45540 — Correct Rectal Prolapse
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). CORRECT RECTAL PROLAPSE (CPT 45540) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/45540?code_type=CPT
MLA (9th ed.)
“CORRECT RECTAL PROLAPSE (CPT 45540) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/45540?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“CORRECT RECTAL PROLAPSE (CPT 45540) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/45540?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,339–$5,154 (25th–75th percentile) across 1,263 hospitals · 1,620 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 45540 — 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
$1,339
$2,910 typical
$5,154
The middle 50% of negotiated facility rates for this procedure, measured across 1,263 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. | $2,910 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $974 × 1.22 commercial. | $1,189 |
| Likely subtotal | $4,098 |
Surgical episode (typical)
~$4,098
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)
~$7,883
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 ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $6.88 | $3,820.00 | — | 2024-12-31 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | BCBS MEDICAID CONTRACTED [320046] | HB SPRG KANCARE HEALTHY BLUE MEDICAID | $24.42 | $31,650.74 | $20,572.98 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | BCBS MEDICAID CONTRACTED [320046] | HB SPRG KANCARE HEALTHY BLUE MEDICAID | $24.42 | $31,650.74 | $20,572.98 | 2026-03-12 | 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 ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB SPRG OK MEDICAID | $31.11 | $31,650.74 | $20,572.98 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB SPRG OK MEDICAID | $31.11 | $31,650.74 | $20,572.98 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB SPRG OK MEDICAID | $31.11 | $31,650.74 | $20,572.98 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | HUMANA MEDICAID CONTRACTED [320486] | HB SPRG OK MEDICAID | $31.11 | $31,650.74 | $20,572.98 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB SPRG OK MEDICAID | $31.11 | $31,650.74 | $20,572.98 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | MEDICAID [20240] | HB SPRG OK MEDICAID | $31.11 | $31,650.74 | $20,572.98 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | MEDICAID [20240] | HB SPRG OK MEDICAID | $31.11 | $31,650.74 | $20,572.98 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | HUMANA MEDICAID CONTRACTED [320486] | HB SPRG OK MEDICAID | $31.11 | $31,650.74 | $20,572.98 | 2026-03-12 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 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 | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $61.32 | $4,360.00 | $4,360.00 | 2026-02-13 | MRF ↗ |
| CLAY COUNTY MEDICAL CENTER Outpatient | HEALTH PARTNERS - ALL PLANS | HEALTH PARTNERS - ALL PLANS | $75.00 | $2,031.75 | $2,031.75 | 2026-04-24 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $76.41 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $84.90 | — | — | 2026-04-14 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Riverside Community Hospital Outpatient | MedCare Partners | MGMCR | — | — | — | 2026-03-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $95.90 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $95.90 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $95.90 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $95.90 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $95.90 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $95.90 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $95.90 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $95.90 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $95.90 | — | — | 2026-04-14 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $96.11 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $96.11 | — | — | 2026-04-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | MedCare Partners | MGMCR | — | — | — | 2026-03-01 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $106.56 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $106.56 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $106.56 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $106.56 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $106.56 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $106.56 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $106.56 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $106.56 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $106.56 | — | — | 2026-04-14 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $106.78 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $106.78 | — | — | 2026-04-01 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $112.37 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $112.37 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $112.37 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $112.37 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $112.37 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $112.37 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $112.37 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $112.37 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $112.37 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $124.85 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $124.85 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $124.85 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $124.85 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $124.85 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $124.85 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $124.85 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $124.85 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $124.85 | — | — | 2026-04-14 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Healthy Kids | $135.08 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Sunshine State Oncology | Medicaid HMO | $135.08 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Medicaid HMO | $135.08 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Molina Oncology | Healthy Kids | $138.93 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Molina Oncology | Medicaid HMO | $138.93 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Community Care Plan Oncology | Medicaid HMO | $141.51 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Amerihealth Caritas Oncology | Medicaid HMO | $141.51 | — | — | 2025-08-01 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $141.75 | — | — | 2026-04-14 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $145.53 | $1,078.00 | $808.50 | 2026-01-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Wellcare Health Plan Inc MCR Adv | Default | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Fidelis Medicare Advantage MCR Adv | Default | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Tricare East Region DOS GT 01012025 | Default | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Tricare North | Default | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Medicare A NY JK | Default | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Tricare For Life | Default | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Aetna Medicare Advantage | Medicare Advantage | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Blue Cross Blue Shield of NY Utica Watertown | Medicaid Replacement | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Fidelis Medicaid Managed Care MCD Rep | Default | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Blue Cross Blue Shield of NY Utica Watertown | Default | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Capital District Physicians Health Plan CDPHP | Medicaid Replacement | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Capital District Physicians Health Plan MCR Adv | Medicare Advantage | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Medicaid New York | Default | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Medicare B NY Upstate JK | Default | $145.65 | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Capital District Physicians Health Plan CDPHP | Default | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Tricare West | Default | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Blue Cross Blue Shield of NY Utica Watertown | Medicare Advantage | — | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ADIRONDACK MEDICAL CENTER - SARANAC LAKE Both | Blue Cross Blue Shield of NY Empire | Medicare Advantage | $156.05 | $2,611.00 | $1,618.82 | 2026-03-16 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Peia | Other Governmental | $163.28 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Highmark Blue Cross | Medicare | $163.28 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Highmark Blue Cross | Ppo/Pos | $163.28 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Aetna | Medicare | $163.28 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Peak Health | Medicare | $163.28 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Humana | Medicare | $163.28 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | United Healthcare | Medicare | $163.28 | — | — | 2026-05-06 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Blue Cross Oncology | Medicare Advantage | $164.07 | — | — | 2025-08-01 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | BCBS - TN | Commercial|Network S | $167.00 | — | — | 2026-02-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Interwest Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Pacific Source | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | VA Health | All | $168.85 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Montana Health CoOp | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | First Health Network | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $168.85 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Tricare | All | $168.85 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Coventry | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Prime Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | UHC | Medicare Advantage | $168.85 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $168.85 | — | — | 2026-03-28 | MRF ↗ |
| Shepherd Center Outpatient | Medicare | Commercial | $169.69 | — | — | 2026-05-06 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Florida Community Care Oncology | Medicaid HMO | $169.81 | — | — | 2025-08-01 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Devoted | Medicare Advantage (MMG) | $171.06 | — | — | 2025-10-24 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Devoted | Medicare Advantage Prevailing (MMG) | $171.06 | — | — | 2025-10-24 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Humana | Medicare Advantage (MMG) | $171.06 | — | — | 2025-10-24 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Humana | HMO/PPO | $173.55 | — | — | 2025-10-24 | MRF ↗ |
| LIBERTY HOSPITAL Outpatient | Blue Cross Blue Shield | Freedom Network | $173.59 | — | — | 2026-05-26 | MRF ↗ |
| LIBERTY HOSPITAL Outpatient | Blue Cross Blue Shield | Freedom Network Select | $173.59 | — | — | 2026-05-26 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | United Healthcare Oncology | Medicare Advantage | $175.29 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | United Healthcare Oncology | Commercial | $177.04 | — | — | 2025-08-01 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $178.20 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $178.20 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $178.20 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $178.20 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $178.20 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $178.20 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $178.20 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $178.20 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $178.20 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $178.20 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $178.20 | — | — | 2026-04-14 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | MEDICAID [20240] | HB SPRG MO MEDICAID | $179.61 | $31,650.74 | $20,572.98 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | MEDICAID [20240] | HB SPRG MO MEDICAID | $179.61 | $31,650.74 | $20,572.98 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | MO MEDICAID BH CARVE OUT [320315] | HB SPRG MO MEDICAID | $179.61 | $31,650.74 | $20,572.98 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | MO MEDICAID BH CARVE OUT [320315] | HB SPRG MO MEDICAID | $179.61 | $31,650.74 | $20,572.98 | 2026-03-12 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | CarePlus | Medicare Advantage (MMG) | $179.62 | — | — | 2025-10-24 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | WellCare Oncology | Medicare Advantage | $181.32 | — | — | 2025-08-01 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $182.72 | — | — | 2025-12-31 | 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.