43250 — Egd Cautery Tumor Polyp
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). EGD CAUTERY TUMOR POLYP (CPT 43250) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/43250?code_type=CPT
MLA (9th ed.)
“EGD CAUTERY TUMOR POLYP (CPT 43250) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/43250?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“EGD CAUTERY TUMOR POLYP (CPT 43250) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/43250?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,173–$3,127 (25th–75th percentile) across 2,042 hospitals · 5,666 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 43250 — 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
$1,173
$2,087 typical
$3,127
The middle 50% of negotiated facility rates for this procedure, measured across 2,042 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. | $2,087 |
| Endoscopist (professional fee) Estimate national typical Medicare $153 × 1.22 commercial. | $186 |
| Anesthesia Estimate national typical Generic anesthesia (~30 min typical, median CMS base units). Medicare $123 × 3.14 commercial. Approximate — no procedure-specific anesthesia mapping for this code. | $386 |
| Likely subtotal | $2,660 |
Complete-episode estimate (typical)
~$2,660
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)
~$6,444
- The anesthesia component is a generic, approximate estimate — no procedure-specific anesthesia mapping exists for this code, so a typical anesthesia for this procedure type is shown.
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Endoscopist (professional fee) (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
- Anesthesia (estimate)
- base_units_version: CY2022 file (base units unchanged for CY2026 per CMS) · anesthesia_cf: $20.49754 (National) · cf_rule: CMS-1832-F · multiplier_source: AJMC/Duffy 2016-2017 (PMID 34156223) national · basis: generic surgical anesthesia — 4 base units (typical CMS value) × ~30 min; approximate, NOT a procedure-specific crosswalk
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Cigna | Commercial | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Longevity | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana Choicecare | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Healthy Blue | Managed Medicaid | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | First Carolina Care | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna | Commercial | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Liberty Advantage | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Troy | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Commercial | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Wellcare | Managed Medicaid | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Blue Medicare Partner Health Plan | Medicare | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | New Hanover | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Wellcare | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Compass | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Onenet Ppo | $0.13 | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Managed Medicaid | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Carolina Complete Health | Managed Medicaid | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana Choicecare | Commercial | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Multiplan | Commercial | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Medicare Advantage | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Medcost | Commercial | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Tricare | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna Nc State Health Plan | Commercial | — | $3,621.00 | $2,172.60 | 2026-05-23 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $1.65 | $699.00 | $524.25 | 2025-03-07 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $4.94 | $419.00 | $79.61 | 2026-01-25 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $6.72 | $3,732.00 | $1,912.13 | 2024-12-31 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Oscar Health | Exchange | $8.87 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Aetna | Medicare | $12.32 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Essential Health Partners | Medicare | $12.32 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Essential Health Partners | Hmo | $12.32 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Humana | Medicare | $12.32 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Devoted Healthcare | Medicare | $12.32 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Blue Cross Blue Shield | Medicare | $12.32 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | United Healthcare | Medicare | $12.32 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Cigna | Medicare | $12.57 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Meridian | Medicare (Wellcare) | $12.69 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | GRANTS [20507] | All TB GETCHELL [226] Plans | $13.00 | $23,802.33 | $23,802.33 | 2026-03-26 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Meridian | Exchange (Ambetter) | $14.78 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| MAYERS MEMORIAL HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $15.00 | $1,790.00 | $1,790.00 | 2026-05-12 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Health Net | Health Net Individual - EPO | $17.63 | $4,930.00 | $3,697.50 | 2026-04-01 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Aetna | Commercial | $19.96 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $20.00 | $737.00 | $737.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $20.40 | $737.00 | $737.00 | 2025-10-04 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $22.39 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $22.53 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $22.53 | — | — | 2026-03-18 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Hst Technologies | Epo, Ppo | $23.65 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $25.66 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $25.82 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $25.82 | — | — | 2026-03-18 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $26.00 | $737.00 | $737.00 | 2025-10-04 | MRF ↗ |
| UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER HR [124] Plans | $27.79 | $10,686.83 | $10,686.83 | 2026-04-03 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $27.94 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $28.11 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $28.11 | — | — | 2026-03-18 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | $3,483.38 | 2024-12-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | United Healthcare | Navigate, Core, Charter, Aco Tiered | $30.80 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | $3,483.38 | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | United Healthcare | All Other Plans | $34.23 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Cigna | Local Plus | $35.40 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Cigna | Hmo, Ppo, Pos | $35.40 | $57.00 | $19.95 | 2026-05-08 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HMO/POS | 9229_ANTHEM HMO POS VCIN 20250101 | — | — | — | 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 Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $44.37 | — | — | 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 CARMEL Both | ANTHEM HEALTHSYNC POS | 9228_ANTHEM HEALTHSYNC POS VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PPO PREFERRED | 9232_ANTHEM PREFERRED VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM TRADITIONAL | 9233_ANTHEM TRADITIONAL VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $44.37 | — | — | 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 RANDOLPH 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 CARMEL Both | ANTHEM HEALTHSYNC HMO | 9227_ANTHEM HEALTHSYNC HMO VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8813_ANTHEM UNIFIED GROUPS VKIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $44.37 | — | — | 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 SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $44.37 | — | — | 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 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 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $44.37 | — | — | 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 MERCY 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 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $44.37 | — | — | 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 CARMEL Both | ANTHEM PATHWAY | 9230_ANTHEM PATHWAY VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $44.37 | — | — | 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 Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $44.37 | — | — | 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 EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $44.37 | — | — | 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 ANDERSON 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 | $44.37 | — | — | 2026-01-01 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | $3,483.38 | 2024-12-08 | MRF ↗ |
| S E LACKEY MEMORIAL HOSPITAL Outpatient | CIGNA COMM - ALL PLANS | CIGNA COMM - ALL PLANS | $50.00 | $1,235.00 | $1,235.00 | 2026-02-10 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | GENERIC MEDICAID HMO [9000] | GENERIC MEDICAID HMO [900001] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL HAP EMPOWERED [300613] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | HEALTH PARTNERS MEDICAID [9017] | HEALTH PARTNERS MEDICAID [901701] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | CHILDRENS SPECIAL HEALTH SERVICES ALT [3009] | CHILDRENS SPECIAL HEALTHCARE SERVICES [300901] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL PRIORITY HEALTH CAID [300611] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | BLUE CROSS COMPLETE [9001] | BLUE CROSS COMPLETE [900102] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | COVENTRY CARES MEDICAID [9009] | OMNICARE HEALTH PLAN MEDICAID [900901] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL MCLAREN CAID [300601] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | PLAN FIRST FAMILY PLANNING [300003] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID QMB [300007] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | EMERGENCY MEDICAID [300004] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID [300001] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID TEMPORARY PRESUMPTIVE [300005] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID MICHILD [300008] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MOLINA HEALTH CARE [9008] | MOLINA HEALTH CARE [900801] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL MOLINA CAID [300603] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL BLUE CROSS COMPLETE [300610] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | BCCCP/WISEWOMAN [300006] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL UNITED HEALTHCARE CARE [300609] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MICHIGAN COMPLETE HEALTH MEDICAID [9019] | MICHIGAN COMPLETE HEALTH MEDICAID [901901] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | GENESEE COUNTY CMH [9003] | GENESEE COUNTY CMH [900301] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL HEALTH PLUS CAID [300604] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL TOTAL HEALTHCARE [300606] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MERIDIAN HEALTH PLAN [9007] | MERIDIAN HEALTH PLAN [900701] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MOLINA [1071] | MOLINA MICHILD [107101] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MERIDIAN HEALTH PLAN [9007] | MERIDIAN MICHILD [900702] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH OAKLAND COUNTY [901005] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | AETNA BETTER HEALTH PLAN [9018] | AETNA BETTER HEALTH PLAN [901801] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL OMNICARE CAID [300608] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | OUT OF COUNTY CMH [901001] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH CLINTON EATON & INGHAM COUNTY [901006] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL AETNA BETTER HEALTH MEDICAID [300612] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH SAGINAW COUNTY [901002] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH LAPEER COUNTY [901004] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH SHIAWASSEE COUNTY [901003] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | CHILDRENS SPECIAL HEALTHCARE SERVICES (CSHCS) [3002] | CHILDRENS SPECIAL HEALTHCARE SERVICES [300201] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID DEDUCTIBLE/SPENDDOWN [3001] | MEDICAID DEDUCTIBLE/SPENDDOWN [300101] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | HARBOR HEALTH PLAN [9016] | HARBOR HEALTH PLAN [901601] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MATERNITY OUT PATIENT MEDICAL (MOMS) [300002] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL MIDWEST HEALTH CAID [300607] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF STATE MEDICAID [3004] | OUT OF STATE MEDICAID GENERIC [300402] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID HEALTHY MICHIGAN [3007] | MEDICAID HEALTHY MICHIGAN [300701] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | PRIORITY HEALTH PLAN MEDICAID [9013] | PRIORITY HEALTH PLAN MEDICAID [901301] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL MERIDIAN CAID [300605] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF STATE MEDICAID [3004] | OUT OF STATE MEDICAID [300401] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | UPPER PENINSULA HEALTH PLAN MEDICAID [9015] | UPPER PENINSULA HEALTH [901501] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL GREAT LAKES [300602] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | ABW COVERAGE NO HMO LISTED [3003] | ABW COVERAGE NO HMO LISTED [300301] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | PACE MEDICAID HMO [9020] | GENESYS PACE [902001] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | UNITED HEALTH CARE COMMUNITY PLAN MEDICAID [9004] | UNITED HEALTH CARE MEDICAID [900401] | $53.89 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| MACKINAC STRAITS HOSPITAL AND HEALTH CENTER | BLUE CROSS BLUE SHIELD | — | — | $434.00 | $260.40 | 2025-06-01 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | MODA HEALTH PLAN - ALL OTHER PLANS | MODA HEALTH PLAN - ALL OTHER PLANS | $57.82 | $1,553.12 | $1,553.12 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $57.82 | $1,553.12 | $1,553.12 | 2025-05-29 | MRF ↗ |
| SATANTA DISTRICT HOSPITAL, CLINICS, & LTCU Outpatient | DIRECT BENEFIT-ALL PLANS | DIRECT BENEFIT-ALL PLANS | $58.08 | $242.00 | $217.80 | 2026-03-10 | MRF ↗ |
| SATANTA DISTRICT HOSPITAL, CLINICS, & LTCU Outpatient | DIRECT BENEFIT-ALL PLANS | DIRECT BENEFIT-ALL PLANS | $58.08 | $242.00 | $217.80 | 2026-03-10 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | BLUE CROSS - ALL PLANS | BLUE CROSS - ALL PLANS | $58.31 | $1,553.12 | $1,553.12 | 2025-05-29 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | COUNTY HEALTH PLAN B [1022] | COUNTY HEALTH PLAN B NON GENESEE COUNTY [102202] | $59.28 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | COUNTY HEALTH PLAN B [1022] | GENESEE HEALTH PLAN B [102204] | $59.28 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | KEY BENEFIT ADMINISTRATORS [1089] | KEY BENEFIT ADMINISTRATORS [108901] | $59.28 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | HEALTH ALLIANCE PLAN MEDICAID [9012] | HAP CARESOURCE [901202] | $59.28 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $61.02 | $452.00 | $339.00 | 2026-01-16 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Outpatient | Tricare | Commercial | $62.00 | $386.00 | $386.00 | 2025-11-07 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | PROVIDENCE PREFERRED - ALL PLANS | PROVIDENCE PREFERRED - ALL PLANS | $64.68 | $1,553.12 | $1,553.12 | 2025-05-29 | MRF ↗ |
| LAKESIDE MEDICAL CENTER OutpatientFacility | UHC | CHIP | $66.88 | $3,192.00 | $1,904.16 | 2025-12-02 | MRF ↗ |
| LAKESIDE MEDICAL CENTER OutpatientFacility | UHC | Managed Medicaid | $66.88 | $3,192.00 | $1,904.16 | 2025-12-02 | MRF ↗ |
| RIVERLAND MEDICAL CENTER Both | Humana Advantage Care Plans Med Advantage | Default | $67.35 | $324.00 | $162.00 | 2024-10-24 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | PACE MEDICARE HMO [7023] | GENESYS PACE MEDICARE HMO [702301] | $67.87 | $364.00 | $364.00 | 2026-03-23 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - Meridian | Medicaid - Meridian | $68.00 | $673.00 | $336.00 | 2025-02-03 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $68.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $68.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $68.19 | — | — | 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.