45331 — Sigmoidoscopy And Biopsy
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). SIGMOIDOSCOPY AND BIOPSY (CPT 45331) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/45331?code_type=CPT
MLA (9th ed.)
“SIGMOIDOSCOPY AND BIOPSY (CPT 45331) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/45331?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“SIGMOIDOSCOPY AND BIOPSY (CPT 45331) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/45331?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $799–$2,096 (25th–75th percentile) across 2,502 hospitals · 7,258 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 45331 — 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 the surgeon's fee are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$799
$1,152 typical
$2,096
The middle 50% of negotiated facility rates for this procedure, measured across 2,502 hospitals. The the surgeon's fee 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. | $1,152 |
| Surgeon (professional fee) Estimate national typical Medicare $67 × 1.22 commercial. | $82 |
| Likely subtotal | $1,234 |
Surgical episode (typical)
~$1,234
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Surgeon (professional fee) (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $0.87 | $370.00 | $277.50 | 2025-03-07 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $1.56 | $3,662.43 | $2,197.46 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $1.56 | $3,662.43 | $2,197.46 | 2025-08-11 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $2.06 | $181.00 | $34.39 | 2026-01-25 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - TX | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VT | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - UT (REGENCE) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (CAPITAL) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE DISTINCTION TRANSPLANT | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS DOMESTIC | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CARE NETWORK | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - FEDERAL | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MT | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AR | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | WC DOMESTIC | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CA (ANTHEM) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - CA | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK HMO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CO (ANTHEM) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | KAISER DOMESTIC | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MO (ANTHEM) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ID | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OK | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - KS | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - PA (HIGHMARK) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (INDEPENDENCE) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BCN DOMESTIC | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NV (ANTHEM) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - TN | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MA | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - HI | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MS | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - FL | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WA (PREMERA) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NH (ANTHEM) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - DE (HIGHMARK) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (ANTHEM) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MN | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NE | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (CAREFIRST) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WV (HIGHMARK) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CT (ANTHEM) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - ID (REGENCE) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NM | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - LA | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NC | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (EXCELLUS) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MI | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (ANTHEM) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK WESTERN | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WI (ANTHEM) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AZ | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL ALTERNATE | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - KY (ANTHEM) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AK (PREMERA) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | PRE-EMPLOYMENT | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IN (ANTHEM) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - GA (ANTHEM) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OR (REGENCE) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OH (ANTHEM) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WY | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - DC (CAREFIRST) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BCBS GENERIC | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NJ (HORIZON) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MD (CAREFIRST) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ME (ANTHEM) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ND | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AL | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - SD (WELLMARK) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - WA (REGENCE) | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - RI | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK NORTHEASTERN | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - SC | WELLMARK PPO | $2.46 | — | $3,261.31 | 2026-03-31 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Cigna | Cigna - HMO | $3.26 | $3,502.00 | $2,626.50 | 2026-04-01 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $4.12 | $410.00 | $410.00 | 2026-02-13 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $4.62 | $2,566.00 | $912.42 | 2024-12-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $5.99 | $299.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $5.99 | $299.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $5.99 | $299.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $5.99 | $299.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $5.99 | $299.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $5.99 | $299.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $5.99 | $299.50 | — | 2026-03-31 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE MEDICAID (FORMERLY BMC) UM [75] Plans | $7.46 | $6,831.29 | $6,831.29 | 2026-03-26 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $8.66 | $3,925.00 | $1,452.25 | 2026-03-31 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | WELLSENSE MEDICAID [10901] | All WELLSENSE SPECIAL KIDS (FORMERLY BMC) UM [255] Plans | $9.33 | $6,831.29 | $6,831.29 | 2026-03-26 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $11.02 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $11.09 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $11.09 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $12.63 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $12.71 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $12.71 | — | — | 2026-03-18 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $13.42 | $3,662.43 | $2,197.46 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $13.42 | $3,662.43 | $2,197.46 | 2025-08-11 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $13.75 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $13.84 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $13.84 | — | — | 2026-03-18 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $17.35 | — | — | 2026-01-01 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC ALLIANCE MEDI-CAL | PACIFIC ALLIANCE MEDI-CAL | $20.00 | $227.00 | $40.86 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BLUE SHIELD MEDI-CAL | BLUE SHIELD MEDI-CAL | $20.00 | $227.00 | $40.86 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | MEDI-CAL | MEDI-CAL | $20.00 | $227.00 | $40.86 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | LASALLE MG MEDI-CAL | LASALLE MG MEDI-CAL | $20.00 | $227.00 | $40.86 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHCARE INC MEDI-CAL | HEALTHCARE INC MEDI-CAL | $20.00 | $227.00 | $40.86 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PACIFIC IPA MEDI-CAL | PACIFIC IPA MEDI-CAL | $20.00 | $227.00 | $40.86 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | BC MEDI-CAL | BC MEDI-CAL | $20.00 | $227.00 | $40.86 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ALTAMED MEDI-CAL - ALL OTHER PLANS | ALTAMED MEDI-CAL - ALL OTHER PLANS | $20.00 | $227.00 | $40.86 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | ACCESS MEDI-CAL | ACCESS MEDI-CAL | $20.00 | $227.00 | $40.86 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | PREFERRED MEDI-CAL | PREFERRED MEDI-CAL | $20.00 | $227.00 | $40.86 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | CARE FIRST MEDI-CAL | CARE FIRST MEDI-CAL | $20.00 | $227.00 | $40.86 | 2026-01-30 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $21.60 | $160.00 | $120.00 | 2026-01-16 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | CHILDRENS SPECIAL HEALTHCARE SERVICES (CSHCS) [3002] | CHILDRENS SPECIAL HEALTHCARE SERVICES [300201] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | GENERIC MEDICAID HMO [9000] | GENERIC MEDICAID HMO [900001] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH SHIAWASSEE COUNTY [901003] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | HARBOR HEALTH PLAN [9016] | HARBOR HEALTH PLAN [901601] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | BCCCP/WISEWOMAN [300006] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID TEMPORARY PRESUMPTIVE [300005] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL HEALTH PLUS CAID [300604] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID HEALTHY MICHIGAN [3007] | MEDICAID HEALTHY MICHIGAN [300701] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID [300001] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | EMERGENCY MEDICAID [300004] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID QMB [300007] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MATERNITY OUT PATIENT MEDICAL (MOMS) [300002] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | PLAN FIRST FAMILY PLANNING [300003] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID [3000] | MEDICAID MICHILD [300008] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH LAPEER COUNTY [901004] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MICHIGAN COMPLETE HEALTH MEDICAID [9019] | MICHIGAN COMPLETE HEALTH MEDICAID [901901] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL UNITED HEALTHCARE CARE [300609] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH CLINTON EATON & INGHAM COUNTY [901006] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH SAGINAW COUNTY [901002] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL MCLAREN CAID [300601] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | GENESEE COUNTY CMH [9003] | GENESEE COUNTY CMH [900301] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | AETNA BETTER HEALTH PLAN [9018] | AETNA BETTER HEALTH PLAN [901801] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | CMH OAKLAND COUNTY [901005] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF COUNTY CMH [9010] | OUT OF COUNTY CMH [901001] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL GREAT LAKES [300602] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL AETNA BETTER HEALTH MEDICAID [300612] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MEDICAID DEDUCTIBLE/SPENDDOWN [3001] | MEDICAID DEDUCTIBLE/SPENDDOWN [300101] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | UPPER PENINSULA HEALTH PLAN MEDICAID [9015] | UPPER PENINSULA HEALTH [901501] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | HEALTH ALLIANCE PLAN MEDICAID [9012] | HAP CARESOURCE [901202] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | PACE MEDICAID HMO [9020] | GENESYS PACE [902001] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF STATE MEDICAID [3004] | OUT OF STATE MEDICAID GENERIC [300402] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | OUT OF STATE MEDICAID [3004] | OUT OF STATE MEDICAID [300401] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MERIDIAN HEALTH PLAN [9007] | MERIDIAN MICHILD [900702] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL PRIORITY HEALTH CAID [300611] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL MIDWEST HEALTH CAID [300607] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MERIDIAN HEALTH PLAN [9007] | MERIDIAN HEALTH PLAN [900701] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MOLINA [1071] | MOLINA MICHILD [107101] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | HEALTH PARTNERS MEDICAID [9017] | HEALTH PARTNERS MEDICAID [901701] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | MOLINA HEALTH CARE [9008] | MOLINA HEALTH CARE [900801] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | ABW COVERAGE NO HMO LISTED [3003] | ABW COVERAGE NO HMO LISTED [300301] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL OMNICARE CAID [300608] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | CHILDRENS SPECIAL HEALTH SERVICES ALT [3009] | CHILDRENS SPECIAL HEALTHCARE SERVICES [300901] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | BLUE CROSS COMPLETE [9001] | BLUE CROSS COMPLETE [900102] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL TOTAL HEALTHCARE [300606] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | PRIORITY HEALTH PLAN MEDICAID [9013] | PRIORITY HEALTH PLAN MEDICAID [901301] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL MERIDIAN CAID [300605] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | UNITED HEALTH CARE COMMUNITY PLAN MEDICAID [9004] | UNITED HEALTH CARE MEDICAID [900401] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | COVENTRY CARES MEDICAID [9009] | OMNICARE HEALTH PLAN MEDICAID [900901] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL MOLINA CAID [300603] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL BLUE CROSS COMPLETE [300610] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Inpatient | JVHL MEDICAID LABS [3006] | JVHL HAP EMPOWERED [300613] | $23.11 | $151.00 | $151.00 | 2026-03-23 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $23.82 | $227.00 | $40.86 | 2026-01-30 | MRF ↗ |
| ADVENTIST HEALTH WHITE MEMORIAL Outpatient | FCS IPA MEDI-CAL OP/PROFEE ONLY | FCS IPA MEDI-CAL OP/PROFEE ONLY | $24.00 | $227.00 | $40.86 | 2026-01-30 | MRF ↗ |
| MAYERS MEMORIAL HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $25.00 | $692.00 | $692.00 | 2026-05-12 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | KEY BENEFIT ADMINISTRATORS [1089] | KEY BENEFIT ADMINISTRATORS [108901] | $25.42 | $151.00 | $151.00 | 2026-03-23 | 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.