43775 — Lap Sleeve Gastrectomy
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). LAP SLEEVE GASTRECTOMY (CPT 43775) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/43775?code_type=CPT
MLA (9th ed.)
“LAP SLEEVE GASTRECTOMY (CPT 43775) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/43775?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“LAP SLEEVE GASTRECTOMY (CPT 43775) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/43775?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,361–$12,976 (25th–75th percentile) across 1,796 hospitals · 2,838 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 43775 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Also priced as a different code
The same procedure is billed under different code systems depending on the setting. These facilities price it under a code you won’t see in the CPT/HCPCS 43775 table above — including hospitals that only publish the bundled version.
2,699 facilities · 1,100 not in the CPT/HCPCS table
- ABBEVILLE GENERAL HOSPITAL, ABBEVILLE • only here
- ABBOTT NORTHWESTERN HOSPITAL, MINNEAPOLIS • only here
- ABRAHAM LINCOLN MEMORIAL HOSPITAL, LINCOLN • only here
- ACADIAN MEDICAL CENTER, EUNICE • only here
- Acuity Specialty Hospital Of New Jersey, Atlantic City • only here
- Acuity Specialty Hospital Ohio Valley, BELLAIRE • only here
2,778 facilities · 1,137 not in the CPT/HCPCS table
- ABBEVILLE GENERAL HOSPITAL, ABBEVILLE • only here
- ABBOTT NORTHWESTERN HOSPITAL, MINNEAPOLIS • only here
- ABRAHAM LINCOLN MEMORIAL HOSPITAL, LINCOLN • only here
- ACADIAN MEDICAL CENTER, EUNICE • only here
- Acuity Specialty Hospital Of New Jersey, Atlantic City • only here
- Acuity Specialty Hospital Ohio Valley, BELLAIRE • only here
2,801 facilities · 1,155 not in the CPT/HCPCS table
- ABBEVILLE GENERAL HOSPITAL, ABBEVILLE • only here
- ABBOTT NORTHWESTERN HOSPITAL, MINNEAPOLIS • only here
- ABRAHAM LINCOLN MEMORIAL HOSPITAL, LINCOLN • only here
- ACADIAN MEDICAL CENTER, EUNICE • only here
- Acuity Specialty Hospital Of New Jersey, Atlantic City • only here
- Acuity Specialty Hospital Ohio Valley, BELLAIRE • only here
An MS-DRG / APR-DRG price is the hospital’s single bundled charge for the entire inpatient stay — operating room, room & board, recovery, imaging, anesthesia (facility), implants and supplies — so it’s a broader, usually higher figure than the CPT/HCPCS 43775 line above, which prices the procedure alone. Neither includes the surgeon’s or anesthesiologist’s professional fees, which 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 fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$1,361
$4,844 typical
$12,976
The middle 50% of negotiated facility rates for this procedure, measured across 1,796 hospitals. The surgeon and anesthesia fees are modeled estimates added on top.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $4,844 |
| Surgeon (professional fee) Estimate national typical Medicare $1,000 × 1.22 commercial. | $1,220 |
| Anesthesia Estimate national typical 00797, ~90 min typical. Medicare $348 × 3.14 commercial. | $1,094 |
| Likely subtotal | $7,159 |
Surgical episode (typical)
~$7,159
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 $1,361–$12,976.
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)
~$10,943
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
- 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 |
|---|---|---|---|---|---|---|---|
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $7.89 | $4,384.00 | — | 2024-12-31 | MRF ↗ |
| ADVENTIST HEALTH CASTLE Outpatient | PACIFIC ADMIN PPO - ALL PLANS | PACIFIC ADMIN PPO - ALL PLANS | $29.27 | $2,608.00 | $834.56 | 2026-05-18 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $32.57 | $578.00 | $109.82 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $32.57 | $2,640.00 | $501.60 | 2026-01-25 | MRF ↗ |
| SCHNECK MEDICAL CENTER Both | — | — | — | $71.00 | $49.70 | 2024-12-31 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE MCAL | CENTRAL CA ALLIANCE MCAL | $60.00 | $578.00 | $98.26 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | MEDI-CAL | MEDI-CAL | $60.00 | $578.00 | $98.26 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CELTIC CA HLTH WELL MCAL - ALL PLANS | CELTIC CA HLTH WELL MCAL - ALL PLANS | $60.00 | $578.00 | $98.26 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $60.00 | $578.00 | $98.26 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | BC MCAL | BC MCAL | $60.00 | $578.00 | $98.26 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | BLUE CROSS MCS-ALL OTHER PLANS | BLUE CROSS MCS-ALL OTHER PLANS | $66.41 | $578.00 | $115.60 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | BLUE CROSS NON-MCS | BLUE CROSS NON-MCS | $66.41 | $578.00 | $115.60 | 2026-05-24 | MRF ↗ |
| SEARHC WRANGELL MEDICAL CENTER & LTC Outpatient | UHC-ALL PLANS | UHC-ALL PLANS | $72.00 | $4,200.35 | $4,200.35 | 2024-12-09 | MRF ↗ |
| CLAY COUNTY MEDICAL CENTER Outpatient | HEALTH PARTNERS - ALL PLANS | HEALTH PARTNERS - ALL PLANS | $75.00 | $2,900.65 | $2,900.65 | 2026-07-22 | MRF ↗ |
| CLAY COUNTY MEDICAL CENTER Outpatient | HEALTH PARTNERS - ALL PLANS | HEALTH PARTNERS - ALL PLANS | $75.00 | $2,900.65 | $2,900.65 | 2026-04-24 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | LIFETIME_BEN | LIFETIME BENEFITS | $75.08 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | AETNA COMM-ALL OTHER PLANS | AETNA COMM-ALL OTHER PLANS | $78.57 | $3,530.00 | $2,294.50 | 2026-08-10 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $90.00 | $578.00 | $115.60 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE CCS MCAL | CENTRAL CA ALLIANCE CCS MCAL | $90.00 | $578.00 | $98.26 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE COMM PROFEE ONLY-ALL OTHER PLA | CENTRAL CA ALLIANCE COMM PROFEE ONLY-ALL OTHER PLA | $90.00 | $578.00 | $98.26 | 2026-05-23 | MRF ↗ |
| Riverside Community Hospital Outpatient | MedCare Partners | MGMCR | — | — | — | 2026-03-01 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS | DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS | $90.00 | $578.00 | $109.82 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CAL VIVA HLTH MCAL - ALL PLANS | CAL VIVA HLTH MCAL - ALL PLANS | $90.00 | $578.00 | $109.82 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | KAISER MEDI-CAL | KAISER MEDI-CAL | $90.00 | $578.00 | $115.60 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | UPN MCAL PROFEE ONLY-ALL OTHER PLANS | UPN MCAL PROFEE ONLY-ALL OTHER PLANS | $90.00 | $578.00 | $109.82 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | MEDI-CAL | MEDI-CAL | $90.00 | $578.00 | $109.82 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE MCAL PROFEE ONLY | CENTRAL CA ALLIANCE MCAL PROFEE ONLY | $90.00 | $578.00 | $109.82 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | BC MCAL | BC MCAL | $90.00 | $578.00 | $109.82 | 2026-05-20 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | AETNA | AETNA | $92.96 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Multiplan | MultiplanWC | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Humana | HumanaCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Hap | MidwestMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Mclaren Health Plan | McLarenAdvantagePPO | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Priority Health | PriorityHealthSBDHMOPPO | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | United Healthcare | UnitedMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Centene | AmbetterHIX | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Centene | CenteneHNWellcareMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Corvel | CorvelWC | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Priority Health | PriorityHealthMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Wellcare | MeridianMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Point Comfort Underwriters | PointComfortUnderwriters | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | United Healthcare | UnitedCommunityPlanMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Prime Health Services | PrimeHealthServicesMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | BCBS-MI | BCBSMICommercial | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Aetna | AetnaExistingBusiness | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Provider Partners Health Plan | ProviderPartnersHealthPlanMedicareAdvantage | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Amerihealth | AmerihealthCaritasMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Priority Health | PriorityHealthCigna | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Mclaren Health Plan | McLarenMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Mclaren Health Plan | McLarenMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Wellcare | CenteneHNWellcareMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Commonwealth Care Alliance | CommonwealthCareAllianceMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Community Care | CommunityCareComm | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Longevity Health Plan | LongevityHealthPlan | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Naphcare Inc. | NaphCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Enlyte/Genex/Coventry | CoventryAKAGenexWC | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaHIX | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | BCBS-MI | BCBSMIMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Zing Health | ZingHealthMedicareNonNarrow | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Humana | HumanaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Hap | HAPMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Employers Choice Network | EmployersChoiceNetworkWC | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Americas Choice Provider Network | AmericasChoiceProviderNetworkWC | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Priority Health | PriorityHealthSEMIPartnersNet | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | BCBS-MI | BCBSMIBCNMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Mclaren Health Plan | McLarenCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | American Health Plan | AmericanHealthPlanMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Prime Health Services | PrimeHealthServicesWC | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Priority Health | PriorityHealthMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Amerihealth | BlueCrossCompleteMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Aetna | AetnaMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | AllyAlign Health | AllyAlignHealthMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Priority Health | PriorityHealthCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Hap | HAPHPICigna | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Aetna | AetnaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | KAISER MCAL | KAISER MCAL | $95.00 | $578.00 | $109.82 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | BC MCAL | BC MCAL | $95.00 | $578.00 | $109.82 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | UNIVERSAL HC MCAL PROFEE | UNIVERSAL HC MCAL PROFEE | $95.00 | $578.00 | $109.82 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $95.00 | $578.00 | $156.06 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $95.00 | $578.00 | $109.82 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | MEDI-CAL | MEDI-CAL | $95.00 | $578.00 | $109.82 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | UNIVERSAL IPA MCAL OP/PROFEE ONLY | UNIVERSAL IPA MCAL OP/PROFEE ONLY | $95.00 | $578.00 | $156.06 | 2026-01-31 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | LIFETIME_BEN | LIFETIME BENEFITS | $95.26 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | MedCare Partners | MGMCR | — | — | — | 2026-03-01 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Univera | Medicare Managed Care Plan | $100.26 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $100.26 | — | — | 2026-04-01 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELISCARE_1401 | FIDELISCARE MARKETPLACE AMBULATORY SURGERY | $101.30 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELISCARE_1400 | FIDELISCARE MARKETPLACE CLINIC | $101.30 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELISCARE_0000 | FIDELISCARE MARKETPLACE IP AND OP NO RATE CODE | $101.30 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELISCARE_1402 | FIDELISCARE MARKETPLACE EMERGENCY ROOM | $101.30 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | BCBS-MI | BCBSMICommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Commonwealth Care Alliance | CommonwealthCareAllianceMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Community Care | CommunityCareComm | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | BCBS-MI | BCBSMIBCNMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthSEMIPartnersNet | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | AllyAlign Health | AllyAlignHealthMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Humana | HumanaCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthSBDHMOPPO | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Enlyte/Genex/Coventry | CoventryAKAGenexWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Wellcare | CenteneHNWellcareMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Employers Choice Network | EmployersChoiceNetworkWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHPICigna | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Centene | CenteneHNWellcareMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Contigo Health | ContigoHealthWCfkaThreeRiversWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | United Healthcare | HealthSmartMgdWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | American Health Plan | AmericanHealthPlanMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | BCBS-MI | BCBSMIMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Wellcare | MeridianMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | MidwestMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Mclaren Health Plan | McLarenMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthCigna | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Humana | HumanaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Centene | AmbetterHIX | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Multiplan | MultiplanWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Zing Health | ZingHealthMedicareNonNarrow | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Amerihealth | AmerihealthCaritasMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Amerihealth | BlueCrossCompleteMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Aetna | AetnaExistingBusiness | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Aetna | AetnaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Aetna | AetnaMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Mclaren Health Plan | McLarenMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Mclaren Health Plan | McLarenCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | United Healthcare | UnitedMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Longevity Health Plan | LongevityHealthPlan | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Prime Health Services | PrimeHealthServicesWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Prime Health Services | PrimeHealthServicesMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaHIX | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Mclaren Health Plan | McLarenAdvantagePPO | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | United Healthcare | UnitedCommunityPlanMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Naphcare Inc. | NaphCare | — | — | — | 2025-01-31 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Univera | Medicare Managed Care Plan | $111.40 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $111.40 | — | — | 2026-04-01 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | KERN HEALTH SYSTEMS MCAL-ALL PLANS | KERN HEALTH SYSTEMS MCAL-ALL PLANS | $112.50 | $578.00 | $109.82 | 2026-05-20 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | AETNA | AETNA | $117.94 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | MVP-MEDICARE_ADV | MVP MEDICARE ADVANTAGE | $119.18 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | AETNA_MCAREHMO | AETNA MEDICARE HMO | $119.18 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | EXCELLUS-BC_MCAREADV | EXCELLUS BLUECROSS MEDICARE ADVANTAGE | $119.18 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | MEDICARE | AUBURN MEDICARE | $119.18 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | HUMANA_MCARE_ADV | HUMANA GOLD PLUS MEDICARE HMO | $119.18 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | UHC | UNITED HEALTHCARE | $119.18 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | UMR | UNITED MEDICAL RESOURCES | $119.18 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | UHC_MCARE_ADV | UHC MEDICARE COMPLETE CHOICE | $119.18 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | VA | VETERANS ADMINISTRATION | $119.18 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | UHC_EMPIRE | UNITED HEALTHCARE EMPIRE PLAN | $119.18 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELIS_MCARE_ADV | FIDELIS MEDICARE ADVANTAGE PLAN | $119.18 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE CHDP MCAL | CENTRAL CA ALLIANCE CHDP MCAL | $120.00 | $578.00 | $98.26 | 2026-05-23 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELISCARE_0000 | FIDELISCARE MARKETPLACE IP AND OP NO RATE CODE | $128.52 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELISCARE_1401 | FIDELISCARE MARKETPLACE AMBULATORY SURGERY | $128.52 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELISCARE_1402 | FIDELISCARE MARKETPLACE EMERGENCY ROOM | $128.52 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELISCARE_1400 | FIDELISCARE MARKETPLACE CLINIC | $128.52 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | WELLCARE_MCARE_ADV | WELLCARE MEDICARE ADVANTAGE | $128.71 | $119.18 | $132.07 | 2025-01-19 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P | CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P | $135.00 | $578.00 | $109.82 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE CCS PROFEE ONLY | CENTRAL CA ALLIANCE CCS PROFEE ONLY | $135.00 | $578.00 | $109.82 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | UPN MCAL PROFEE | UPN MCAL PROFEE | $144.50 | $578.00 | $109.82 | 2026-05-19 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Medicare B NY Upstate JK | Default | $147.36 | $3,051.00 | $1,891.62 | 2026-03-16 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | MVP-MEDICARE_ADV | MVP MEDICARE ADVANTAGE | $151.20 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | VA | VETERANS ADMINISTRATION | $151.20 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | AETNA_MCAREHMO | AETNA MEDICARE HMO | $151.20 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | EXCELLUS-BC_MCAREADV | EXCELLUS BLUECROSS MEDICARE ADVANTAGE | $151.20 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | UMR | UNITED MEDICAL RESOURCES | $151.20 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | MEDICARE | AUBURN MEDICARE | $151.20 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | UHC_EMPIRE | UNITED HEALTHCARE EMPIRE PLAN | $151.20 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | UHC | UNITED HEALTHCARE | $151.20 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | UHC_MCARE_ADV | UHC MEDICARE COMPLETE CHOICE | $151.20 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELIS_MCARE_ADV | FIDELIS MEDICARE ADVANTAGE PLAN | $151.20 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | HUMANA_MCARE_ADV | HUMANA GOLD PLUS MEDICARE HMO | $151.20 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Blue Cross Blue Shield of NY Empire | Medicare Advantage | $157.89 | $3,051.00 | $1,891.62 | 2026-03-16 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | VALLEY CHILDRENS - ALL PLANS | VALLEY CHILDRENS - ALL PLANS | $159.60 | $578.00 | $109.82 | 2026-05-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | WELLCARE_MCARE_ADV | WELLCARE MEDICARE ADVANTAGE | $163.30 | $151.20 | $53.63 | 2025-01-19 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE CHDP PROFEE ONLY | CENTRAL CA ALLIANCE CHDP PROFEE ONLY | $180.00 | $578.00 | $109.82 | 2026-05-20 | MRF ↗ |
| ST JOSEPH HEALTH SYSTEM, LLC Inpatient | Anthem | Anthem In Marketplace Stld | — | $721.00 | $396.55 | 2026-07-15 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | UNIVERSAL IPA MCAL OP/PROFEE ONLY | UNIVERSAL IPA MCAL OP/PROFEE ONLY | $214.82 | $578.00 | $156.06 | 2026-05-21 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $214.82 | $578.00 | $156.06 | 2026-05-21 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - Meridian | Medicaid - Meridian | $241.00 | $2,381.00 | $1,190.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - United | Medicaid - United | $245.00 | $2,381.00 | $1,190.00 | 2025-02-03 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Outpatient | Lutheran Three Rivers Preferred Plus 175 | Lutheran Three Rivers Preferred Plus 175 | $252.35 | $721.00 | $360.50 | 2026-07-15 | MRF ↗ |
| Shepherd Center Outpatient | Humana | Commercial | $253.05 | — | — | 2026-05-06 | MRF ↗ |
| Shepherd Center Outpatient | Humana | Commercial | $253.05 | — | — | 2026-09-21 | MRF ↗ |
| TEXAS ORTHOPEDIC HOSPITAL Outpatient | Cigna | Cigna Hmo | $253.07 | $721.00 | $194.67 | 2026-07-17 | MRF ↗ |
| BLUFFTON REGIONAL MEDICAL CENTER Outpatient | Cigna | Cigna Ppo | $255.23 | $721.00 | $173.04 | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Encore Prime | Commercial | $255.23 | — | — | 2026-07-17 | MRF ↗ |
| LUTHERAN HOSPITAL Inpatient | Self Pay | Self Pay | $259.56 | $721.00 | $259.56 | 2026-07-17 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Outpatient | Prime Health Services | Prime Health Services In Work Comp | $259.56 | $721.00 | $360.50 | 2026-07-15 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Inpatient | Aetna Pssd J&J | Aetna Pssd Jj | $259.56 | $721.00 | $396.55 | 2026-07-15 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Inpatient | Aetna | Aetna Nbd | $259.56 | $721.00 | $396.55 | 2026-07-15 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Outpatient | Encore Work Comp In | Encore Work Comp In | $259.56 | $721.00 | $360.50 | 2026-07-15 | MRF ↗ |
| BLUFFTON REGIONAL MEDICAL CENTER Inpatient | Aetna Pssd J&J | Aetna Pssd Jj | $261.00 | $721.00 | $396.55 | 2026-07-15 | MRF ↗ |
| BLUFFTON REGIONAL MEDICAL CENTER Inpatient | Aetna | Aetna Nbd | $261.00 | $721.00 | $396.55 | 2026-07-15 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Avmed | Commercial (MMG) | $261.06 | — | — | 2025-10-24 | MRF ↗ |
| ST JOSEPH HEALTH SYSTEM, LLC Outpatient | Anthem Bcbs | Anthem In Ppo | $261.51 | $721.00 | $173.04 | 2026-07-15 | MRF ↗ |
| ST JOSEPH HEALTH SYSTEM, LLC Outpatient | Cigna | Cigna Ppo | $261.72 | $721.00 | $173.04 | 2026-07-15 | 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.