43500 — Surgical Opening Of Stomach
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). SURGICAL OPENING OF STOMACH (HCPCS 43500) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/43500?code_type=HCPCS
MLA (9th ed.)
“SURGICAL OPENING OF STOMACH (HCPCS 43500) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/43500?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“SURGICAL OPENING OF STOMACH (HCPCS 43500) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/43500?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $948–$4,840 (25th–75th percentile) across 1,298 hospitals · 1,590 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 43500 — 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
$948
$2,424 typical
$4,840
The middle 50% of negotiated facility rates for this procedure, measured across 1,298 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. | $2,424 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $752 × 1.22 commercial. | $917 |
| Likely subtotal | $3,341 |
Surgical episode (typical)
~$3,341
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)
~$7,126
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 |
|---|---|---|---|---|---|---|---|
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Multiplan | Ppo | — | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Joliet | Hmo | — | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Health Alliance | Public Exchange | — | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Blue Cross Blue Shield | Ppo | — | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Blue Cross Blue Shield | Hmo Illinois | — | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Oscar Health | Exchange | $3.42 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Union Medical | Hmo | — | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Blue Cross Blue Shield | Blue Precision Hmo | — | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Professional Benefits Administrator | Ppo | — | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Health Alliance | Commercial | — | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Blue Cross Blue Shield | Blue Choice | — | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $3.69 | $2,048.00 | — | 2024-12-31 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Devoted Healthcare | Medicare | $4.75 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | United Healthcare | Medicare | $4.75 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Essential Health Partners | Medicare | $4.75 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Essential Health Partners | Hmo | $4.75 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Blue Cross Blue Shield | Medicare | $4.75 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Humana | Medicare | $4.75 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Aetna | Medicare | $4.75 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Cigna | Medicare | $4.84 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Meridian | Medicare (Wellcare) | $4.89 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Meridian | Exchange (Ambetter) | $5.70 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Aetna | Commercial | $7.70 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Hst Technologies | Epo, Ppo | $9.12 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | United Healthcare | Navigate, Core, Charter, Aco Tiered | $11.86 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | United Healthcare | All Other Plans | $13.18 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Cigna | Hmo, Ppo, Pos | $13.98 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Cigna | Local Plus | $13.98 | $12.00 | $4.20 | 2026-05-08 | MRF ↗ |
| COMANCHE COUNTY MEDICAL CENTER Outpatient | MPI - ALL PLANS | MPI - ALL PLANS | $25.11 | $1,495.00 | $971.75 | 2026-05-07 | 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 | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 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 ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $57.12 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $63.47 | — | — | 2026-04-14 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $71.38 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $71.38 | — | — | 2026-04-01 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $71.70 | — | — | 2026-04-14 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $79.32 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $79.32 | — | — | 2026-04-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $79.66 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $79.66 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $79.66 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $79.66 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $79.66 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $79.66 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $79.66 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $79.66 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $79.66 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $84.01 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $84.01 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $84.01 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $84.01 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $84.01 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $84.01 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $84.01 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $84.01 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $84.01 | — | — | 2026-04-14 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Riverside Community Hospital Outpatient | MedCare Partners | MGMCR | — | — | — | 2026-03-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $93.34 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $93.34 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $93.34 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $93.34 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $93.34 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $93.34 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $93.34 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $93.34 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $93.34 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $95.03 | — | — | 2026-04-14 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Sunshine State Oncology | Medicaid HMO | $102.35 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Healthy Kids | $102.35 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Medicaid HMO | $102.35 | — | — | 2025-08-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | MedCare Partners | MGMCR | — | — | — | 2026-03-01 | MRF ↗ |
| CHAMBERS MEMORIAL HOSPITAL Outpatient | AR TOTAL CARE MCAID - ALL PLANS | AR TOTAL CARE MCAID - ALL PLANS | $104.50 | $1,436.45 | $718.23 | 2026-05-05 | MRF ↗ |
| CHAMBERS MEMORIAL HOSPITAL Outpatient | CARESOURCE MCAID | CARESOURCE MCAID | $104.50 | $1,436.45 | $718.23 | 2026-05-05 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Molina Oncology | Healthy Kids | $105.27 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Molina Oncology | Medicaid HMO | $105.27 | — | — | 2025-08-01 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $106.65 | $790.00 | $592.50 | 2026-01-16 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Community Care Plan Oncology | Medicaid HMO | $107.22 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Amerihealth Caritas Oncology | Medicaid HMO | $107.22 | — | — | 2025-08-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $119.46 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $119.46 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $119.46 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $119.46 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $119.46 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $119.46 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $119.46 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $119.46 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $119.46 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $119.46 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $119.46 | — | — | 2026-04-14 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Peak Health | Medicare | $121.78 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Peia | Other Governmental | $121.78 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Highmark Blue Cross | Medicare | $121.78 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Humana | Medicare | $121.78 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Aetna | Medicare | $121.78 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Highmark Blue Cross | Ppo/Pos | $121.78 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | United Healthcare | Medicare | $121.78 | — | — | 2026-05-06 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Blue Cross Oncology | Medicare Advantage | $126.59 | — | — | 2025-08-01 | MRF ↗ |
| Shepherd Center Outpatient | Medicare | Commercial | $127.21 | — | — | 2026-05-06 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Florida Community Care Oncology | Medicaid HMO | $128.66 | — | — | 2025-08-01 | MRF ↗ |
| LIBERTY HOSPITAL Outpatient | Blue Cross Blue Shield | Freedom Network Select | $129.97 | — | — | 2026-05-26 | MRF ↗ |
| LIBERTY HOSPITAL Outpatient | Blue Cross Blue Shield | Freedom Network | $129.97 | — | — | 2026-05-26 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Geisinger | Geisinger CHIP | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | United Healthcare | United Healthcare Medicaid | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Geisinger | Geisinger Medicaid HC | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Geisinger | Geisinger CHIP | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Geisinger | Geisinger Medicaid HC | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $131.23 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $131.23 | — | — | 2026-04-14 | 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.