43265 — Ercp Lithotripsy Calculi
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). ERCP LITHOTRIPSY CALCULI (HCPCS 43265) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/43265?code_type=HCPCS
MLA (9th ed.)
“ERCP LITHOTRIPSY CALCULI (HCPCS 43265) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/43265?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“ERCP LITHOTRIPSY CALCULI (HCPCS 43265) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/43265?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $2,852–$8,035 (25th–75th percentile) across 2,120 hospitals · 4,888 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 43265 — 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
$2,852
$5,916 typical
$8,035
The middle 50% of negotiated facility rates for this procedure, measured across 2,120 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. | $5,916 |
| Endoscopist (professional fee) Estimate national typical Medicare $377 × 1.22 commercial. | $460 |
| Anesthesia Estimate national typical 00732, ~30 min typical. Medicare $164 × 3.14 commercial. | $515 |
| Likely subtotal | $6,891 |
Complete-episode estimate (typical)
~$6,891
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge (see the recovery plan below)
- Complications, revisions, or readmissions
- Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)
The biggest swing: which insurer's rate applies — negotiated prices here run $2,852–$8,035.
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)
~$10,676
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Endoscopist (professional fee) (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
- Anesthesia (estimate)
- base_units_version: CY2022 file (base units unchanged for CY2026 per CMS) · anesthesia_cf: $20.49754 (National) · cf_rule: CMS-1832-F · multiplier_source: AJMC/Duffy 2016-2017 (PMID 34156223) national
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | HEALTHSMART | HEALTHSMART WORKERS COMP | $0.17 | — | — | 2026-05-20 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $0.20 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | HEALTHSMART | HEALTHSMART WORKERS COMP | $0.22 | — | — | 2026-09-02 | MRF ↗ |
| James Cancer Hospital & Solove Research Institute Outpatient | Cigna | Cigna - Transplant | $0.62 | $7,644.00 | — | 2026-07-01 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE SHIELD - MANTECA SURGERY CENTER MEDICARE ADVANTAGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $2,806.00 | $2,300.92 | 2025-11-26 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE COMMERCIAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | CARE1ST MEDICARE ADVANTAGE | CARE1ST MEDICARE ADVANTAGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $2,806.00 | $2,300.92 | 2025-11-26 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID STAR KIDS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR PLUS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $2,806.00 | $2,300.92 | 2025-11-26 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID STAR | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE - OPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW BUSINESS | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR KIDS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID NON UHRIP | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| SHELBY BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $2,806.00 | $2,300.92 | 2025-11-26 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM NON UHRIP | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR PLUS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR KIDS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| SHELBY BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| PRINCETON BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID STAR PLUS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| CITIZENS BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Medicaid | Medicaid | $1.00 | $11,633.00 | $5,816.50 | 2026-07-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW BUSINESS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| CITIZENS BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NON OPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE CHARTER | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | CARE1ST MEDICARE ADVANTAGE | CARE1ST MEDICARE ADVANTAGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA HMO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PRINCETON BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE SHIELD PROMISE MEDICARE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE CHARTER | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $2,806.00 | $2,300.92 | 2025-11-26 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE COMMERCIAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | HMO | — | $2,806.00 | $2,300.92 | 2025-11-26 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NON OPTIONS PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE - OPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA HMO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE SHIELD PROMISE MEDICARE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.06 | — | — | 2026-09-02 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $1.07 | $11,633.00 | $5,816.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $1.10 | $11,633.00 | $5,816.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $1.18 | $11,633.00 | $5,816.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Jefferson Health Plan | Jefferson Health Plan - Managed Medicaid | $1.20 | $11,633.00 | $5,816.50 | 2026-07-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.30 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.30 | — | — | 2026-09-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - Managed Medicaid | $1.47 | $11,633.00 | $5,816.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - CHIP - Managed Medicare | $2.50 | $11,633.00 | $5,816.50 | 2026-07-01 | MRF ↗ |
| GROSSMONT HOSPITAL Outpatient | Aetna | Aetna Whole Health | $2.76 | $8,626.00 | $6,469.50 | 2026-04-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $4.88 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $4.88 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $4.88 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $4.88 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $4.88 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| GROSSMONT HOSPITAL Outpatient | Health Net | Health Net - HMO/POS/EPO | $5.39 | $8,626.00 | $6,469.50 | 2026-04-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $5.63 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $5.63 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $5.63 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $5.63 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $5.63 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $6.20 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $6.20 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $6.20 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $6.20 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $6.20 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $6.20 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $6.20 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $6.20 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $6.20 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $6.20 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $6.58 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $6.58 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $6.58 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $6.58 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $6.58 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $6.58 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $6.58 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $6.58 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $6.58 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $6.58 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $7.14 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $7.14 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $7.14 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $7.14 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $7.14 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $7.14 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $7.14 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $7.14 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $7.14 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $7.14 | — | — | 2026-05-20 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | BCBS MEDICARE [250503] | BCBS MEDICARE REPLACEMENT [25050301] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | WELLCARE HEALTH PLAN [250516] | MEDICARE REPLACEMENT [25051601] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | CIGNA MCR HMO/PPO [250525] | MEDICARE REPLACEMENT [25052501] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | CIGNA MCR HMO/PPO [250525] | MEDICARE REPLACEMENT [25052501] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | WELLCARE HEALTH PLAN [250516] | MEDICARE REPLACEMENT [25051601] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | BCBS MEDICARE [250503] | BCBS MEDICARE REPLACEMENT [25050301] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | CIGNA MCR HMO/PPO [250525] | MEDICARE REPLACEMENT [25052501] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | BCBS MEDICARE [250503] | BCBS MEDICARE REPLACEMENT [25050301] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | BCBS MEDICARE [250503] | BCBS MEDICARE REPLACEMENT [25050301] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | CIGNA MCR HMO/PPO [250525] | MEDICARE REPLACEMENT [25052501] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | BCBS MEDICARE [250503] | BCBS MEDICARE REPLACEMENT [25050301] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | CIGNA MCR HMO/PPO [250525] | MEDICARE REPLACEMENT [25052501] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | BCBS MEDICARE [250503] | BCBS MEDICARE REPLACEMENT [25050301] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | CIGNA MCR HMO/PPO [250525] | MEDICARE REPLACEMENT [25052501] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | WELLCARE HEALTH PLAN [250516] | MEDICARE REPLACEMENT [25051601] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | WELLCARE HEALTH PLAN [250516] | MEDICARE REPLACEMENT [25051601] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | WELLCARE HEALTH PLAN [250516] | MEDICARE REPLACEMENT [25051601] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | WELLCARE HEALTH PLAN [250516] | MEDICARE REPLACEMENT [25051601] | $8.16 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | AETNA COVENTRY MCR REPLACEMENT [250518] | AETNA MEDICARE [25051801] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | HUMANA GOLD [250508] | PFFS MEDICARE REPLACEMENT [25050801] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | UNITED HEALTH MCR HMO/PPO [250515] | UHC MEDICARE REPLACEMENT [25051501] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | AETNA COVENTRY MCR REPLACEMENT [250518] | AETNA MEDICARE [25051801] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | AETNA COVENTRY MCR REPLACEMENT [250518] | AETNA MEDICARE [25051801] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | HUMANA GOLD [250508] | PFFS MEDICARE REPLACEMENT [25050801] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | AETNA COVENTRY MCR REPLACEMENT [250518] | AETNA MEDICARE [25051801] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | HUMANA GOLD [250508] | PFFS MEDICARE REPLACEMENT [25050801] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | HUMANA GOLD [250508] | PFFS MEDICARE REPLACEMENT [25050801] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | UNITED HEALTH MCR HMO/PPO [250515] | UHC MEDICARE REPLACEMENT [25051501] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | UNITED HEALTH MCR HMO/PPO [250515] | UHC MEDICARE REPLACEMENT [25051501] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | UNITED HEALTH MCR HMO/PPO [250515] | UHC MEDICARE REPLACEMENT [25051501] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | AETNA COVENTRY MCR REPLACEMENT [250518] | AETNA MEDICARE [25051801] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | AETNA COVENTRY MCR REPLACEMENT [250518] | AETNA MEDICARE [25051801] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | UNITED HEALTH MCR HMO/PPO [250515] | UHC MEDICARE REPLACEMENT [25051501] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | UNITED HEALTH MCR HMO/PPO [250515] | UHC MEDICARE REPLACEMENT [25051501] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | HUMANA GOLD [250508] | PFFS MEDICARE REPLACEMENT [25050801] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | HUMANA GOLD [250508] | PFFS MEDICARE REPLACEMENT [25050801] | $8.30 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | ALIGN SENIOR CARE [250524] | ALIGN MEDICARE REPLACEMENT [25052401] | $8.31 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | ALIGN SENIOR CARE [250524] | ALIGN MEDICARE REPLACEMENT [25052401] | $8.31 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | FREEDOM HEALTH [250505] | FREEDOM HLTH MEDICARE REPLACEMENT [25050501] | $8.31 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | FREEDOM HEALTH [250505] | FREEDOM HLTH MEDICARE REPLACEMENT [25050501] | $8.31 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | FREEDOM HEALTH [250505] | FREEDOM HLTH MEDICARE REPLACEMENT [25050501] | $8.31 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | FREEDOM HEALTH [250505] | FREEDOM HLTH MEDICARE REPLACEMENT [25050501] | $8.31 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | ALIGN SENIOR CARE [250524] | ALIGN MEDICARE REPLACEMENT [25052401] | $8.31 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | FREEDOM HEALTH [250505] | FREEDOM HLTH MEDICARE REPLACEMENT [25050501] | $8.31 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | ALIGN SENIOR CARE [250524] | ALIGN MEDICARE REPLACEMENT [25052401] | $8.31 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| LEE MEMORIAL HOSPITAL OutpatientFacility | ALIGN SENIOR CARE [250524] | ALIGN MEDICARE REPLACEMENT [25052401] | $8.31 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | FREEDOM HEALTH [250505] | FREEDOM HLTH MEDICARE REPLACEMENT [25050501] | $8.31 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | ALIGN SENIOR CARE [250524] | ALIGN MEDICARE REPLACEMENT [25052401] | $8.31 | $28,006.76 | $5,601.35 | 2026-03-26 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $9.19 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $9.19 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $9.19 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $9.19 | — | — | 2026-09-02 | 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.