44378 — Small Bowel Endoscopy
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). SMALL BOWEL ENDOSCOPY (CPT 44378) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/44378?code_type=CPT
MLA (9th ed.)
“SMALL BOWEL ENDOSCOPY (CPT 44378) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/44378?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“SMALL BOWEL ENDOSCOPY (CPT 44378) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/44378?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,495–$3,359 (25th–75th percentile) across 1,651 hospitals · 3,844 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 44378 — 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
$1,495
$2,201 typical
$3,359
The middle 50% of negotiated facility rates for this procedure, measured across 1,651 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. | $2,201 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $335 × 1.22 commercial. | $409 |
| Likely subtotal | $2,610 |
Surgical episode (typical)
~$2,610
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)
~$6,395
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 |
|---|---|---|---|---|---|---|---|
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $8.49 | $4,718.00 | $1,912.13 | 2024-12-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Wellcare | Medicare Advantage | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna | Commercial | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana Choicecare | Commercial | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Multiplan | Commercial | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Tricare | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Wellcare | Managed Medicaid | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Medcost | Commercial | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | New Hanover | Medicare Advantage | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Managed Medicaid | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Liberty Advantage | Medicare Advantage | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Commercial | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana Choicecare | Medicare Advantage | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Cigna | Commercial | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Carolina Complete Health | Managed Medicaid | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Medicare Advantage | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Healthy Blue | Managed Medicaid | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Troy | Medicare Advantage | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Blue Medicare Partner Health Plan | Medicare | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna | Medicare Advantage | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | First Carolina Care | Medicare Advantage | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Onenet Ppo | $9.80 | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Longevity | Medicare Advantage | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna Nc State Health Plan | Commercial | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Compass | — | $3,971.00 | $2,382.60 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $11.10 | $946.00 | $179.74 | 2026-01-25 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $27.94 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $28.11 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $28.11 | — | — | 2026-03-18 | 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 ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $32.02 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $32.22 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $32.22 | — | — | 2026-03-18 | 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 ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $34.86 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $35.08 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $35.08 | — | — | 2026-03-18 | MRF ↗ |
| EPHRAIM MCDOWELL FORT LOGAN HOSPITAL Outpatient | UHC Fort Logan Hospital | PPO | $43.38 | $67.25 | — | 2026-02-24 | MRF ↗ |
| EPHRAIM MCDOWELL FORT LOGAN HOSPITAL Inpatient | Anthem Commercial Traditional Fort Logan Hospital | PPO | $48.59 | $48.81 | — | 2026-02-24 | 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 ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $55.76 | $413.00 | $309.75 | 2026-01-16 | MRF ↗ |
| EPHRAIM MCDOWELL FORT LOGAN HOSPITAL Inpatient | Anthem Commercial Traditional Fort Logan Hospital | PPO | $66.94 | $67.25 | — | 2026-02-24 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $85.70 | $413.00 | $309.75 | 2026-01-16 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $93.15 | $1,433.00 | $931.45 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $93.15 | $1,433.00 | $931.45 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $93.15 | $1,433.00 | $931.45 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $93.15 | $1,433.00 | $931.45 | 2026-03-12 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PATHWAY | 9230_ANTHEM PATHWAY VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HMO/POS | 9229_ANTHEM HMO POS VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HEALTHSYNC POS | 9228_ANTHEM HEALTHSYNC POS VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM HEALTHSYNC HMO | 9227_ANTHEM HEALTHSYNC HMO VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PATHWAY X | 9231_ANTHEM PATHWAY X VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Inpatient | SMARTHEALTH PPO | 8842_SMARTHEALTH PPO 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM SHORT TERM LIMITED DURATION | 9361_ANTHEM SHORT TERM LIMITED DURATION VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | UNIFIED GROUP SERVICES | 8813_ANTHEM UNIFIED GROUPS VKIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $97.25 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM TRADITIONAL | 9233_ANTHEM TRADITIONAL VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | UNIFIED GROUP SERVICES | 8811_ANTHEM UNIFIED GROUPS VCIN ECIN ASIN 20241001 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM PPO PREFERRED | 9232_ANTHEM PREFERRED VCIN 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $109.59 | $1,686.00 | $1,095.90 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $109.59 | $1,686.00 | $1,095.90 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $109.59 | $1,686.00 | $1,095.90 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $109.59 | $1,686.00 | $1,095.90 | 2026-03-12 | MRF ↗ |
| EPHRAIM MCDOWELL FORT LOGAN HOSPITAL Outpatient | UHC Fort Logan Hospital | PPO | $116.58 | $180.75 | — | 2026-02-24 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | UNITED HEALTH CARE COMMUNITY PLAN MEDICAID [9004] | UNITED HEALTH CARE MEDICAID [900401] | $120.67 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| EPHRAIM MCDOWELL FORT LOGAN HOSPITAL Inpatient | UHC Fort Logan Hospital | PPO | $122.72 | $318.75 | — | 2026-02-24 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | KEY BENEFIT ADMINISTRATORS [1089] | KEY BENEFIT ADMINISTRATORS [108901] | $132.73 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | COUNTY HEALTH PLAN B [1022] | GENESEE HEALTH PLAN B [102204] | $132.73 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | COUNTY HEALTH PLAN B [1022] | COUNTY HEALTH PLAN B NON GENESEE COUNTY [102202] | $132.73 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| EPHRAIM MCDOWELL FORT LOGAN HOSPITAL Inpatient | UHC Fort Logan Hospital | PPO | $140.24 | $364.25 | — | 2026-02-24 | MRF ↗ |
| EPHRAIM MCDOWELL FORT LOGAN HOSPITAL Outpatient | UHC Fort Logan Hospital | PPO | $143.69 | $222.77 | — | 2026-02-24 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | PACE MEDICARE HMO [7023] | GENESYS PACE MEDICARE HMO [702301] | $149.05 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| RIVERLAND MEDICAL CENTER Both | Humana Advantage Care Plans Med Advantage | Default | $151.12 | $727.00 | $363.50 | 2024-10-24 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $152.83 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $152.83 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $152.83 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $152.83 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $152.83 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $152.83 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $152.83 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $152.83 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $152.83 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $152.83 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $152.83 | — | — | 2026-01-01 | MRF ↗ |
| EPHRAIM MCDOWELL FORT LOGAN HOSPITAL Outpatient | UHC Fort Logan Hospital | PPO | $159.64 | $247.50 | — | 2026-02-24 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716, UNITED HEALTHCARE 5158 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL (W/ MEDICAID 171602, UNITED HEALTHCARE ESSENTIAL (NO MEDICAID 515812, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $163.24 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $163.98 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $163.98 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | EXCELLUS MEDICAID 1706, EXCELLUS 2201 | BLUE CHOICE OPTION MEDICAID 170601, EXCELLUS ESSENTIAL (W/ MEDICAID) 170604, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS ESSENTIAL (NO MEDICAID) 220109, EXCELLUS HEALTHY NY 220110 | $163.98 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $163.98 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | EXCELLUS MEDICAID 1706, EXCELLUS 2201 | BLUE CHOICE OPTION MEDICAID 170601, EXCELLUS ESSENTIAL (W/ MEDICAID) 170604, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS ESSENTIAL (NO MEDICAID) 220109, EXCELLUS HEALTHY NY 220110 | $163.98 | — | — | 2026-01-01 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | BLUE CARE NETWORK ADVANTAGE [7001] | BLUE CARE NETWORK ADVANTAGE [700101] | $165.61 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | AMBETTER [1094] | AMBETTER OUT OF STATE [109402] | $165.61 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | AMBETTER [1094] | AMBETTER MARKETPLACE [109401] | $165.61 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | VA MEDICAL CENTER [1061] | VA COMMUNITY CARE NETWORK [106104] | $165.61 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | MOLINA [1071] | MOLINA MARKETPLACE [107102] | $165.61 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | MOLINA MEDICARE [7006] | MOLINA MEDICARE COMPLETE CARE [700602] | $165.61 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | BCBS - TN | Commercial|Network S | $167.00 | — | — | 2026-02-28 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | EXCELLUS MEDICAID 1706, EXCELLUS 2201 | BLUE CHOICE OPTION MEDICAID 170601, EXCELLUS ESSENTIAL (W/ MEDICAID) 170604, UNIVERA ESSENTIAL (W/ MEDICAID) 170605, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS ESSENTIAL (NO MEDICAID) 220109, EXCELLUS HEALTHY NY 220110, UNIVERA ESSENTIAL (NO | $167.59 | — | — | 2026-01-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Both | EXCELLUS BC/BS MEDICAID [1706], EXCELLUS BC/BS [2201] | BLUE CHOICE OPTION MEDICAID [170601], EXCELLUS CHILD HEALTH PLUS [220108],EXCELLUS HEALTHY NY [220110], EXCELLUS ESSENTIAL (NO MEDICAID) [220109], EXCELLUS ESSENTIAL (W/ MEDICAID) [170604], UNIVERA HEALTHY NY [220112], UNIVERA ESSENTIAL (NO MEDICAID) [220 | $167.59 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Both | EXCELLUS BC/BS MEDICAID [1706], EXCELLUS BC/BS [2201] | BLUE CHOICE OPTION MEDICAID [170601], EXCELLUS CHILD HEALTH PLUS [220108],EXCELLUS HEALTHY NY [220110], EXCELLUS ESSENTIAL (NO MEDICAID) [220109], EXCELLUS ESSENTIAL (W/ MEDICAID) [170604], UNIVERA HEALTHY NY [220112], UNIVERA ESSENTIAL (NO MEDICAID) [220 | $167.59 | — | — | 2026-04-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | EXCELLUS MEDICAID 1706, EXCELLUS 2201 | BLUE CHOICE OPTION MEDICAID 170601, EXCELLUS ESSENTIAL (W/ MEDICAID) 170604, UNIVERA ESSENTIAL (W/ MEDICAID) 170605, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS ESSENTIAL (NO MEDICAID) 220109, EXCELLUS HEALTHY NY 220110, UNIVERA ESSENTIAL (NO | $167.59 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | EXCELLUS MEDICAID 1706, EXCELLUS 2201 | BLUE CHOICE OPTION MEDICAID 170601, EXCELLUS ESSENTIAL (W/ MEDICAID) 170604, UNIVERA ESSENTIAL (W/ MEDICAID) 170605, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS ESSENTIAL (NO MEDICAID) 220109, EXCELLUS HEALTHY NY 220110, UNIVERA ESSENTIAL (NO | $167.59 | — | — | 2026-01-01 | MRF ↗ |
| HIGHLAND HOSPITAL Both | HIGHMARK BC/BS OF WESTERN NY MEDICAID [1702], AMERIGROUP (BSWNY ALTERNATE) [1720], HIGHMARK BC/BS OF WESTERN NY [5143] | HIGHMARK BC/BS OF WESTERN NY MEDICAID [170201], AMERIGROUP (BSWNY ALTERNATE) [172001], COMMUNITY BLUE CHILD HEALTH PLUS [514306], BC/BS OF WNY ESSENTIAL (NO MEDICAID) [514307] | $174.22 | — | — | 2026-04-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD OF WESTERN NY MEDICAID 1702, HIGHMARK BLUE CROSS BLUE SHIELD OF WESTERN NY 5143 | HIGHMARK BC/BS OF WESTERN NY MEDICAID 170201, COMMUNITY CARE MEDICAID 170202, COMMUNITY BLUE CHILD HEALTH PLUS 514306, BCBSWNY-COMMUNITYBLUEESSENTIALPLAN1 514307 | $174.22 | — | — | 2026-01-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Both | HIGHMARK BC/BS OF WESTERN NY MEDICAID [1702], AMERIGROUP (BSWNY ALTERNATE) [1720], HIGHMARK BC/BS OF WESTERN NY [5143] | HIGHMARK BC/BS OF WESTERN NY MEDICAID [170201], AMERIGROUP (BSWNY ALTERNATE) [172001], COMMUNITY BLUE CHILD HEALTH PLUS [514306], BC/BS OF WNY ESSENTIAL (NO MEDICAID) [514307] | $174.22 | — | — | 2026-04-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD OF WESTERN NY MEDICAID 1702, HIGHMARK BLUE CROSS BLUE SHIELD OF WESTERN NY 5143 | HIGHMARK BC/BS OF WESTERN NY MEDICAID 170201, COMMUNITY CARE MEDICAID 170202, COMMUNITY BLUE CHILD HEALTH PLUS 514306, BCBSWNY-COMMUNITYBLUEESSENTIALPLAN1 514307 | $174.22 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | EXCELLUS MEDICAID 1706, EXCELLUS 2201 | BLUE CHOICE OPTION MEDICAID 170601, EXCELLUS ESSENTIAL (W/ MEDICAID) 170604, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS ESSENTIAL (NO MEDICAID) 220109, EXCELLUS HEALTHY NY 220110 | $174.22 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | EXCELLUS MEDICAID 1706, EXCELLUS 2201 | BLUE CHOICE OPTION MEDICAID 170601, EXCELLUS ESSENTIAL (W/ MEDICAID) 170604, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS ESSENTIAL (NO MEDICAID) 220109, EXCELLUS HEALTHY NY 220110 | $174.22 | — | — | 2026-01-01 | MRF ↗ |
| EPHRAIM MCDOWELL FORT LOGAN HOSPITAL Outpatient | UHC Fort Logan Hospital | PPO | $177.05 | $274.50 | — | 2026-02-24 | MRF ↗ |
| EPHRAIM MCDOWELL FORT LOGAN HOSPITAL Inpatient | Anthem Commercial Traditional Fort Logan Hospital | PPO | $179.92 | $180.75 | — | 2026-02-24 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | VHA OFFICE OF COMMUNITY CARE [1011] | CHAMPVA [101101] | $180.52 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | HUMANA MILITARY [1098] | HUMANA MILITARY TRICARE EAST [109801] | $180.52 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | TRICARE [1056] | TRICARE FOR LIFE [105602] | $180.52 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | TRICARE [1056] | TRICARE WEST [105601] | $180.52 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | ChoiceCare Network | Commercial | $181.00 | $753.00 | $753.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Amerigroup | Children's Health Insurance Program | $181.00 | $753.00 | $753.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Superior HealthPlan | Commercial | $181.00 | $753.00 | $753.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Amerigroup | Medicare Advantage | $181.00 | $753.00 | $753.00 | 2025-07-03 | MRF ↗ |
| EPHRAIM MCDOWELL FORT LOGAN HOSPITAL Outpatient | UHC Fort Logan Hospital | PPO | $183.18 | $284.00 | — | 2026-02-24 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | MCLAREN HEALTH ADVANTAGE [1038] | MCLAREN HEALTH PLAN COMMUNITY [103802] | $184.13 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | MCLAREN HEALTH ADVANTAGE [1038] | MCLAREN HEALTH ADVANTAGE [103801] | $184.13 | $780.00 | $780.00 | 2026-03-23 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | CIGNA-ALL PLANS | CIGNA-ALL PLANS | $185.85 | $413.00 | $309.75 | 2026-01-16 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | EXCELLUS MEDICAID 1706, EXCELLUS 2201 | BLUE CHOICE OPTION MEDICAID 170601, EXCELLUS ESSENTIAL (W/ MEDICAID) 170604, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS ESSENTIAL (NO MEDICAID) 220109, EXCELLUS HEALTHY NY 220110 | $187.40 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $187.40 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $187.40 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | EXCELLUS MEDICAID 1706, EXCELLUS 2201 | BLUE CHOICE OPTION MEDICAID 170601, EXCELLUS ESSENTIAL (W/ MEDICAID) 170604, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS ESSENTIAL (NO MEDICAID) 220109, EXCELLUS HEALTHY NY 220110 | $187.40 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $187.40 | — | — | 2026-01-01 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - Meridian | Medicaid - Meridian | $189.00 | $1,870.00 | $935.00 | 2025-02-03 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | HAP CareSource | MEDICAID | $190.47 | $3,122.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Blue Cross Complete | MEDICAID | $190.47 | $3,122.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | McLaren | MEDICAID | $190.47 | $3,122.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $190.47 | $3,122.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Priority Health | MEDICAID | $190.47 | $3,122.00 | — | 2025-06-28 | MRF ↗ |
| TRINITAS REGIONAL MEDICAL CENTER OutpatientFacility | Wellpoint | NJ Family Care | $190.84 | — | — | 2026-03-04 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - United | Medicaid - United | $192.00 | $1,870.00 | $935.00 | 2025-02-03 | MRF ↗ |
| RIVERLAND MEDICAL CENTER Both | Healthy Blue Community Care of LA MCD | Default | $195.27 | $727.00 | $363.50 | 2024-10-24 | MRF ↗ |
| RIVERLAND MEDICAL CENTER Both | Medicaid Louisiana IP OP | Default | $196.00 | $727.00 | $363.50 | 2024-10-24 | MRF ↗ |
| NEWARK BETH ISRAEL MEDICAL CENTER OutpatientFacility | United Healthcare | Community Plan | $196.46 | — | — | 2026-03-04 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | EXCELLUS MEDICAID 1706, EXCELLUS 2201 | BLUE CHOICE OPTION MEDICAID 170601, EXCELLUS ESSENTIAL (W/ MEDICAID) 170604, UNIVERA ESSENTIAL (W/ MEDICAID) 170605, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS ESSENTIAL (NO MEDICAID) 220109, EXCELLUS HEALTHY NY 220110, UNIVERA ESSENTIAL (NO | $197.16 | — | — | 2026-01-01 | MRF ↗ |
| Memorial Hospital For Cancer And Allied Diseases Both | [EMBLEM] | [HIP_ESS_1_2_HOSP_OP_DEPT] | $197.16 | $2,710.00 | $2,710.00 | 2024-09-15 | MRF ↗ |
| HIGHLAND HOSPITAL Both | EXCELLUS BC/BS MEDICAID [1706], EXCELLUS BC/BS [2201] | BLUE CHOICE OPTION MEDICAID [170601], EXCELLUS CHILD HEALTH PLUS [220108],EXCELLUS HEALTHY NY [220110], EXCELLUS ESSENTIAL (NO MEDICAID) [220109], EXCELLUS ESSENTIAL (W/ MEDICAID) [170604], UNIVERA HEALTHY NY [220112], UNIVERA ESSENTIAL (NO MEDICAID) [220 | $197.16 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Both | EXCELLUS BC/BS MEDICAID [1706], EXCELLUS BC/BS [2201] | BLUE CHOICE OPTION MEDICAID [170601], EXCELLUS CHILD HEALTH PLUS [220108],EXCELLUS HEALTHY NY [220110], EXCELLUS ESSENTIAL (NO MEDICAID) [220109], EXCELLUS ESSENTIAL (W/ MEDICAID) [170604], UNIVERA HEALTHY NY [220112], UNIVERA ESSENTIAL (NO MEDICAID) [220 | $197.16 | — | — | 2026-04-01 | MRF ↗ |
| Memorial Hospital For Cancer And Allied Diseases Both | [EMBLEM] | [HIP_ESS_1_2_MR/DD/TBI Pts] | $197.16 | $2,710.00 | $2,710.00 | 2024-09-15 | 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.