43260 — Ercp W/specimen Collection
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). ERCP W/SPECIMEN COLLECTION (CPT 43260) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/43260?code_type=CPT
MLA (9th ed.)
“ERCP W/SPECIMEN COLLECTION (CPT 43260) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/43260?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“ERCP W/SPECIMEN COLLECTION (CPT 43260) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/43260?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $2,250–$5,356 (25th–75th percentile) across 1,961 hospitals · 5,415 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 43260 — 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
$2,250
$4,001 typical
$5,356
The middle 50% of negotiated facility rates for this procedure, measured across 1,961 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. | $4,001 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $281 × 1.22 commercial. | $343 |
| Likely subtotal | $4,344 |
Surgical episode (typical)
~$4,344
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)
~$8,129
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 |
|---|---|---|---|---|---|---|---|
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $8,591.00 | $7,044.62 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $8,591.00 | $7,044.62 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $8,591.00 | $7,044.62 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | Health Net of California, Inc. | HMO | — | $8,591.00 | $7,044.62 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $8,591.00 | $7,044.62 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $8,591.00 | $7,044.62 | 2025-11-26 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UNITED HEALTHCARE ALTERNATE [100260] | UHC EMPIRE ALTERNATE [10026001] | $3.94 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UNITED HEALTHCARE ALTERNATE [100260] | UHC EMPIRE ALTERNATE [10026001] | $3.94 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| BARNES JEWISH HOSPITAL Outpatient | CIGNA [202] | BJC HB CIGNA LOCAL PLUS BJH | $5.56 | $596.40 | $357.84 | 2025-12-15 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Health Net | Health Net - HMO/POS/EPO | $6.14 | $6,432.00 | $4,824.00 | 2026-04-01 | MRF ↗ |
| BARNES JEWISH HOSPITAL Outpatient | CIGNA [202] | BJC HB CIGNA HMO/PPO BJH | $6.28 | $596.40 | $357.84 | 2025-12-15 | MRF ↗ |
| BARNES JEWISH HOSPITAL Outpatient | NALC HEALTH BENEFIT PLAN [242] | BJC HB CIGNA HMO/PPO BJH | $6.28 | $596.40 | $357.84 | 2025-12-15 | MRF ↗ |
| BARNES JEWISH HOSPITAL Outpatient | APWU HEALTH PLAN [216] | BJC HB CIGNA HMO/PPO BJH | $6.28 | $596.40 | $357.84 | 2025-12-15 | MRF ↗ |
| BARNES JEWISH HOSPITAL Outpatient | CIGNA [202] | BJC HB CIGNA SPECIAL BJH | $6.28 | $596.40 | $357.84 | 2025-12-15 | MRF ↗ |
| BARNES JEWISH HOSPITAL Outpatient | PRIORITY HEALTH [648] | BJC HB CIGNA HMO/PPO BJH | $6.28 | $596.40 | $357.84 | 2025-12-15 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | SEDGWICK [700027] | WC SEDGWICK [70002701] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NF MISC. [809999] | NF MISC. [80999901] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UTICA NATIONAL NO FAULT [800007] | NF UTICA NATIONAL INS [80000701] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UTICA NATIONAL WORKER'S COMP [700062] | WC UTICA NATIONAL INS [70006201] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS NO FAULT [800006] | NF TRAVELERS [80000601] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | HARTFORD INS WC [700055] | WC HARTFORD INS [70005501] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC TRAVELER'S MVHS EMPLOYEE [70005903] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | GEICO AUTO INSURANCE [800003] | NF GEICO AUTO INSURANCE [80000301] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ERIE INS NF [800002] | NF ERIE INS [80000201] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | PROGRESSIVE AUTO INSURANCE [800005] | NF PROGRESSIVE AUTO INSURANCE [80000501] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | HARTFORD INS WC [700055] | WC HARTFORD INS [70005501] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ERIE INS NF [800002] | NF ERIE INS [80000201] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL WORK COMP [700016] | WC LIBERTY MUTUAL [70001601] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS WORK COMP [700028] | WC TRAVELERS [70002801] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ALLSTATE AUTO INSURANCE [800001] | NF ALLSTATE [80000101] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NY CTRL MUTUAL NF [800004] | NF NY CTRL MUTUAL [80000401] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS NO FAULT [800006] | NF TRAVELERS [80000601] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MADISON ONEIDA HERK WC [700056] | WC MADISON ONEIDA HERK [70005601] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | CHARTIS WC [700029] | WC CHARTIS [70002901] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MET LIFE AUTO INSURANCE [800009] | NF MET LIFE AUTO INS [80000901] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | PMA WORK COMP [700031] | WC PMA [70003101] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA FSLH EMPLOYEE [70005901] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STRATEGIC COMP SERVICES [700061] | WC STRATEGIC COMP SERVICES [70006101] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC TRAVELER'S MVHS EMPLOYEE [70005903] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | PMA WORK COMP [700031] | WC PMA [70003101] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | CHARTIS WC [700029] | WC CHARTIS [70002901] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ESIS WORK COMP [700010] | WC ESIS [70001001] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MET LIFE AUTO INSURANCE [800009] | NF MET LIFE AUTO INS [80000901] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | GALLAGHER BASSETT WORK COMP [700013] | WC GALLAGHER BASSETT [70001301] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MADISON ONEIDA HERK WC [700056] | WC MADISON ONEIDA HERK [70005601] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC TRAVELER'S SEMC EMPLOYEE [70005904] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | CORVEL CORP WC [700054] | WC CORVEL CORP [70005401] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | WC MISC. [709999] | WC MISC. [70999901] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA SEMC EMPLOYEE [70005902] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NYSIF [700058] | WC NY STATE INSURANCE FUND [70005801] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | SEDGWICK [700027] | WC SEDGWICK [70002701] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NF MISC. [809999] | NF MISC. [80999901] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STATE FARM AUTO INSURANCE NF [800026] | NF STATE FARM AUTO INSURANCE [80002601] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STRATEGIC COMP SERVICES [700061] | WC STRATEGIC COMP SERVICES [70006101] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ESIS WORK COMP [700010] | WC ESIS [70001001] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL AUTO INSURANCE [800008] | NF LIBERTY MUTUAL AUTO INS [80000801] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ALLSTATE AUTO INSURANCE [800001] | NF ALLSTATE [80000101] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA FSLH EMPLOYEE [70005901] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UTICA NATIONAL WORKER'S COMP [700062] | WC UTICA NATIONAL INS [70006201] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | CORVEL CORP WC [700054] | WC CORVEL CORP [70005401] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STATE FARM AUTO INSURANCE NF [800026] | NF STATE FARM AUTO INSURANCE [80002601] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | GEICO AUTO INSURANCE [800003] | NF GEICO AUTO INSURANCE [80000301] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NY CTRL MUTUAL NF [800004] | NF NY CTRL MUTUAL [80000401] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | GALLAGHER BASSETT WORK COMP [700013] | WC GALLAGHER BASSETT [70001301] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL WORK COMP [700016] | WC LIBERTY MUTUAL [70001601] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | PROGRESSIVE AUTO INSURANCE [800005] | NF PROGRESSIVE AUTO INSURANCE [80000501] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS WORK COMP [700028] | WC TRAVELERS [70002801] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA SEMC EMPLOYEE [70005902] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UTICA NATIONAL NO FAULT [800007] | NF UTICA NATIONAL INS [80000701] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL AUTO INSURANCE [800008] | NF LIBERTY MUTUAL AUTO INS [80000801] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NYSIF [700058] | WC NY STATE INSURANCE FUND [70005801] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NCA WC [700057] | WC NCA [70005701] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NCA WC [700057] | WC NCA [70005701] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | WC MISC. [709999] | WC MISC. [70999901] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC TRAVELER'S SEMC EMPLOYEE [70005904] | $6.53 | $8,655.88 | $5,193.53 | 2025-01-17 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $9.31 | $795.00 | $151.05 | 2026-01-25 | MRF ↗ |
| UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) HR [40] Plans | $11.34 | $34,005.02 | $34,005.02 | 2026-04-03 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Allianz Global Assistance | AZGA Services Canada | $12.86 | $6,432.00 | $4,824.00 | 2026-04-01 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $13.05 | $7,251.00 | $3,579.98 | 2024-12-31 | MRF ↗ |
| KERALTY HOSPITAL Both | AVMED HEALTH COMMERCIAL | AVMED SELECT NETWORK | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | CIGNA MEDICARE | CIGNA MEDICARE | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | AVMED HEALTH COMMERCIAL | AVMED EXCHANGE NETWORKAL | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | AVMED HEALTH COMMERCIAL | AVMED BROAD NETWORK | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | AVMED HEALTH COMMERCIAL | AVMED BROAD NETWORK | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | CIGNA MEDICARE | CIGNA MEDICARE IDEMNITY | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | CIGNA MEDICARE | CIGNA MEDICARE | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | AVMED HEALTH COMMERCIAL | AVMED EXCHANGE NETWORKAL | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | AVMED HEALTH COMMERCIAL | AVMED BROAD NTWRK | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | CIGNA MEDICARE | CIGNA MEDICARE IDEMNITY | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | AVMED HEALTH COMMERCIAL | AVMED SELECT NETWORK | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | CIGNA COMMERCIAL | CIGNA COMMERCIAL | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | AVMED HEALTH COMMERCIAL | AVMED EXCHANGE NETWORK | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | AVMED HEALTH COMMERCIAL | AVMED BROAD NTWRK | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | CIGNA COMMERCIAL | CIGNA COMMERCIAL | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | AVMED HEALTH COMMERCIAL | AVMED EXCHANGE NETWORK | $14.50 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | HUMANA COMMERCIAL | HUMANA COMMERCIAL | $17.40 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | HUMANA COMMERCIAL | HUMANA COMMERCIAL | $17.40 | $58.00 | — | 2024-06-28 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $17.71 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $17.71 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $17.71 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $18.19 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $18.67 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $19.14 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $22.97 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $22.97 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $23.45 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $23.45 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $23.45 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $23.45 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $23.93 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $24.41 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $24.89 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $25.84 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| KERALTY HOSPITAL Both | FIRST HEALTH COMMERICAL | FIRST HEALTH | $29.00 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | FIRST HEALTH COMMERICAL | FIRST HEALTH | $29.00 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | HUMANA COMMERCIAL | HUMANA COMMERCIAL | $30.74 | $58.00 | — | 2024-06-28 | MRF ↗ |
| KERALTY HOSPITAL Both | HUMANA COMMERCIAL | HUMANA COMMERCIAL | $30.74 | $58.00 | — | 2024-06-28 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $43.69 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $43.97 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $43.97 | — | — | 2026-03-18 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $46.85 | $347.00 | $260.25 | 2026-01-16 | 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 ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $50.07 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $50.39 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $50.39 | — | — | 2026-03-18 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | POS | — | $8,591.00 | $7,044.62 | 2025-11-26 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $54.52 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $54.86 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $54.86 | — | — | 2026-03-18 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Both | Anthem Blue Cross Blue Shield | Medicaid | $55.00 | $6,295.00 | $2,518.00 | 2026-05-23 | MRF ↗ |
| PALMDALE REGIONAL MEDICAL CENTER Both | Anthem Blue Cross Blue Shield | Medicaid | $55.00 | $6,295.00 | $2,518.00 | 2026-05-14 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $62.90 | — | $20,215.60 | 2026-03-31 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Blue Shield | Blue Shield - Promise | $63.62 | $6,432.00 | $4,824.00 | 2026-04-01 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | BCBS - MN | Medicaid|All Plans | $66.60 | $222.00 | $128.76 | 2026-02-28 | MRF ↗ |
| LAKESIDE MEDICAL CENTER OutpatientFacility | UHC | Managed Medicaid | $66.88 | $8,474.00 | $3,818.91 | 2025-12-02 | MRF ↗ |
| LAKESIDE MEDICAL CENTER OutpatientFacility | UHC | CHIP | $66.88 | $8,474.00 | $3,818.91 | 2025-12-02 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $72.00 | $347.00 | $260.25 | 2026-01-16 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Health Partners | Medicare|All Plans | $73.26 | $222.00 | $128.76 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Medica | Medicare|All Plans | $76.93 | $222.00 | $128.76 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Humana | Medicare|All Plans | $79.92 | $222.00 | $128.76 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | BCBS - MN | Medicare|All Plans | $79.92 | $222.00 | $128.76 | 2026-02-28 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | UHC COMMUNITY MEDICAID [2175] | HB XR UHC INDIANA PATHWAYS MEDICAID | $80.55 | $12,488.10 | $7,896.25 | 2025-12-19 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $81.65 | — | — | 2026-01-01 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Health Partners | Medicaid|All Plans | $82.14 | $222.00 | $128.76 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Medica | Medicaid|All Plans | $82.14 | $222.00 | $128.76 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Ucare | Medicare|All Plans | $83.92 | $222.00 | $128.76 | 2026-02-28 | MRF ↗ |
| KANSAS MEDICAL CENTER LLC Outpatient | UNITED | UNITED HEALTHCARE COMMERCIAL PLAN | $84.00 | $1,862.80 | $1,117.68 | 2026-03-31 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Ucare | Medicaid|All Plans | $90.36 | $222.00 | $128.76 | 2026-02-28 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| HOSPITAL DE LA CONCEPCION OutpatientFacility | Triple S | Commercial | $97.00 | $1,500.00 | $1,500.00 | 2024-12-26 | MRF ↗ |
| HOSPITAL DE LA CONCEPCION OutpatientFacility | Triple S | Commercial | $97.00 | $1,500.00 | $1,500.00 | 2024-12-26 | MRF ↗ |
| CENTRO MEDICO DEL NORESTE BothFacility | MENONITA ASES | MENONITA REFORMA | $100.00 | $683.36 | — | 2025-11-28 | MRF ↗ |
| CENTRO MEDICO DEL NORESTE BothFacility | MENONITA ASES | MENONITA IPA 650 | $100.00 | $683.36 | — | 2025-11-28 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | UNITED HEALTH CARE COMMUNITY PLAN MEDICAID [9004] | UNITED HEALTH CARE MEDICAID [900401] | $101.28 | $656.00 | $656.00 | 2026-03-23 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| HOSPITAL DE LA CONCEPCION OutpatientFacility | Triple S Vital | Medicaid | $105.00 | $1,500.00 | $1,500.00 | 2024-12-26 | MRF ↗ |
| HOSPITAL DE LA CONCEPCION OutpatientFacility | Triple S Vital | Medicaid | $105.00 | $1,500.00 | $1,500.00 | 2024-12-26 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | INDIAN HEALTH SERVICE CONTRACTED [320198] | HB FTSM MEDICARE | $105.96 | $10,958.16 | $7,122.80 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | BLUE CROSS AND BLUE SHIELD [20053] | HB FTSM MANAGED MEDICARE | $105.96 | $10,958.16 | $7,122.80 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | INDIAN HEALTH SERVICE [20198] | HB FTSM MEDICARE | $105.96 | $10,958.16 | $7,122.80 | 2026-03-13 | 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.