43999 — Unlisted Procedure Stomach
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). UNLISTED PROCEDURE STOMACH (HCPCS 43999) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/43999?code_type=HCPCS
MLA (9th ed.)
“UNLISTED PROCEDURE STOMACH (HCPCS 43999) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/43999?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“UNLISTED PROCEDURE STOMACH (HCPCS 43999) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/43999?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $933–$3,019 (25th–75th percentile) across 1,843 hospitals · 5,019 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 43999 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
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 |
|---|---|---|---|---|---|---|---|
| Nationwide Children's Hospital OutpatientFacility | Anthem BCBS | All Products | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Anthem BCBS | All Products | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| GROSSMONT HOSPITAL Inpatient | San Diego Pace | San Diego Pace | $0.52 | $7,637.00 | $5,727.75 | 2026-04-01 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | INDIAN HEALTH SERVICE CONTRACTED [320198] | HB STLO MANAGED MEDICARE | $3.86 | $17,476.01 | $11,359.41 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | BLUE CROSS AND BLUE SHIELD [20053] | HB STLO MANAGED MEDICARE | $3.86 | $17,476.01 | $11,359.41 | 2026-03-12 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $5.11 | $1,380.75 | $1,311.71 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $5.11 | $1,380.75 | $1,311.71 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $5.11 | $1,380.75 | $1,311.71 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $5.25 | $1,380.75 | $1,311.71 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $5.38 | $1,380.75 | $1,311.71 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $5.52 | $1,380.75 | $1,311.71 | 2026-02-20 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $6.18 | $3,435.00 | $906.34 | 2024-12-31 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $6.57 | $101.00 | $65.65 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $6.57 | $101.00 | $65.65 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $6.57 | $101.00 | $65.65 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $6.57 | $101.00 | $65.65 | 2026-03-12 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $6.63 | $1,381.00 | $1,311.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $6.63 | $1,381.00 | $1,311.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $6.77 | $1,381.00 | $1,311.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $6.77 | $1,381.00 | $1,311.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $6.77 | $1,380.75 | $1,311.71 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $6.77 | $1,380.75 | $1,311.71 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $6.90 | $1,380.75 | $1,311.71 | 2026-02-20 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | MEDICAID [20240] | HB FTSM OK MEDICAID | $7.00 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | MEDICAID [20240] | HB FTSM OK MEDICAID | $7.00 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $7.04 | $1,381.00 | $1,311.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $7.18 | $1,380.75 | $1,311.71 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $7.46 | $1,380.75 | $1,311.71 | 2026-02-20 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | INDIAN HEALTH SERVICE CONTRACTED [320198] | HB FTSM MEDICARE | $7.71 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | INDIAN HEALTH SERVICE CONTRACTED [320198] | HB FTSM MEDICARE | $7.71 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | INDIAN HEALTH SERVICE [20198] | HB FTSM MEDICARE | $7.71 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | INDIAN HEALTH SERVICE [20198] | HB FTSM MEDICARE | $7.71 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | BLUE CROSS AND BLUE SHIELD [20053] | HB FTSM MANAGED MEDICARE | $7.71 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | BLUE CROSS AND BLUE SHIELD [20053] | HB FTSM MANAGED MEDICARE | $7.71 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Oscar Health | Exchange | $9.87 | $70.00 | $24.50 | 2026-05-08 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | MERCY INTERFACILITY [20513] | HB ROGR Inter-Facility CCR New 6.1.25 | $10.56 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | HUMANA CONTRACTED [320193] | HB ROGR HUMANA | — | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | SUMMIT COMMUNITY CARE [20368] | HB FTSM ARK MEDICAID | $11.20 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | ARKANSAS DEPARTMENT OF HEALTH [20036] | HB FTSM ARK MEDICAID | $11.20 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | MEDICAID [20240] | HB FTSM ARK MEDICAID | $11.20 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | ARKANSAS DEPARTMENT OF HEALTH [20036] | HB FTSM ARK MEDICAID | $11.20 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | SUMMIT COMMUNITY CARE CONTRACTED [320368] | HB FTSM SUMMIT | $11.20 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | SUMMIT COMMUNITY CARE [20368] | HB FTSM ARK MEDICAID | $11.20 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | MEDICAID [20240] | HB FTSM ARK MEDICAID | $11.20 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | SUMMIT COMMUNITY CARE CONTRACTED [320368] | HB FTSM SUMMIT | $11.20 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | CARESOURCE MEDICAID [20460] | HB FTSM CARESOURCE MEDICAID | $11.42 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | CARESOURCE MEDICAID CONTRACTED [320460] | HB FTSM CARESOURCE MEDICAID | $11.42 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | CARESOURCE MEDICAID [20460] | HB FTSM CARESOURCE MEDICAID | $11.42 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | CARESOURCE MEDICAID CONTRACTED [320460] | HB FTSM CARESOURCE MEDICAID | $11.42 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Aetna | Medicare | $13.71 | $70.00 | $24.50 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Essential Health Partners | Hmo | $13.71 | $70.00 | $24.50 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Devoted Healthcare | Medicare | $13.71 | $70.00 | $24.50 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Essential Health Partners | Medicare | $13.71 | $70.00 | $24.50 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | United Healthcare | Medicare | $13.71 | $70.00 | $24.50 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Blue Cross Blue Shield | Medicare | $13.71 | $70.00 | $24.50 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Humana | Medicare | $13.71 | $70.00 | $24.50 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Cigna | Medicare | $13.98 | $70.00 | $24.50 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Meridian | Medicare (Wellcare) | $14.12 | $70.00 | $24.50 | 2026-05-08 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | EMPOWER HEALTHCARE SOLUTIONS MEDICAID [20118] | HB FTSM PASSE EMPOWER | $14.22 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | EMPOWER HEALTHCARE SOLUTIONS MEDICAID [20118] | HB FTSM PASSE EMPOWER | $14.22 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | EMPOWER HEALTHCARE SOLUTIONS MEDICAID CONTRACTED [320118] | HB FTSM PASSE EMPOWER | $14.22 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | EMPOWER HEALTHCARE SOLUTIONS MEDICAID CONTRACTED [320118] | HB FTSM PASSE EMPOWER | $14.22 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | MERCY BENEFIT ADMIN CONTRACTED [320251] | HB ROGR DEC SCHAEFER QCG | $14.50 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | MERCY BENEFIT ADMIN CONTRACTED [320251] | HB ROGR DEC BARTEL | $14.50 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | AITHER HEALTH CONTRACTED [320449] | HB ROGR DEC LACLEDE - NEW 07.01.25 | $14.50 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | AITHER HEALTH CONTRACTED [320449] | HB ROGR DEC WOODARD | $14.50 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | HUMANA MEDICAID CONTRACTED [320486] | HB ROGR OK MANAGED MEDICAID | $14.50 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB ROGR OK MANAGED MEDICAID | $14.50 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | EDISON HEALTH SOLUTIONS CONTRACTED [320502] | HB ROGR DEC WOODARD | $14.50 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB ROGR OK MANAGED MEDICAID | $14.50 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | YUZU HEALTH CONTRACTED [320521] | HB ROGR DEC LEVEL HEALTH - NEW 01.01.26 | $14.50 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | MERCY BENEFIT ADMIN CONTRACTED [320251] | HB ROGR DEC TALL TREE | $14.50 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Blue Cross | Blue Cross - Standard | $14.56 | $2,627.00 | $1,970.25 | 2026-04-01 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $14.95 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $15.04 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $15.04 | — | — | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | BLUE CROSS AND BLUE SHIELD [20053] | HB ROGR BCBS EXCHANGE | $15.08 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| UPMC MEMORIAL OutpatientFacility | Highmark BCBS of PA | Medicare | $15.15 | — | — | 2026-03-06 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MEDICAID [20240] | HB STLO CAPE IL MEDICAID | $15.15 | $101.00 | $65.65 | 2026-03-12 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Blue Cross | Blue Cross - Prudent Buyer | $16.38 | $2,627.00 | $1,970.25 | 2026-04-01 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Aetna | First Health - Leased/CCN | $16.38 | $2,627.00 | $1,970.25 | 2026-04-01 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Health Net | Health Net - PPO | $16.38 | $2,627.00 | $1,970.25 | 2026-04-01 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Meridian | Exchange (Ambetter) | $16.45 | $70.00 | $24.50 | 2026-05-08 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $17.13 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $17.24 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $17.24 | — | — | 2026-03-18 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.59 | $3,608.00 | $2,164.80 | 2026-03-06 | MRF ↗ |
| UPMC HAMOT OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.59 | $5,164.00 | $3,098.40 | 2026-03-06 | MRF ↗ |
| UPMC ALTOONA OutpatientFacility | Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $18.59 | $174.00 | $104.40 | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.59 | $3,608.00 | $2,164.80 | 2026-03-06 | MRF ↗ |
| UPMC ALTOONA OutpatientFacility | Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $18.59 | $174.00 | $104.40 | 2026-03-06 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $18.65 | — | — | 2026-03-18 | MRF ↗ |
| UPMC PASSAVANT OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.77 | $4,962.00 | $2,977.20 | 2026-03-07 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $18.77 | — | — | 2026-03-18 | MRF ↗ |
| UPMC MCKEESPORT HOSPITAL OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.77 | $160.00 | $96.00 | 2026-03-06 | MRF ↗ |
| UPMC EAST OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.77 | — | — | 2026-03-06 | MRF ↗ |
| MAGEE WOMENS HOSPITAL OF UPMC HEALTH SYSTEM OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.77 | $230.00 | $138.00 | 2026-03-06 | MRF ↗ |
| MAGEE WOMENS HOSPITAL OF UPMC HEALTH SYSTEM OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.77 | $230.00 | $138.00 | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.77 | $134.00 | $80.40 | 2026-03-06 | MRF ↗ |
| UPMC PASSAVANT OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.77 | $4,962.00 | $2,977.20 | 2026-03-07 | MRF ↗ |
| Upmc Presbyterian Shadyside OutpatientFacility | Highmark BCBS of PA | Medicare Advantage | $18.77 | $4,962.00 | $2,977.20 | 2026-03-06 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $18.77 | — | — | 2026-03-18 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.77 | $134.00 | $80.40 | 2026-03-06 | MRF ↗ |
| UPMC JAMESON OutpatientFacility | Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $18.92 | $2,108.00 | $1,264.80 | 2026-03-06 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | KANCARE [20213] | HB CTHG KANCARE UHC MEDICAID | $19.75 | $79.00 | $51.35 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | KANCARE [20213] | HB CTHG KANCARE UHC MEDICAID | $19.75 | $79.00 | $51.35 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | KANCARE [20213] | HB SPRG AETNA BETTER HEALTH (KANCARE) | $19.75 | $79.00 | $51.35 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | KANCARE [20213] | HB SPRG AETNA BETTER HEALTH (KANCARE) | $19.75 | $79.00 | $51.35 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | KANCARE CONTRACTED [320213] | HB CTHG KANCARE UHC MEDICAID | $19.75 | $79.00 | $51.35 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | KANCARE CONTRACTED [320213] | HB CTHG KANCARE UHC MEDICAID | $19.75 | $79.00 | $51.35 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | KANCARE CONTRACTED [320213] | HB SPRG AETNA BETTER HEALTH (KANCARE) | $19.75 | $79.00 | $51.35 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | KANCARE CONTRACTED [320213] | HB SPRG AETNA BETTER HEALTH (KANCARE) | $19.75 | $79.00 | $51.35 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | NOVASYS CONTRACTED [320285] | HB ROGR NOVASYS AMBETTER EXCHANGE | $20.14 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | AMBETTER CONTRACTED [320452] | HB ROGR NOVASYS AMBETTER EXCHANGE | $20.14 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | HOME STATE HEALTH PLAN CONTRACTED [320187] | HB ROGR NOVASYS AMBETTER EXCHANGE | $20.14 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | SUNFLOWER HEALTH PLAN CONTRACTED [320369] | HB ROGR NOVASYS AMBETTER EXCHANGE | $20.14 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| HENRY COUNTY MEMORIAL HOSPITAL Outpatient | UHC-ALL PLANS | UHC-ALL PLANS | $20.20 | $101.00 | $70.70 | 2026-04-21 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Aetna | Commercial | $22.22 | $70.00 | $24.50 | 2026-05-08 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Upmc | All Commercial Plans | $22.76 | — | — | 2026-04-01 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | BLUE CROSS NON MCS - ALL OTHER PLANS | BLUE CROSS NON MCS - ALL OTHER PLANS | $25.00 | $1,700.00 | $323.00 | 2026-01-31 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center Commercial | $25.18 | — | — | 2026-04-14 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | ARKANSAS TOTAL CARE [20039] | HB FTSM PASSE AR TOTAL CARE | $25.42 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | ARKANSAS TOTAL CARE CONTRACTED [320039] | HB FTSM PASSE AR TOTAL CARE | $25.42 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | ARKANSAS TOTAL CARE [20039] | HB FTSM PASSE AR TOTAL CARE | $25.42 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | ARKANSAS TOTAL CARE CONTRACTED [320039] | HB FTSM PASSE AR TOTAL CARE | $25.42 | $7,387.81 | $4,802.08 | 2026-03-13 | MRF ↗ |
| FROEDTERT MEMORIAL LUTHERAN HOSPITAL OutpatientFacility | Centivo | WI 2 Median | $25.50 | $85.00 | $46.75 | 2025-12-31 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Managed Health Network | MHN - Medicare | $25.86 | $7,637.00 | $5,727.75 | 2026-04-01 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Hst Technologies | Epo, Ppo | $26.32 | $70.00 | $24.50 | 2026-05-08 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MEDICA CONTRACTED [320239] | HB STLO MEDICA EXCHANGE | $26.36 | $101.00 | $65.65 | 2026-03-12 | MRF ↗ |
| UPMC MCKEESPORT HOSPITAL OutpatientFacility | UPMC Health Plan | Commercial | $26.53 | $160.00 | $96.00 | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | UPMC Health Plan | Commercial | $26.93 | $3,608.00 | $2,164.80 | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | UPMC Health Plan | Commercial | $26.93 | $3,608.00 | $2,164.80 | 2026-03-06 | MRF ↗ |
| UPMC PASSAVANT OutpatientFacility | UPMC Health Plan | Commercial | $27.15 | $4,962.00 | $2,977.20 | 2026-03-07 | MRF ↗ |
| UPMC PASSAVANT OutpatientFacility | UPMC Health Plan | Commercial | $27.15 | $4,962.00 | $2,977.20 | 2026-03-07 | MRF ↗ |
| UPMC HORIZON OutpatientFacility | UPMC Health Plan | Commercial | $27.29 | $3,429.00 | $2,057.40 | 2026-03-06 | MRF ↗ |
| Upmc Presbyterian Shadyside OutpatientFacility | UPMC Health Plan | Commercial | $27.61 | $4,962.00 | $2,977.20 | 2026-03-06 | MRF ↗ |
| UPMC EAST OutpatientFacility | UPMC Health Plan | Commercial | $27.83 | — | — | 2026-03-06 | MRF ↗ |
| FROEDTERT MEMORIAL LUTHERAN HOSPITAL OutpatientFacility | Centivo | WI 1 Broad | $28.05 | $85.00 | $46.75 | 2025-12-31 | MRF ↗ |
| FROEDTERT MEMORIAL LUTHERAN HOSPITAL OutpatientFacility | Medical College of Wisconsin | Employee Plan | $28.05 | $85.00 | $46.75 | 2025-12-31 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | UPMC Health Plan | Commercial | $28.15 | $134.00 | $80.40 | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | UPMC Health Plan | Commercial | $28.15 | $134.00 | $80.40 | 2026-03-06 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | MERCY INTERFACILITY [20513] | HB FTSM Inter-Facility CCR New 6.1.25 | $28.19 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | MERCY INTERFACILITY [20513] | HB FTSM Inter-Facility CCR New 6.1.25 | $28.19 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | 90 DEGREE BENEFITS CONTRACTED [320436] | HB ROGR DEC SHOW ME | $29.00 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | MERCY BENEFIT ADMIN CONTRACTED [320251] | HB ROGR DEC SHOW ME | $29.00 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | SHOW-ME HEALTH ADMINISTRATORS CONTRACTED [320483] | HB FTSM ROGR DEC ASI | $29.00 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | MERCY BENEFIT ADMIN CONTRACTED [320251] | HB ROGR DEC TOWN AND COIUNTRY | $29.00 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | CIGNA HEALTHCARE CONTRACTED [320071] | HB ROGR CIGNA | $30.16 | $58.00 | $37.70 | 2026-03-13 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | INSURANCE SYSTEM INC CONTRACTED [320465] | HB SPRG HEALTH SYSTEMS | $31.60 | $79.00 | $51.35 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | HEALTH SYSTEMS INC CONTRACTED [320174] | HB SPRG HEALTH SYSTEMS | $31.60 | $79.00 | $51.35 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | BENEFIT MANAGEMENT CONTRACTED [320052] | HB SPRG DEC OZARK COMMUNITY HOSPITAL | $31.60 | $79.00 | $51.35 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | BENEFIT MANAGEMENT CONTRACTED [320052] | HB SPRG DEC OZARK COMMUNITY HOSPITAL | $31.60 | $79.00 | $51.35 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | INSURANCE SYSTEM INC CONTRACTED [320465] | HB SPRG HEALTH SYSTEMS | $31.60 | $79.00 | $51.35 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | HEALTH SYSTEMS INC CONTRACTED [320174] | HB SPRG HEALTH SYSTEMS | $31.60 | $79.00 | $51.35 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB FTSM OK MANAGED MEDICAID | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | AITHER HEALTH CONTRACTED [320449] | HB FTSM DEC LACLEDE - NEW 07.01.25 | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB FTSM OK MANAGED MEDICAID | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | AITHER HEALTH CONTRACTED [320449] | HB FTSM DEC WOODARD | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | AITHER HEALTH CONTRACTED [320449] | HB FTSM DEC WOODARD | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB FTSM OK MANAGED MEDICAID | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | EDISON HEALTH SOLUTIONS CONTRACTED [320502] | HB FTSM DEC WOODARD | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | AITHER HEALTH CONTRACTED [320449] | HB FTSM DEC LACLEDE - NEW 07.01.25 | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM DEC SCHAEFER QCG | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM DEC TALL TREE | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM DEC SCHAEFER QCG | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM DEC BARTEL | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB FTSM OK MANAGED MEDICAID | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | HUMANA MEDICAID CONTRACTED [320486] | HB FTSM OK MANAGED MEDICAID | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM DEC BARTEL | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | HUMANA MEDICAID CONTRACTED [320486] | HB FTSM OK MANAGED MEDICAID | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | EDISON HEALTH SOLUTIONS CONTRACTED [320502] | HB FTSM DEC WOODARD | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | MERCY BENEFIT ADMIN CONTRACTED [320251] | HB FTSM DEC TALL TREE | $32.00 | $128.00 | $83.20 | 2026-03-13 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center Commercial | $32.80 | — | — | 2026-04-14 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| FROEDTERT MEMORIAL LUTHERAN HOSPITAL OutpatientFacility | Chorus Community Health Plan | All Contracted Commercial Plans | $33.15 | $85.00 | $46.75 | 2025-12-31 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Blue Care Network | Medicare Advantage | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Blue Care Network | Commercial | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Healthy Michigan Blue Cross Complete | Managed Medicaid | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Aetna | Medicare Advantage | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Priority Health | Medicare Advantage | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Healthy Michigan Priority Health | Managed Medicaid | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Molina Healthplan | Medicare Advantage | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Blue Cross Trust | Commercial | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Humana | PPO Medicare Advantage | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Healthy Michigan Molina | Managed Medicaid | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Wellcare/Meridian | Medicare Advantage | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Healthy Michigan Meridian | Managed Medicaid | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Health Alliance Plan of Michigan | PPO | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Blue Cross Anthem | Commercial | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | McLaren Health Advantage | Commercial | $33.30 | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Physicians Health Plan Advantage/Advantage Plus | HMO Medicare Advantage | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | McLaren Advantage | Medicare Advantage | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Covenant Advantage/Advantage Plus | HMO/POS Medicare Advantage | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Blue Cross Blue Shield Traditional | Commercial | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Health Alliance Plan of Michigan | HMO | — | $74.00 | $51.80 | 2025-03-12 | MRF ↗ |
| COVENANT MEDICAL CENTER InpatientFacility | Healthy Michigan McLaren | Managed Medicaid | — | $74.00 | $51.80 | 2025-03-12 | 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.