT HEALTH ASSOCIATION,IN [138] MEDICARE HMO INDEPENDENT HLTH|NOVA HEALTHCARE MEDICARE — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient MVP [109] MVP GOLD PPO — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient MVP [109] MVP GOLD HMO — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient HIGHMARK [114] HIGHMARK|HIGHMARK INDEMNITY- OUT OF AREA|HIGHMARK HMO BLUE — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient UNITED HEALTHCARE [101] UHC DUAL COMPLETE — $7,528.60 $4,893.59 2024-12-30 MRF ↗
NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient WELLCARE MEDICARE HMO [122] WELLCARE MEDICARE HMO — $7,528.60 $4,893.59 2024-12-30 MRF ↗
BELLEVUE MEDICAL CENTER Outpatient AETNA COMM-ALL OTHER PLANS AETNA COMM-ALL OTHER PLANS $78.57 $1,200.20 $780.13 2026-08-10 MRF ↗
UNITY HOSPITAL Outpatient MVP [109] MVP OPTION|MVP CHILD HEALTH PLUS $78.67 $7,445.92 $5,956.74 2024-12-30 MRF ↗
UNITY HOSPITAL Outpatient MVP [109] MVP ESSENTIAL 1&2|MVP ESSENTIAL 3&4 $78.67 $7,445.92 $5,956.74 2024-12-30 MRF ↗
HURLEY MEDICAL CENTER Both UNITED HEALTH CARE COMMUNITY PLAN MEDICAID [9004] UNITED HEALTH CARE MEDICAID [900401] $82.54 $801.00 $801.00 2026-03-23 MRF ↗
UNITY HOSPITAL Outpatient MVP [109] MVP EXCHANGE-INDIVIDUAL $84.04 $7,445.92 $5,956.74 2024-12-30 MRF ↗
FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility Coventry All — — — 2026-03-28 MRF ↗
FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility Prime Health All — — — 2026-03-28 MRF ↗
FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility Tricare All $87.98 — — 2026-03-28 MRF ↗
FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility First Health Network All — — — 2026-03-28 MRF ↗
FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility VA Health All $87.98 — — 2026-03-28 MRF ↗
FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility UHC Medicare Advantage $87.98 — — 2026-03-28 MRF ↗
FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility Humana Medicare Advantage $87.98 — — 2026-03-28 MRF ↗
FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility Pacific Source All — — — 2026-03-28 MRF ↗
FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility Interwest Health All — — — 2026-03-28 MRF ↗
FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility Montana Health CoOp All — — — 2026-03-28 MRF ↗
FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility Blue Cross Blue Shield Medicare Advantage $87.98 — — 2026-03-28 MRF ↗
HURLEY MEDICAL CENTER Both COUNTY HEALTH PLAN B [1022] COUNTY HEALTH PLAN B NON GENESEE COUNTY [102202] $90.80 $801.00 $801.00 2026-03-23 MRF ↗
HURLEY MEDICAL CENTER Both KEY BENEFIT ADMINISTRATORS [1089] KEY BENEFIT ADMINISTRATORS [108901] $90.80 $801.00 $801.00 2026-03-23 MRF ↗
HURLEY MEDICAL CENTER Both COUNTY HEALTH PLAN B [1022] GENESEE HEALTH PLAN B [102204] $90.80 $801.00 $801.00 2026-03-23 MRF ↗
CONCORD HOSPITAL Outpatient Medicaid Medicaid Nhhf $91.44 $995.00 $298.50 2026-07-15 MRF ↗
HARPER UNIVERSITY HOSPITAL Outpatient Hap HAPHMO $93.00 — — 2025-01-31 MRF ↗
ROCHESTER GENERAL HOSPITAL Outpatient UNITED HEALTHCARE [101] UHC COMMUNITY PLAN [10104] $97.80 $461.10 $461.10 2024-12-30 MRF ↗
ROCHESTER GENERAL HOSPITAL Inpatient GENERIC CARRIER [107] COMMERCIAL [10701] — $461.10 $461.10 2024-12-30 MRF ↗
ROCHESTER GENERAL HOSPITAL Inpatient CHAMPUS/TRICARE [103] CHAMPUS/TRICARE [10301] — $461.10 $461.10 2024-12-30 MRF ↗
ROCHESTER GENERAL HOSPITAL Inpatient EMBLEM GHI [113] EMBLEM GHI [11301] — $461.10 $461.10 2024-12-30 MRF ↗
ROCHESTER GENERAL HOSPITAL Inpatient HIGHMARK [114] HIGHMARK MEDICARE [11402] — $461.10 $461.10 2024-12-30 MRF ↗
ROCHESTER GENERAL HOSPITAL Outpatient UNITED BEHAVORIAL HEALTH [120] UNITED BEHAVORIAL HEALTH [12001] — $461.10 $461.10 2024-12-30 MRF ↗
ROCHESTER GENERAL HOSPITAL Outpatient GENERIC MEDICARE HMO [125] GENERIC MEDICARE HMO [12505] — $461.10 $461.10 2024-12-30 MRF ↗
ROCHESTER GENERAL HOSPITAL Outpatient HIGHMARK [114] HIGHMARK [11401] — $461.10 $461.10 2024-12-30 MRF ↗
ROCHESTER GENERAL HOSPITAL Inpatient MULTIPLAN [141] MULTIPLAN [14101] — $461.10 $461.10 2024-12-30 MRF ↗
ROCHESTER GENERAL HOSPITAL Outpatient HIGHMARK [114] HIGHMARK ESSENTIALS [11404] — $461.10 $461.10 2024-12-30 MRF ↗
CONCORD HOSPITAL Outpatient Medicaid Medicaid-Trad $99.50 $995.00 $298.50 2026-07-15 MRF ↗
ASCENSION ST VINCENT CARMEL Both ANTHEM HMO/POS 9229_ANTHEM HMO POS VCIN 20250101 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT WILLIAMSPORT Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT MERCY Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT MERCY Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CARMEL Both ANTHEM PATHWAY X 9231_ANTHEM PATHWAY X VCIN 20250101 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT EVANSVILLE Outpatient UNIFIED GROUP SERVICES 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT MERCY Outpatient UNIFIED GROUP SERVICES 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT RANDOLPH Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CARMEL Both ANTHEM PPO PREFERRED 9232_ANTHEM PREFERRED VCIN 20250101 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CARMEL Outpatient UNIFIED GROUP SERVICES 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CARMEL Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT RANDOLPH Outpatient UNIFIED GROUP SERVICES 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CARMEL Both ANTHEM PATHWAY 9230_ANTHEM PATHWAY VCIN 20250101 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CARMEL Both ANTHEM HEALTHSYNC HMO 9227_ANTHEM HEALTHSYNC HMO VCIN 20250101 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT WILLIAMSPORT Outpatient UNIFIED GROUP SERVICES 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 — — — 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 WILLIAMSPORT Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT RANDOLPH Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CARMEL Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT EVANSVILLE Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT ANDERSON Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CARMEL Both ANTHEM TRADITIONAL 9233_ANTHEM TRADITIONAL VCIN 20250101 — — — 2026-01-01 MRF ↗
Ascension St. Vincent Seton Specialty Hospital Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT ANDERSON Outpatient UNIFIED GROUP SERVICES 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT JENNINGS Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT EVANSVILLE Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 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 HOSPITAL Outpatient UNIFIED GROUP SERVICES 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 — — — 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 HEALTHSYNC POS 9228_ANTHEM HEALTHSYNC POS VCIN 20250101 — — — 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 FISHERS Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
ST VINCENT HEART CENTER Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT KOKOMO Outpatient UNIFIED GROUP SERVICES 8813_ANTHEM UNIFIED GROUPS VKIN 20241001 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CARMEL Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CLAY Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT RANDOLPH Outpatient UNIFIED GROUP SERVICES 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CARMEL Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT HOSPITAL Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 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 CLAY Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 2026-01-01 MRF ↗
ST VINCENT HEART CENTER Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT ANDERSON Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT MERCY Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 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 FISHERS Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CARMEL Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 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 CARMEL Outpatient UNIFIED GROUP SERVICES 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT MERCY Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 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 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT JENNINGS Outpatient UNIFIED GROUP SERVICES 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT FISHERS Outpatient UNIFIED GROUP SERVICES 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT KOKOMO Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT HOSPITAL Inpatient SMARTHEALTH PPO 8842_SMARTHEALTH PPO 20241001 — — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT KOKOMO Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT WARRICK Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT WARRICK Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CARMEL Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT JENNINGS Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT RANDOLPH Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
Ascension St. Vincent Seton Specialty Hospital Both UHC 9470_UNITED HEALTHCARE VEIN 20250101 $99.62 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT HOSPITAL Both UHC SELF 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 $99.62 — — 2026-01-01 MRF ↗
CONCORD HOSPITAL Outpatient Medicaid-Amerihealth Medicaid-Amerihealth $100.49 $995.00 $298.50 2026-07-15 MRF ↗
GRITMAN MEDICAL CENTER OutpatientFacility Molina of ID Medicaid Advantage $100.98 — — 2026-08-19 MRF ↗
St. Louise Regional Hospital BothFacility CENTRAL CA ALLIANCE [340] CENTRAL CA ALLIANCE [340001] $101.90 $10,710.00 $7,497.00 2026-09-01 MRF ↗
SANTA CLARA VALLEY MEDICAL CENTER BothFacility CENTRAL CA ALLIANCE [340] CENTRAL CA ALLIANCE [340001] $101.90 $10,710.00 $7,497.00 2026-09-01 MRF ↗
SANTA CLARA VALLEY MEDICAL CENTER BothFacility KAISER MEDI-CAL MC [410] KAISER MEDI-CAL MC [410002] $101.90 $10,710.00 $7,497.00 2026-09-01 MRF ↗
O'connor Hospital BothFacility KAISER MEDI-CAL MC [410] KAISER MEDI-CAL MC [410002] $101.90 $10,710.00 $7,497.00 2026-09-01 MRF ↗
O'connor Hospital BothFacility CENTRAL CA ALLIANCE [340] CENTRAL CA ALLIANCE [340001] $101.90 $10,710.00 $7,497.00 2026-09-01 MRF ↗
St. Louise Regional Hospital BothFacility KAISER MEDI-CAL MC [410] KAISER MEDI-CAL MC [410002] $101.90 $10,710.00 $7,497.00 2026-09-01 MRF ↗
HURLEY MEDICAL CENTER Both PACE MEDICARE HMO [7023] GENESYS PACE MEDICARE HMO [702301] $102.04 $801.00 $801.00 2026-03-23 MRF ↗
Rehabilitation Institute Of Michigan Outpatient Hap HAPHMO $104.79 — — 2025-01-31 MRF ↗
ASCENSION ST VINCENT KOKOMO Both UHC 9393_UNITED HEALTHCARE VKIN 20250101 $105.09 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT HOSPITAL Outpatient UHC SELF 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 $105.09 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT WARRICK Inpatient UHC 8493_UNITED HEALTHCARE SWIN 20240701 $105.09 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT WARRICK Inpatient UHC BEHAVIORAL HEALTH 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 $105.09 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT RANDOLPH Both UHC 9395_UNITED HEALTHCARE VRIN 20250101 $105.09 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT HOSPITAL Outpatient UHC NEW 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 $105.09 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT ANDERSON Both UHC 9390_UNITED HEALTHCARE VAIN 20250101 $105.09 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CARMEL Outpatient UHC NEW 6790_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ASIN 20230101 $105.09 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT WILLIAMSPORT Both UHC 9397_UNITED HEALTHCARE VWIN 20250101 $105.09 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT RANDOLPH Both UHC 9395_UNITED HEALTHCARE VRIN 20250101 $105.09 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CLAY Both UHC 9384_UNITED HEALTHCARE CLIN 20250101 $105.09 — — 2026-01-01 MRF ↗
ASCENSION ST VINCENT CARMEL Outpatient UHC NEW 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 $105.09 — — 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.