43262 — Endo Cholangiopancreatograph
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). ENDO CHOLANGIOPANCREATOGRAPH (CPT 43262) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/43262?code_type=CPT
MLA (9th ed.)
“ENDO CHOLANGIOPANCREATOGRAPH (CPT 43262) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/43262?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“ENDO CHOLANGIOPANCREATOGRAPH (CPT 43262) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/43262?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $2,406–$5,764 (25th–75th percentile) across 1,957 hospitals · 5,507 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 43262 — 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
$2,406
$3,995 typical
$5,764
The middle 50% of negotiated facility rates for this procedure, measured across 1,957 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. | $3,995 |
| Endoscopist (professional fee) Estimate national typical Medicare $311 × 1.22 commercial. | $380 |
| 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 | $4,760 |
Complete-episode estimate (typical)
~$4,760
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)
~$8,545
- 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 |
|---|---|---|---|---|---|---|---|
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Blue Cross | Blue Cross - Standard | $1.48 | $7,109.00 | $5,331.75 | 2026-04-01 | MRF ↗ |
| GROSSMONT HOSPITAL Outpatient | Blue Shield | Blue Shield - PPO | $4.95 | $7,109.00 | $5,331.75 | 2026-04-01 | MRF ↗ |
| GROSSMONT HOSPITAL Outpatient | Blue Shield | Blue Shield - Promise | $4.95 | $7,109.00 | $5,331.75 | 2026-04-01 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Oscar Health | Exchange | $5.18 | $29.00 | $10.15 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Devoted Healthcare | Medicare | $7.20 | $29.00 | $10.15 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Essential Health Partners | Hmo | $7.20 | $29.00 | $10.15 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Aetna | Medicare | $7.20 | $29.00 | $10.15 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Humana | Medicare | $7.20 | $29.00 | $10.15 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Essential Health Partners | Medicare | $7.20 | $29.00 | $10.15 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | United Healthcare | Medicare | $7.20 | $29.00 | $10.15 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Blue Cross Blue Shield | Medicare | $7.20 | $29.00 | $10.15 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Cigna | Medicare | $7.34 | $29.00 | $10.15 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Meridian | Medicare (Wellcare) | $7.42 | $29.00 | $10.15 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Meridian | Exchange (Ambetter) | $8.64 | $29.00 | $10.15 | 2026-05-08 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $10.30 | $879.00 | $167.01 | 2026-01-25 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Aetna | Commercial | $11.66 | $29.00 | $10.15 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Hst Technologies | Epo, Ppo | $13.82 | $29.00 | $10.15 | 2026-05-08 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $14.85 | $8,250.00 | $3,579.98 | 2024-12-31 | 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 ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | United Healthcare | Navigate, Core, Charter, Aco Tiered | $18.00 | $29.00 | $10.15 | 2026-05-08 | 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 ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $20.00 | $1,869.00 | $1,869.00 | 2025-10-04 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | United Healthcare | All Other Plans | $20.00 | $29.00 | $10.15 | 2026-05-08 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $20.40 | $1,869.00 | $1,869.00 | 2025-10-04 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Cigna | Hmo, Ppo, Pos | $20.50 | $29.00 | $10.15 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Cigna | Local Plus | $20.50 | $29.00 | $10.15 | 2026-05-08 | 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 - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $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 - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $23.45 | $4,786.00 | $4,546.70 | 2026-02-20 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Molina | Molina Medi-Cal | $23.64 | $7,109.00 | $5,331.75 | 2026-04-01 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Epic Americas | AXA Assistance | $23.64 | $7,109.00 | $5,331.75 | 2026-04-01 | 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 ↗ |
| 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 ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | 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 ↗ |
| HILTON HEAD REGIONAL 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 ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Outpatient | UHC MEDICAID [350006] | HB UHC MSCHIPS OB & MLH-TN ADULT HOSPITALS CONTRACT | $50.00 | $19,273.22 | $4,240.11 | 2026-03-19 | 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 ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $51.84 | $384.00 | $288.00 | 2026-01-16 | 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 HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $54.86 | — | — | 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 ↗ |
| 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 ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC MEDICARE COMPLETE | — | $7,771.77 | $5,051.65 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | EXCELLUS HMO [104] | MEDICARE BLUE CHOICE|MEDICARE BLUE DUAL|UNIVERA SENIOR|MEDICARE BLUE PPO | — | $7,771.77 | $5,051.65 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK|HIGHMARK INDEMNITY- OUT OF AREA|HIGHMARK HMO BLUE | — | $7,771.77 | $5,051.65 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK MEDICARE | — | $7,771.77 | $5,051.65 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | VETERANS ADMINISTRATION [178] | VA VETERAN'S CHOICE VACAA [17803] | — | $7,771.77 | $5,051.65 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE|TRICARE FOR LIFE|MARTINS POINT/US FAMILY | — | $7,771.77 | $5,051.65 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP|CIGNA|GWH CIGNA|NALC CIGNA | — | $7,771.77 | $5,051.65 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | FIDELIS CARE NEW YORK [112] | FIDELIS CARE NEW YORK|FIDELIS FHP|FIDELIS CHP | — | $7,771.77 | $5,051.65 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS(INCLUDING GOLD,SILVER,BRONZE AND PLATINUM) | — | $7,771.77 | $5,051.65 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP GOLD HMO | — | $7,771.77 | $5,051.65 | 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 | — | $7,771.77 | $5,051.65 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | GENERIC CARRIER [107] | COMMERCIAL|HUMANA|CDPHP COMMERCIAL | — | $7,771.77 | $5,051.65 | 2024-12-30 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $79.68 | $384.00 | $288.00 | 2026-01-16 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | UHC COMMUNITY MEDICAID [2175] | HB XR UHC INDIANA PATHWAYS MEDICAID | $80.55 | $10,052.96 | $6,693.51 | 2025-12-19 | MRF ↗ |
| VALLEY MEDICAL CENTER Outpatient | GREAT WEST [190102] | CIGNA.COMMERCIAL.FACILITY.VMC | $84.22 | $25,381.14 | $17,766.80 | 2026-03-12 | 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 | $86.69 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Pacific Source | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | First Health Network | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Interwest Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | VA Health | All | $86.69 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Coventry | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | UHC | Medicare Advantage | $86.69 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $86.69 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Tricare | All | $86.69 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Prime Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC BothFacility | NETWORK HEALTH PLANS - Medicare-HMO | Medicare Advantage | $87.35 | $9,615.70 | $5,384.79 | 2026-03-02 | MRF ↗ |
| THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC BothFacility | NETWORK HEALTH PLANS - Medicare-HMO | Medicare Advantage | $87.35 | $9,615.70 | $5,384.79 | 2026-03-02 | MRF ↗ |
| ThedaCare Oshkosh BothFacility | NETWORK HEALTH PLANS - Medicare-HMO | Medicare Advantage | $87.35 | $9,615.70 | $5,384.79 | 2026-03-02 | MRF ↗ |
| THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC BothFacility | NETWORK HEALTH PLANS - Medicare-HMO | Medicare Advantage | $87.35 | $9,615.70 | $5,384.79 | 2026-03-02 | MRF ↗ |
| THEDACARE REGIONAL MED CTR - NEENAH BothFacility | NETWORK HEALTH PLANS - Medicare-HMO | Medicare Advantage | $87.35 | $9,615.70 | $5,384.79 | 2026-03-02 | 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 ↗ |
| CENTRO MEDICO DEL NORESTE BothFacility | MENONITA ASES | MENONITA REFORMA | $100.00 | $756.08 | — | 2025-11-28 | MRF ↗ |
| CENTRO MEDICO DEL NORESTE BothFacility | MENONITA ASES | MENONITA IPA 650 | $100.00 | $756.08 | — | 2025-11-28 | MRF ↗ |
| VALLEY MEDICAL CENTER Outpatient | CHRISTIAN BROTHER EMPLOYEE BENEFIT TRUST [110100] | AETNA.COMMERCIAL.FACILITY.VMC | $100.07 | $25,381.14 | $17,766.80 | 2026-03-12 | MRF ↗ |
| VALLEY MEDICAL CENTER Outpatient | PACIFICSOURCE [130122] | AETNA.COMMERCIAL.FACILITY.VMC | $100.07 | $25,381.14 | $17,766.80 | 2026-03-12 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Inpatient | SMARTHEALTH PPO | 8842_SMARTHEALTH PPO 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 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 Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 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 ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 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 RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 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 | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 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 WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 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 SHORT TERM LIMITED DURATION | 9361_ANTHEM SHORT TERM LIMITED DURATION VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 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 WILLIAMSPORT Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 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 KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8813_ANTHEM UNIFIED GROUPS VKIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PPO PREFERRED | 9232_ANTHEM PREFERRED VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 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 SALEM 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 Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM TRADITIONAL | 9233_ANTHEM TRADITIONAL VCIN 20250101 | — | — | — | 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 Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 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 CARMEL Both | ANTHEM HMO/POS | 9229_ANTHEM HMO POS VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 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 FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 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 RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $100.87 | — | — | 2026-01-01 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| CENTRO MEDICO DEL NORESTE BothFacility | IMC PRIVADO | INTERNATIONAL MEDICAL CARD | $110.00 | $756.08 | — | 2025-11-28 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | UNITED HEALTH CARE COMMUNITY PLAN MEDICAID [9004] | UNITED HEALTH CARE MEDICAID [900401] | $112.04 | $812.00 | $812.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | KEY BENEFIT ADMINISTRATORS [1089] | KEY BENEFIT ADMINISTRATORS [108901] | $123.25 | $812.00 | $812.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | COUNTY HEALTH PLAN B [1022] | GENESEE HEALTH PLAN B [102204] | $123.25 | $812.00 | $812.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | COUNTY HEALTH PLAN B [1022] | COUNTY HEALTH PLAN B NON GENESEE COUNTY [102202] | $123.25 | $812.00 | $812.00 | 2026-03-23 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | GENERIC CARRIER [107] | COMMERCIAL [10701] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | GENERIC CARRIER [107] | COMMERCIAL [10701] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | GENERIC MEDICARE HMO [125] | GENERIC MEDICARE HMO [12505] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | GENERIC MEDICARE HMO [12505] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE [10301] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN [10104] | $132.69 | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE [10301] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK ESSENTIALS [11404] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK [11401] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK MEDICARE [11402] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | EMBLEM GHI [113] | EMBLEM GHI [11301] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED BEHAVORIAL HEALTH [120] | UNITED BEHAVORIAL HEALTH [12001] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED BEHAVORIAL HEALTH [120] | UNITED BEHAVORIAL HEALTH [12001] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK [11401] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK ESSENTIALS [11404] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MULTIPLAN [141] | MULTIPLAN [14101] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK MEDICARE [11402] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | EMBLEM GHI [113] | EMBLEM GHI [11301] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MULTIPLAN [141] | MULTIPLAN [14101] | — | $623.04 | $623.04 | 2024-12-30 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | PACE MEDICARE HMO [7023] | GENESYS PACE MEDICARE HMO [702301] | $138.46 | $812.00 | $812.00 | 2026-03-23 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $142.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $142.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $142.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $142.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $142.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $142.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $142.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $142.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $142.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $142.00 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $142.00 | — | — | 2026-01-01 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Amerihealth | F8102_Amerihealth | $144.00 | — | — | 2026-04-01 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Upmc | F8120_Upmc Health Plan - Medicaid | $144.00 | — | — | 2026-04-01 | MRF ↗ |
| HERITAGE VALLEY BEAVER Outpatient | AETNA HEALTH INC | AETNA BETTER HEALTH MEDICAID | $144.00 | $2,917.50 | $787.73 | 2024-12-30 | 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.