45378 — Diagnostic Colonoscopy
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). DIAGNOSTIC COLONOSCOPY (HCPCS 45378) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/45378?code_type=HCPCS
MLA (9th ed.)
“DIAGNOSTIC COLONOSCOPY (HCPCS 45378) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/45378?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“DIAGNOSTIC COLONOSCOPY (HCPCS 45378) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/45378?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $866–$2,368 (25th–75th percentile) across 3,380 hospitals · 8,257 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 45378 — 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 physician and sedation fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$866
$1,343 typical
$2,368
The middle 50% of negotiated facility rates for this procedure, measured across 3,380 hospitals. The physician and sedation 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. | $1,343 |
| Endoscopist (professional fee) Estimate national typical Medicare $165 × 1.22 commercial. | $201 |
| Likely subtotal | $1,544 |
You might also be billed (if it applies to your case)
| Anesthesia Estimate ~85% of cases · modeled 00812, ~40 min typical. Medicare $116 × 3.14 commercial. | $365 |
| Pathology Estimate ~55% of cases Medicare $35 × 2.166 commercial. | $76 |
| Typical added cost weighted by how often each applies | ~$352 |
Two ways this can go
- If it stays a screening/diagnostic-only procedure
- Screening colonoscopies are ACA preventive care — with in-network insurance you typically pay $0 out of pocket.
- If a polyp is found and removed (becomes 45385)
- The procedure converts to a therapeutic one and normal cost-sharing applies to the episode total of ~$1,895 — you can’t know which way it goes before the procedure, so plan for both.
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge (see the recovery plan below)
- Complications, revisions, or readmissions
- Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)
The biggest swing: whether a polyp is found and removed, which converts the procedure and its cost-sharing.
Your recovery plan — adjust to what your doctor told you
After your procedure, recovery care is billed separately. We pre-fill the typical plan; change it to your situation.
Recovery cost modeled
~$3,785
With your recovery plan (typical)
~$5,680
- Some components show how often they typically apply (modeled from clinical/coding literature, not claims-measured); the total is the expected typical cost.
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Endoscopist (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 all-professional 1.22x (no GI-specific free)
- Anesthesia (estimate)
- base_units_version: CY2022 file (base units unchanged for CY2026 per CMS) · anesthesia_cf: $20.49754 (National) · cf_rule: CMS-1832-F · multiplier_source: AJMC/Duffy 2016-2017 (PMID 34156223) national
- Pathology (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: in-house pt_negotiated_rates 88305-26 ÷ CMS PFS-26 (n=16216); supersedes 1.18 global proxy
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 |
|---|---|---|---|---|---|---|---|
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $1,088.51 | $108.85 | 2026-07-18 | MRF ↗ |
| CHI Saint Joseph Health - Saint Joseph Jessamine Outpatient | Humana | Medicaid|All Plans | — | — | — | 2026-02-28 | MRF ↗ |
| CHI Saint Joseph Health - Saint Joseph Jessamine Outpatient | Humana | Medicaid|All Plans | — | — | — | 2026-02-28 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Ks | Commercial | — | $2,250.00 | $1,462.50 | 2026-08-01 | MRF ↗ |
| ABBEVILLE AREA MEDICAL CENTER Outpatient | Molina | Commercial | — | $2,767.61 | $1,937.33 | 2026-08-03 | MRF ↗ |
| ABBEVILLE AREA MEDICAL CENTER Outpatient | Molina | Commercial | — | $2,767.61 | $1,937.33 | 2026-07-15 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Ks | Commercial | — | $1.00 | $0.65 | 2026-08-01 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $2,652.00 | $1,591.20 | 2026-07-15 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | United Healthcare | Commercial | — | $2,085.00 | $1,355.25 | 2026-08-01 | MRF ↗ |
| MARION GENERAL HOSPITAL Both | United Healthcare | Uniheuni 1 | — | $6,648.38 | $3,989.03 | 2026-07-15 | MRF ↗ |
| MARION GENERAL HOSPITAL Both | United Healthcare | Uniheuni | — | $6,648.38 | $3,989.03 | 2026-07-15 | MRF ↗ |
| MARION GENERAL HOSPITAL Both | United Healthcare | Uniheuni | — | $6,747.12 | $4,048.27 | 2026-07-15 | MRF ↗ |
| MARION GENERAL HOSPITAL Both | United Healthcare | Uniheuni 1 | — | $6,747.12 | $4,048.27 | 2026-07-15 | MRF ↗ |
| SELF REGIONAL HEALTHCARE Outpatient | Bcbs Of Sc | Commercial | — | $2,767.61 | $1,660.57 | 2026-08-03 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $2,836.00 | $2,325.52 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $2,836.00 | $2,325.52 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | HMO | — | $2,836.00 | $2,325.52 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $2,836.00 | $2,325.52 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $2,836.00 | $2,325.52 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $2,836.00 | $2,325.52 | 2025-11-26 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $1.79 | $1,101.00 | $825.75 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $1.79 | $1,203.00 | $902.25 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $1.79 | $798.00 | $598.50 | 2026-07-01 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $3,744.00 | $374.40 | 2026-07-18 | MRF ↗ |
| PEMISCOT COUNTY MEMORIAL HOSPITAL Outpatient | Cigna | Commercial | $3.20 | $527.00 | $368.90 | 2026-07-15 | MRF ↗ |
| PEMISCOT COUNTY MEMORIAL HOSPITAL Outpatient | Anthem Traditional | Commercial | $3.65 | $641.00 | $448.70 | 2026-07-15 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $5.35 | $623.00 | $118.37 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $5.35 | $456.00 | $86.64 | 2026-01-25 | MRF ↗ |
| COMANCHE COUNTY MEDICAL CENTER Outpatient | MPI - ALL PLANS | MPI - ALL PLANS | $5.89 | $579.00 | $376.35 | 2026-05-07 | MRF ↗ |
| PEMISCOT COUNTY MEMORIAL HOSPITAL Outpatient | Cigna | Commercial | $7.60 | $527.00 | $368.90 | 2026-07-15 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $7.62 | $4,235.00 | $912.42 | 2024-12-31 | MRF ↗ |
| WALLOWA MEMORIAL HOSPITAL Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $7.77 | $1,083.00 | $1,083.00 | 2026-07-09 | MRF ↗ |
| MOBRIDGE REGIONAL HOSPITAL - CAH Outpatient | SANFORD HEALTHPLAN-ALL PLANS | SANFORD HEALTHPLAN-ALL PLANS | $8.12 | $1,544.00 | $1,544.00 | 2026-07-16 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $10.70 | $278.00 | $278.00 | 2026-02-13 | MRF ↗ |
| SPRINGHILL MEDICAL CENTER Outpatient | Unitedhealthcare Insurance Company (Contracting On Behalf Of Itself, Unitedhealthcare Of Alabama, Inc. And United'S Affiliates) | Commercial All Payer | — | $2,424.74 | $2,061.03 | 2026-07-15 | MRF ↗ |
| PEMISCOT COUNTY MEMORIAL HOSPITAL Outpatient | Anthem Traditional | Commercial | $12.16 | $527.00 | $368.90 | 2026-07-15 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Vaccn | Medicare | $17.67 | $2,188.00 | $1,641.00 | 2026-10-01 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Bcbs Medicare | Medicare | $17.67 | $2,188.00 | $1,641.00 | 2026-10-01 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Medicare | Medicare | $17.67 | $2,188.00 | $1,641.00 | 2026-10-01 | MRF ↗ |
| GLENDALE ADVENTIST MEDICAL CENTER Outpatient | BLUE SHIELD MEDI-CAL | BLUE SHIELD MEDI-CAL | $20.00 | $660.00 | $99.00 | 2026-07-30 | MRF ↗ |
| FAIRCHILD MEDICAL CENTER Outpatient | MEDI-CAL | MEDI-CAL | $20.00 | $573.00 | $573.00 | 2026-09-24 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | BC MCAL | BC MCAL | $20.00 | $623.00 | $118.37 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS | DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS | $20.00 | $623.00 | $118.37 | 2026-05-20 | MRF ↗ |
| GLENDALE ADVENTIST MEDICAL CENTER Outpatient | MOLINA MCAL | MOLINA MCAL | $20.00 | $660.00 | $99.00 | 2026-07-30 | MRF ↗ |
| GLENDALE ADVENTIST MEDICAL CENTER Outpatient | MEDI-CAL | MEDI-CAL | $20.00 | $660.00 | $99.00 | 2026-07-30 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | MEDI-CAL | MEDI-CAL | $20.00 | $623.00 | $118.37 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE MCAL PROFEE ONLY | CENTRAL CA ALLIANCE MCAL PROFEE ONLY | $20.00 | $623.00 | $118.37 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CAL VIVA HLTH MCAL - ALL PLANS | CAL VIVA HLTH MCAL - ALL PLANS | $20.00 | $623.00 | $118.37 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | UPN MCAL PROFEE ONLY-ALL OTHER PLANS | UPN MCAL PROFEE ONLY-ALL OTHER PLANS | $20.00 | $623.00 | $118.37 | 2026-05-20 | MRF ↗ |
| KERN VALLEY HEALTHCARE DISTRICT Outpatient | MEDI-CAL | MEDI-CAL | $20.00 | $809.00 | $165.63 | 2026-02-25 | MRF ↗ |
| KERN VALLEY HEALTHCARE DISTRICT Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $20.00 | $809.00 | $165.63 | 2026-02-25 | MRF ↗ |
| GLENDALE ADVENTIST MEDICAL CENTER Outpatient | BC MEDI-CAL | BC MEDI-CAL | $20.00 | $660.00 | $99.00 | 2026-07-30 | MRF ↗ |
| MAYERS MEMORIAL HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $20.00 | $1,712.00 | $1,712.00 | 2026-05-12 | MRF ↗ |
| KERN VALLEY HEALTHCARE DISTRICT Outpatient | HEALTHNET (AIM) | HEALTHNET (AIM) | $20.00 | $809.00 | $165.63 | 2026-02-25 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | VA CCN -ALL PLANS | VA CCN -ALL PLANS | $21.10 | $58.61 | $52.75 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | TRICARE- ALL PLANS | TRICARE- ALL PLANS | $21.10 | $58.61 | $52.75 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MEDICAL ASSOCIATES-ALL PLANS | MEDICAL ASSOCIATES-ALL PLANS | $21.10 | $58.61 | $52.75 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | TRIWEST WELLMARK-ALL PLANS | TRIWEST WELLMARK-ALL PLANS | $21.10 | $58.61 | $52.75 | 2026-01-03 | MRF ↗ |
| GLENDALE ADVENTIST MEDICAL CENTER Outpatient | HERITAGE MCAL | HERITAGE MCAL | $21.20 | $660.00 | $99.00 | 2026-07-30 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | WELLMARK MCR ADV- ALL PLANS | WELLMARK MCR ADV- ALL PLANS | $21.31 | $58.61 | $52.75 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | UHC MCR ADV | UHC MCR ADV | $21.73 | $58.61 | $52.75 | 2026-01-03 | MRF ↗ |
| GLENDALE ADVENTIST MEDICAL CENTER Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $23.82 | $660.00 | $99.00 | 2026-07-30 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | KAISER MCAL | KAISER MCAL | $25.00 | $623.00 | $118.37 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | KERN HEALTH SYSTEMS MCAL-ALL PLANS | KERN HEALTH SYSTEMS MCAL-ALL PLANS | $25.00 | $623.00 | $118.37 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | UNIVERSAL HC MCAL PROFEE | UNIVERSAL HC MCAL PROFEE | $25.00 | $623.00 | $118.37 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | MEDI-CAL | MEDI-CAL | $25.00 | $623.00 | $118.37 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $25.00 | $623.00 | $124.60 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | BC MCAL | BC MCAL | $25.00 | $623.00 | $118.37 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $25.00 | $623.00 | $118.37 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | KAISER MEDI-CAL | KAISER MEDI-CAL | $25.00 | $623.00 | $124.60 | 2026-05-24 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | America'S First Choice | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | First Choice Select Health | Managed Medicaid | — | — | — | 2026-10-03 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Champva | Champva/Health Net | — | $101.00 | $101.00 | 2026-10-02 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Managed Medicare Plans | Managed Medicare Plans | — | $101.00 | $101.00 | 2026-10-02 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $29.12 | $2,800.35 | $2,800.35 | 2026-04-24 | MRF ↗ |
| ADVENTIST HEALTH CASTLE Outpatient | PACIFIC ADMIN PPO - ALL PLANS | PACIFIC ADMIN PPO - ALL PLANS | $29.27 | $453.00 | $144.96 | 2026-05-18 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Regence | Regence Medicare | — | $101.00 | $101.00 | 2026-10-02 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Bcbs | Medicare Advantage | — | $101.00 | $101.00 | 2026-10-02 | MRF ↗ |
| DECATUR COUNTY MEMORIAL HOSPITAL Outpatient | UHC-ALL OTHER PLANS | UHC-ALL OTHER PLANS | $30.00 | $758.00 | $568.50 | 2026-03-18 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P | CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P | $30.00 | $623.00 | $118.37 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE CCS PROFEE ONLY | CENTRAL CA ALLIANCE CCS PROFEE ONLY | $30.00 | $623.00 | $118.37 | 2026-05-20 | MRF ↗ |
| ANTELOPE VALLEY HOSPITAL Outpatient | Health Net Of California - Medi | Cal | — | $4,046.50 | $4,046.50 | 2026-07-15 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Interwest Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Montana Health CoOp | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Pacific Source | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | First Health Network | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Prime Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Coventry | All | — | — | — | 2026-03-28 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Humana | Medicare Advantage | — | $101.00 | $101.00 | 2026-10-02 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | OSCAR-ALL PLANS | OSCAR-ALL PLANS | $31.65 | $58.61 | $52.75 | 2026-01-03 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Hpk (Incl. Cigna) | Commercial | — | $917.00 | $596.05 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | United Healthcare | Commercial | — | $917.00 | $596.05 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Sunflower | Medicaid | — | $917.00 | $596.05 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Healthy Blue | Medicaid | — | $917.00 | $596.05 | 2026-08-01 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Aetna | Medicare Advantage | — | $101.00 | $101.00 | 2026-10-02 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Aetna | Commercial | — | $917.00 | $596.05 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Wppa/Providrscare | Commercial | — | $917.00 | $596.05 | 2026-08-01 | MRF ↗ |
| CITIZENS MEDICAL CENTER Outpatient | Phcs/Multiplan | Commercial | — | $917.00 | $596.05 | 2026-08-01 | MRF ↗ |
| CHI Saint Joseph Health - Saint Joseph Jessamine Outpatient | Humana | Medicaid|All Plans | — | — | — | 2026-02-28 | MRF ↗ |
| CHI Saint Joseph Health - Saint Joseph Jessamine Outpatient | Humana | Medicaid|All Plans | — | — | — | 2026-02-28 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | United Health Care | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Aetna | Commercial | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Absolute Total Care | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Molina | Mangaged Medicare | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Cigna | Commercial | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Blue Cross | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Aetna | Managed Medicare | — | — | — | 2026-10-03 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE CHDP PROFEE ONLY | CENTRAL CA ALLIANCE CHDP PROFEE ONLY | $40.00 | $623.00 | $118.37 | 2026-05-20 | MRF ↗ |
| PEACEHEALTH KETCHIKAN MEDICAL CENTER Outpatient | Aetna Health | Commercial | — | $1,486.00 | $965.90 | 2026-07-15 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MIDLANDS NEW BUSINESS | MIDLANDS NEW BUSINESS | $41.03 | $58.61 | $52.75 | 2026-01-03 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Outpatient | Healthy Indiana Program-Anthem | Anthem In Hip | $41.20 | $206.00 | $103.00 | 2026-07-15 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Outpatient | Anthem Blue Cross Blue Shield | Node Anthem In Mcr Adv | $41.20 | $206.00 | $103.00 | 2026-07-15 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Outpatient | Node Va | Node Va | $41.20 | $206.00 | $103.00 | 2026-07-15 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Outpatient | Node Devoted Health Mcr Adv | Node Devoted Health Mcr Adv | $41.35 | $206.00 | $103.00 | 2026-07-15 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Outpatient | Aetna | Node Aetna Mcr Adv | $41.35 | $206.00 | $103.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Ambetter | Ambetter | $41.47 | $96.00 | $96.00 | 2026-07-15 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE MEDICARE [16044] | UNITED HEALTHCARE MEDICARE SOLUTIONS [1604402] | $41.54 | $627.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | AARP MEDICARE [16001] | AARP MEDICARE COMPLETE [1600101] | $41.54 | $627.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | AETNA MEDICARE [16004] | ALLINA HEALTH AETNA MEDICARE ADV [1600402] | $41.54 | $627.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE MEDICARE [16044] | UNITED HEALTHCARE MEDICARE ADVANTAGE [1604401] | $41.54 | $627.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE MEDICARE [16044] | UNITED HEALTHCARE MEDICARE SOLUTIONS [1604402] | $41.56 | $627.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | AETNA MEDICARE [16004] | ALLINA HEALTH AETNA MEDICARE ADV [1600402] | $41.56 | $627.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | AARP MEDICARE [16001] | AARP MEDICARE COMPLETE [1600101] | $41.56 | $627.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | UNITED HEALTHCARE MEDICARE [16044] | UNITED HEALTHCARE MEDICARE ADVANTAGE [1604401] | $41.56 | $627.00 | — | 2026-01-01 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Blue Cross Blue Shield Of Vt | Default | $41.90 | $113.00 | $84.75 | 2026-05-18 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Blue Cross Blue Shield Of Vt | Federal | $41.90 | $113.00 | $84.75 | 2026-05-18 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Blue Cross Blue Shield Of Vt | Ppo | $41.90 | $113.00 | $84.75 | 2026-05-18 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | VALLEY CHILDRENS - ALL PLANS | VALLEY CHILDRENS - ALL PLANS | $42.00 | $623.00 | $118.37 | 2026-05-19 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | HEALTHPARTNERS MEDICARE [16019] | HEALTHPARTNERS FREEDOM [1601901] | $42.35 | $627.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | HEALTHPARTNERS MEDICARE [16019] | HEALTHPARTNERS MEDICARE ADVANTAGE [1601902] | $42.35 | $627.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | HEALTHPARTNERS MEDICARE [16019] | HEALTHPARTNERS MEDICARE ADVANTAGE [1601902] | $42.37 | $627.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | HEALTHPARTNERS MEDICARE [16019] | HEALTHPARTNERS FREEDOM [1601901] | $42.37 | $627.00 | — | 2026-01-01 | MRF ↗ |
| CHAN SOON- SHIONG MEDICAL CENTER AT WINDBER Outpatient | Highmark | Highmark Comm Performance Blue | $42.50 | $150.00 | $127.50 | 2026-07-15 | MRF ↗ |
| CHAN SOON- SHIONG MEDICAL CENTER AT WINDBER Outpatient | Highmark | Highmark Comm Community Blue | $42.50 | $150.00 | $127.50 | 2026-07-15 | MRF ↗ |
| CHAN SOON- SHIONG MEDICAL CENTER AT WINDBER Outpatient | Highmark | Highmark Aca / My Direct Blue / My Blue Access Ppo | $42.50 | $150.00 | $127.50 | 2026-07-15 | MRF ↗ |
| CHAN SOON- SHIONG MEDICAL CENTER AT WINDBER Outpatient | Highmark | Highmark Comm Managed/Indemnity | $42.50 | $150.00 | $127.50 | 2026-07-15 | MRF ↗ |
| TEXAS ORTHOPEDIC HOSPITAL Outpatient | Amish Aid | Amish Aid | $42.66 | $158.00 | $42.66 | 2026-07-17 | MRF ↗ |
| TEXAS ORTHOPEDIC HOSPITAL Outpatient | Self Pay | Self Pay | $42.66 | $158.00 | $42.66 | 2026-07-17 | MRF ↗ |
| DUPONT HOSPITAL LLC Outpatient | Self Pay | Self Pay | $42.66 | $158.00 | $42.66 | 2026-07-15 | MRF ↗ |
| DUPONT HOSPITAL LLC Outpatient | Amish Aid | Amish Aid | $42.66 | $158.00 | $42.66 | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH UTAH VALLEY HOSPITAL Inpatient | Donor Connect | Other | $42.79 | $3,056.41 | $2,292.31 | 2026-08-01 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Outpatient | Miami County Sheriffs Department | Miami County Jail | $42.85 | $206.00 | $103.00 | 2026-07-15 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Outpatient | In Dept Of Correction | In Doc | $42.85 | $206.00 | $103.00 | 2026-07-15 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Outpatient | Node Pphp Mcr Adv | Node Pphp Mcr Adv | $43.26 | $206.00 | $103.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Ambetter | Ambetter | — | $101.00 | $101.00 | 2026-10-02 | MRF ↗ |
| OCHSNER LAFAYETTE GENERAL MEDICAL CENTER Inpatient | United Healthcare � Commercial Hmo Ppo | All Plans | $43.80 | $219.00 | $45.99 | 2026-07-15 | MRF ↗ |
| UNIVERSITY OF ILLINOIS HOSPITAL AND CLINICS Inpatient | Bcbs | Unite Here Health | $44.35 | $1,096.00 | — | 2026-09-21 | MRF ↗ |
| UNIVERSITY OF ILLINOIS HOSPITAL AND CLINICS Inpatient | Bcbs | Blue Choice Opt Ppo | $44.35 | $1,096.00 | — | 2026-09-21 | MRF ↗ |
| UNIVERSITY OF ILLINOIS HOSPITAL AND CLINICS Inpatient | Bcbs | Blue Choice City Of Chicago | $44.35 | $1,096.00 | — | 2026-09-21 | MRF ↗ |
| ST JOSEPH HEALTH SYSTEM, LLC Outpatient | Lutheran Preferred | Lutheran Preferred Chs Employees | $45.03 | $158.00 | $37.92 | 2026-07-15 | MRF ↗ |
| LOGAN REGIONAL HOSPITAL Outpatient | Selecthealth | Signature Individual Aca | — | — | — | 2026-08-01 | MRF ↗ |
| LOGAN REGIONAL HOSPITAL Outpatient | Selecthealth | Selectvalue | — | — | — | 2026-08-01 | MRF ↗ |
| LOGAN REGIONAL HOSPITAL Outpatient | Selecthealth | Selectcare | — | — | — | 2026-08-01 | MRF ↗ |
| LOGAN REGIONAL HOSPITAL Outpatient | Selecthealth | Fehbp | — | — | — | 2026-08-01 | MRF ↗ |
| LOGAN REGIONAL HOSPITAL Outpatient | Selecthealth | Sm Individual Aca | — | — | — | 2026-08-01 | MRF ↗ |
| LOGAN REGIONAL HOSPITAL Outpatient | Selecthealth | Selectshare | — | — | — | 2026-08-01 | MRF ↗ |
| LOGAN REGIONAL HOSPITAL Outpatient | Selecthealth | Commercial | — | — | — | 2026-08-01 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Veterans Administrations | Veterans Administration | $45.82 | $169.70 | $169.70 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Managed Medicare Plans | Managed Medicare Plans | $45.82 | $169.70 | $169.70 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Umvs | Umvs | $45.82 | $169.70 | $169.70 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Champva | Champva/Health Net | $45.82 | $169.70 | $169.70 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Bcbs | Blue Cross Medicare Advanatage | $45.82 | $169.70 | $169.70 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Care First Health Plan | Care 1St Medicare Advantage | $45.82 | $169.70 | $169.70 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Tricare | Tricare For Life | $45.82 | $169.70 | $169.70 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Cigna | Cigna Medicare Advantage | $45.82 | $169.70 | $169.70 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Uhc | Uhc Medicare Advantage | $45.82 | $169.70 | $169.70 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Aetna | Aetna Medicare Advantage | $45.82 | $169.70 | $169.70 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Group Health Coop (Ghc) | Ghc Medicare | $45.82 | $169.70 | $169.70 | 2026-07-15 | MRF ↗ |
| TEXAS ORTHOPEDIC HOSPITAL Outpatient | Lutheran Preferred | Lutheran Preferred Chs Employees | $46.14 | $158.00 | $42.66 | 2026-07-17 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $46.84 | — | — | 2026-03-18 | MRF ↗ |
| DUPONT HOSPITAL LLC Outpatient | Lutheran Preferred | Lutheran Preferred Chs Employees | $46.93 | $158.00 | $42.66 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Chpw | Chpw | $47.19 | $169.70 | $169.70 | 2026-07-15 | MRF ↗ |
| BLUFFTON REGIONAL MEDICAL CENTER Inpatient | Lutheran Preferred Network | Lutheran Preferred Chs Employees | $47.24 | $158.00 | $86.90 | 2026-07-15 | MRF ↗ |
| LUTHERAN HOSPITAL Inpatient | Lutheran Preferred Network | Lutheran Preferred Chs Employees | $47.40 | $158.00 | $56.88 | 2026-07-17 | MRF ↗ |
| LUTHERAN HOSPITAL Outpatient | Amish Aid | Amish Aid | $47.40 | $158.00 | $47.40 | 2026-07-17 | MRF ↗ |
| LUTHERAN HOSPITAL Outpatient | Self Pay | Self Pay | $47.40 | $158.00 | $47.40 | 2026-07-17 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Outpatient | Node Lutheran Preferred Fixed 2 | Lutheran Preferred Fixed 2 | $47.40 | $158.00 | $79.00 | 2026-07-15 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Outpatient | Lutheran Three Rivers Preferred Plus 150 | Lutheran Three Rivers Preferred Plus 150 | $47.40 | $158.00 | $79.00 | 2026-07-15 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Outpatient | Lutheran Advanced Network | Lutheran Advanced Network | $47.40 | $158.00 | $79.00 | 2026-07-15 | MRF ↗ |
| DUKES MEMORIAL HOSPITAL Outpatient | Node Anthem Essentials Mcr Adv | Node Anthem Essentials Marketplace | $47.40 | $158.00 | $79.00 | 2026-07-15 | MRF ↗ |
| MEMORIAL HOSPITAL OutpatientFacility | UNITED HEALTHCARE INSURANCE COMPANY | Medicare-HMO | $47.96 | $138.05 | $96.64 | 2026-01-01 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Campbell Scientific | Commercial | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Byu Athletics | Commercial | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Deseret Mutual | Commercial | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Pehp | All Plans | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Awh Connected | Connected Utah | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Emi Health | Mint | — | — | — | 2026-07-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Aetna | Connected | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Emi Health | Network Care | — | — | — | 2026-07-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Pehp | Capital Care | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Pehp | Summit Exclusive | — | — | — | 2026-07-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Regence Bcbs | Blueoption | — | — | — | 2026-07-14 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Emi Health | Network Care | — | — | — | 2026-07-15 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Managed Care Admin | Commercial | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Aetna | Connected | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Pehp | Capital Care | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Emi | Commercial | — | — | — | 2026-07-14 | MRF ↗ |
| FILLMORE COMMUNITY HOSPITAL Outpatient | Pehp | All Plans | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH DELTA COMMUNITY HOSPITAL Outpatient | Aetna | Standard | — | — | — | 2026-07-14 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.