50080 — Perq Nl/pl Lithotrp Smpl<2cm
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PERQ NL/PL LITHOTRP SMPL<2CM (HCPCS 50080) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/50080?code_type=HCPCS
MLA (9th ed.)
“PERQ NL/PL LITHOTRP SMPL<2CM (HCPCS 50080) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/50080?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“PERQ NL/PL LITHOTRP SMPL<2CM (HCPCS 50080) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/50080?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,600–$12,175 (25th–75th percentile) across 2,108 hospitals · 4,180 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 50080 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Also priced as a different code
The same procedure is billed under different code systems depending on the setting. These facilities price it under a code you won’t see in the CPT/HCPCS 50080 table above — including hospitals that only publish the bundled version.
2,954 facilities · 1,037 not in the CPT/HCPCS table
- ABBEVILLE GENERAL HOSPITAL, ABBEVILLE • only here
- ABRAHAM LINCOLN MEMORIAL HOSPITAL, LINCOLN • only here
- ACADIAN MEDICAL CENTER, EUNICE • only here
- Acuity Specialty Hospital Of New Jersey, Atlantic City • only here
- Acuity Specialty Hospital Ohio Valley, BELLAIRE • only here
- Advanced Specialty Hospital Of Toledo, Toledo • only here
3,009 facilities · 1,085 not in the CPT/HCPCS table
- ABBEVILLE GENERAL HOSPITAL, ABBEVILLE • only here
- ABRAHAM LINCOLN MEMORIAL HOSPITAL, LINCOLN • only here
- ACADIAN MEDICAL CENTER, EUNICE • only here
- Acuity Specialty Hospital Of New Jersey, Atlantic City • only here
- Acuity Specialty Hospital Ohio Valley, BELLAIRE • only here
- Advanced Specialty Hospital Of Toledo, Toledo • only here
2,980 facilities · 1,060 not in the CPT/HCPCS table
- ABBEVILLE GENERAL HOSPITAL, ABBEVILLE • only here
- ABRAHAM LINCOLN MEMORIAL HOSPITAL, LINCOLN • only here
- ACADIAN MEDICAL CENTER, EUNICE • only here
- Acuity Specialty Hospital Of New Jersey, Atlantic City • only here
- Acuity Specialty Hospital Ohio Valley, BELLAIRE • only here
- ADAMS MEMORIAL HOSPITAL, DECATUR • only here
An MS-DRG / APR-DRG price is the hospital’s single bundled charge for the entire inpatient stay — operating room, room & board, recovery, imaging, anesthesia (facility), implants and supplies — so it’s a broader, usually higher figure than the CPT/HCPCS 50080 line above, which prices the procedure alone. Neither includes the surgeon’s or anesthesiologist’s professional fees, which 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 fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$3,600
$8,987 typical
$12,175
The middle 50% of negotiated facility rates for this procedure, measured across 2,108 hospitals. The surgeon and 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. | $8,987 |
| Surgeon (professional fee) Estimate national typical Medicare $629 × 1.22 commercial. | $767 |
| Anesthesia Estimate national typical 00862, ~90 min typical. Medicare $266 × 3.14 commercial. | $837 |
| Likely subtotal | $10,591 |
Surgical episode (typical)
~$10,591
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: which insurer's rate applies — negotiated prices here run $3,600–$12,175.
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)
~$14,376
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
- 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
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 | — | $24,465.00 | $2,446.50 | 2026-07-18 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | THREE RIVERS - ALL PLANS | THREE RIVERS - ALL PLANS | $5.60 | $7.00 | $4.55 | 2026-09-09 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | THREE RIVERS - ALL PLANS | THREE RIVERS - ALL PLANS | $5.60 | $7.00 | $4.55 | 2026-03-03 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | AETNA BETTER HEALTH - ALL PLANS | AETNA BETTER HEALTH - ALL PLANS | $7.00 | $7.00 | $4.55 | 2026-09-09 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | PASSPORT HEALTH - ALL PLANS | PASSPORT HEALTH - ALL PLANS | $7.00 | $7.00 | $4.55 | 2026-03-03 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | ANTHEM BCBS MEDICAID | ANTHEM BCBS MEDICAID | $7.00 | $7.00 | $4.55 | 2026-03-03 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | MOLINA MEDICAID - ALL PLANS | MOLINA MEDICAID - ALL PLANS | $7.00 | $7.00 | $4.55 | 2026-03-03 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | AETNA BETTER HEALTH - ALL PLANS | AETNA BETTER HEALTH - ALL PLANS | $7.00 | $7.00 | $4.55 | 2026-03-03 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | HUMANA MEDICAID | HUMANA MEDICAID | $7.00 | $7.00 | $4.55 | 2026-09-09 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | PASSPORT HEALTH - ALL PLANS | PASSPORT HEALTH - ALL PLANS | $7.00 | $7.00 | $4.55 | 2026-09-09 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | BCBS MEDICAID | BCBS MEDICAID | $7.00 | $7.00 | $4.55 | 2026-09-09 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | CORVEL CORPORATION - ALL PLANS | CORVEL CORPORATION - ALL PLANS | $7.00 | $7.00 | $4.55 | 2026-09-09 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | CORVEL CORPORATION - ALL PLANS | CORVEL CORPORATION - ALL PLANS | $7.00 | $7.00 | $4.55 | 2026-03-03 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | HUMANA MEDICAID | HUMANA MEDICAID | $7.00 | $7.00 | $4.55 | 2026-03-03 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | MOLINA MEDICAID - ALL PLANS | MOLINA MEDICAID - ALL PLANS | $7.00 | $7.00 | $4.55 | 2026-09-09 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | COVENTRY CARES OF KY - ALL PLANS | COVENTRY CARES OF KY - ALL PLANS | $7.28 | $7.00 | $4.55 | 2026-03-03 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | COVENTRY CARES OF KY - ALL PLANS | COVENTRY CARES OF KY - ALL PLANS | $7.28 | $7.00 | $4.55 | 2026-09-09 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | WELLCARE HEALTH PLAN INC | WELLCARE HEALTH PLAN INC | $7.35 | $7.00 | $4.55 | 2026-09-09 | MRF ↗ |
| MURRAY-CALLOWAY COUNTY HOSPITAL Outpatient | WELLCARE HEALTH PLAN INC | WELLCARE HEALTH PLAN INC | $7.35 | $7.00 | $4.55 | 2026-03-03 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Uhc | Hmo Ppo | — | $108.15 | $54.08 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Anthem | Ppo Hmo | — | $108.15 | $54.08 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Anthem | Traditional | — | $108.15 | $54.08 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Molina | Marketplace | — | $108.15 | $54.08 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Med Mutual | Ppo Hmo | — | $108.15 | $54.08 | 2026-05-13 | MRF ↗ |
| WILSON MEMORIAL HOSPITAL Both | Cigna | Cigna | — | $108.15 | $54.08 | 2026-05-13 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | First Choice Select Health | Managed Medicaid | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Cigna | Commercial | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Aetna | Commercial | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Molina | Mangaged Medicare | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | America'S First Choice | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Absolute Total Care | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | United Health Care | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Aetna | Managed Medicare | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Blue Cross | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | HUMANA MEDICARE HMO | — | $17,838.57 | $11,595.07 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | EXCELLUS HMO [104] | BLUE CHOICE OPTION|CHILD HEALTH PLUS|UNIVERA MYHEALTH PLUS|EXCELLUS ESSENTIAL 1&2|EXCELLUS ESSENTIAL 3&4|UNIVERA MYHEALTH|UNIVERA ESSENTIAL 1&2|HEALTHY NY | — | $17,838.57 | $11,595.07 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN|UHC COMMUNITY MEDICAID DENTAL|UHC ESSENTIAL 1&2|UHC CHPS|UHC ESSENTIAL 3&4 | — | $17,838.57 | $11,595.07 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | GENERIC CARRIER [107] | ST REGIS MOHAWK [10724] | — | $17,838.57 | $11,595.07 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | WELLCARE TODAY'S OPTIONS [12503] | — | $17,838.57 | $11,595.07 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | AETNA [100] | AETNA|AETNA DENTAL|MERITAIN HEALTH | — | $17,838.57 | $11,595.07 | 2024-12-30 | MRF ↗ |
| GOUVERNEUR HOSPITAL Outpatient | AETNA [100] | AETNA MEDICARE ADVANTAGE | — | $17,838.57 | $11,595.07 | 2024-12-30 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $31.47 | $17,486.00 | $9,395.48 | 2024-12-31 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| ISLAND HOSPITAL Outpatient | MULTIPLAN - ALL PLANS | MULTIPLAN - ALL PLANS | $40.00 | $1,632.00 | $1,632.00 | 2025-03-18 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $50.18 | $2,872.00 | $2,872.00 | 2026-02-13 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $50.18 | $2,872.00 | $2,872.00 | 2026-06-03 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Univera | Medicare Managed Care Plan | $55.12 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $55.12 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $62.01 | — | — | 2026-04-01 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Univera | Medicare Managed Care Plan | $62.01 | — | — | 2026-04-01 | MRF ↗ |
| St Anthony Regional Hospital & Nursing Home Outpatient | MIDLANDS CHOICE - ALL PLANS | MIDLANDS CHOICE - ALL PLANS | $76.98 | $2,483.00 | $2,483.00 | 2026-02-09 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | AETNA COMM-ALL OTHER PLANS | AETNA COMM-ALL OTHER PLANS | $78.57 | $2,782.50 | $1,808.63 | 2026-08-10 | MRF ↗ |
| FISHER-TITUS HOSPITAL Both | Galaxy | Galaxy | — | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Both | Galaxy | Galaxy | — | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Both | Claim Doc | Claimdoc | — | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Both | Claim Doc | Claimdoc | — | — | — | 2026-07-31 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $119.88 | $888.00 | $666.00 | 2026-01-16 | MRF ↗ |
| CANTON-POTSDAM HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN|UHC COMMUNITY MEDICAID DENTAL|UHC ESSENTIAL 1&2|UHC CHPS|UHC ESSENTIAL 3&4 | — | $17,838.57 | $11,595.07 | 2024-12-30 | MRF ↗ |
| CANTON-POTSDAM HOSPITAL Outpatient | MH OPTUM [170] | MH OPTUM COMMUNITY | — | $17,838.57 | $11,595.07 | 2024-12-30 | MRF ↗ |
| CANTON-POTSDAM HOSPITAL Outpatient | MVP [109] | MH CIGNA BEHAVORIAL HEALTH|MVP|CIGNA|NALC CIGNA | $158.00 | $17,838.57 | $11,595.07 | 2024-12-30 | MRF ↗ |
| CANTON-POTSDAM HOSPITAL Outpatient | MH OPTUM [170] | MH OPTUM MEDICARE | — | $17,838.57 | $11,595.07 | 2024-12-30 | MRF ↗ |
| CANTON-POTSDAM HOSPITAL Outpatient | UNITED BEHAVORIAL HEALTH [120] | UNITED BEHAVORIAL HEALTH|MH OPTUM COMMERCIAL | — | $17,838.57 | $11,595.07 | 2024-12-30 | MRF ↗ |
| Lac Harbor-ucla Medical Center Outpatient | [Medi-Cal Managed Care] | [Kaiser] | $162.35 | — | — | 2026-09-20 | MRF ↗ |
| LOS ANGELES GENERAL MEDICAL CENTER Outpatient | [Medi-Cal Managed Care] | [Kaiser] | $162.35 | — | — | 2026-09-20 | MRF ↗ |
| LAC/OLIVE VIEW-UCLA MEDICAL CENTER Outpatient | [Medi-Cal Managed Care] | [Kaiser] | $162.35 | — | — | 2026-07-15 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | BCBS - TN | Commercial|Network S | $167.00 | — | — | 2026-02-28 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | BCBS - TN | Commercial|Network S | $167.00 | — | — | 2026-02-28 | MRF ↗ |
| NORTHRIDGE HOSPITAL MEDICAL CENTER Outpatient | BCBS - TN | Commercial|Network S | $167.00 | — | — | 2026-02-28 | MRF ↗ |
| HOMESTEAD HOSPITAL Both | VISTA | COVENTRY MEDICAID | $167.89 | $25,139.00 | $16,340.35 | 2026-03-30 | MRF ↗ |
| Lac Harbor-ucla Medical Center Outpatient | [Medi-Cal Managed Care] | [Anthem Blue Cross] | $172.09 | — | — | 2026-09-20 | MRF ↗ |
| BAPTIST HOSPITAL Both | VISTA | COVENTRY MEDICAID | $173.17 | $12,569.00 | $8,169.85 | 2026-03-30 | MRF ↗ |
| LAC/RANCHO LOS AMIGOS NATIONAL REHABILITATION CTR Outpatient | [Medi-Cal Managed Care] | [Anthem Blue Cross] | $175.34 | — | — | 2026-07-15 | MRF ↗ |
| LAC/OLIVE VIEW-UCLA MEDICAL CENTER Outpatient | [Medi-Cal Managed Care] | [Anthem Blue Cross] | $175.34 | — | — | 2026-07-15 | MRF ↗ |
| LOS ANGELES GENERAL MEDICAL CENTER Outpatient | [Medi-Cal Managed Care] | [Anthem Blue Cross] | $175.34 | — | — | 2026-09-20 | MRF ↗ |
| LAC/RANCHO LOS AMIGOS NATIONAL REHABILITATION CTR Outpatient | [Medi-Cal Managed Care] | [Kaiser] | $178.59 | — | — | 2026-07-15 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $184.26 | $888.00 | $666.00 | 2026-01-16 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $186.92 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $186.92 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $186.92 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $186.92 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $186.92 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $186.92 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $186.92 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $186.92 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6790_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ASIN 20230101 | $186.92 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $186.92 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $186.92 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $186.92 | — | — | 2026-01-01 | MRF ↗ |
| SANTA CLARA VALLEY MEDICAL CENTER BothFacility | BLUE CROSS MEDI-CAL MC [320] | BLUE CROSS MCMC [320001] | $192.94 | $65,532.00 | $45,872.40 | 2026-09-01 | MRF ↗ |
| St. Louise Regional Hospital BothFacility | BLUE CROSS MEDI-CAL MC [320] | BLUE CROSS MCMC [320001] | $192.94 | $65,532.00 | $45,872.40 | 2026-09-01 | MRF ↗ |
| O'connor Hospital BothFacility | BLUE CROSS MEDI-CAL MC [320] | BLUE CROSS MCMC [320001] | $192.94 | $65,532.00 | $45,872.40 | 2026-09-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | $9,689.00 | $5,813.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | $9,689.00 | $5,813.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $194.96 | — | — | 2026-01-01 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | UNITED HEALTHCARE CONTRACTED [320396] | HB STLO UHC HMO PPO ALL PAYER | — | $44,322.73 | $28,809.77 | 2026-06-04 | MRF ↗ |
| Lac Harbor-ucla Medical Center Outpatient | [Medi-Cal Managed Care] | [L.A. Care Term Jan 2026-Jun 2026] | $202.94 | — | — | 2026-09-20 | MRF ↗ |
| LOS ANGELES GENERAL MEDICAL CENTER Outpatient | [Medi-Cal Managed Care] | [L.A. Care Term Jan 2026-Jun 2026] | $202.94 | — | — | 2026-09-20 | MRF ↗ |
| LAC/OLIVE VIEW-UCLA MEDICAL CENTER Outpatient | [Medi-Cal Managed Care] | [L.A. Care] [Jan 2026-Jun 2026] | $202.94 | — | — | 2026-07-15 | MRF ↗ |
| Lac Harbor-ucla Medical Center Outpatient | [Medi-Cal Managed Care] | [L.A. Care Term Jul 2026-Dec 2026] | $202.94 | — | — | 2026-09-20 | MRF ↗ |
| LAC/RANCHO LOS AMIGOS NATIONAL REHABILITATION CTR Outpatient | [Medi-Cal Managed Care] | [L.A. Care] [Term Jan 2026-Jun 2026] | $202.94 | — | — | 2026-07-15 | MRF ↗ |
| MON HEALTH MARION Outpatient | The Health Plan Commercial Plan | Commercial | $205.79 | $1,469.91 | $734.96 | 2026-07-15 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Blue Cross | All Vermont Plans | $207.05 | $628.00 | $439.60 | 2026-07-15 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Arkansas Total Care | Medicaid | $208.66 | — | — | 2026-07-15 | MRF ↗ |
| WASHINGTON HOSPITAL, THE OutpatientFacility | UPMC Health Plan | Managed Medicare | $210.36 | $618.70 | $185.61 | 2025-08-06 | MRF ↗ |
| LAC/OLIVE VIEW-UCLA MEDICAL CENTER Outpatient | [Medi-Cal Managed Care] | [L.A. Care] [Jul 2026-Dec 2026] | $211.06 | — | — | 2026-07-15 | MRF ↗ |
| LOS ANGELES GENERAL MEDICAL CENTER Outpatient | [Medi-Cal Managed Care] | [L.A. Care Term Jul 2026-Dec 2026] | $211.06 | — | — | 2026-09-20 | MRF ↗ |
| LAC/RANCHO LOS AMIGOS NATIONAL REHABILITATION CTR Outpatient | [Medi-Cal Managed Care] | [L.A. Care] [Term Jul 2026-Dec 2026] | $211.06 | — | — | 2026-07-15 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | BCBS - TN | Commercial|Network P | $217.00 | — | — | 2026-02-28 | MRF ↗ |
| NORTHRIDGE HOSPITAL MEDICAL CENTER Outpatient | BCBS - TN | Commercial|Network P | $217.00 | — | — | 2026-02-28 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | BCBS - TN | Commercial|Network P | $217.00 | — | — | 2026-02-28 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Caresource | Medicaid | $217.01 | — | — | 2026-07-15 | MRF ↗ |
| BASSETT HEALTHCARE Inpatient | Mvp | Ppo/Epo | $222.82 | $2,724.00 | $1,362.00 | 2026-07-17 | MRF ↗ |
| BASSETT HEALTHCARE Inpatient | Mvp | Select Care | $222.82 | $2,724.00 | $1,362.00 | 2026-07-17 | MRF ↗ |
| BASSETT HEALTHCARE Inpatient | Mvp | Select Care | $222.82 | $544.80 | $272.40 | 2026-07-17 | MRF ↗ |
| BASSETT HEALTHCARE Inpatient | Mvp | Groups | $222.82 | $2,724.00 | $1,362.00 | 2026-07-17 | MRF ↗ |
| BASSETT HEALTHCARE Inpatient | Mvp | Groups | $222.82 | $544.80 | $272.40 | 2026-07-17 | MRF ↗ |
| BASSETT HEALTHCARE Inpatient | Mvp | Ppo/Epo | $222.82 | $544.80 | $272.40 | 2026-07-17 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | UNITED HEALTH CARE COMMUNITY PLAN MEDICAID [9004] | UNITED HEALTH CARE MEDICAID [900401] | $222.91 | $1,602.00 | $1,602.00 | 2026-03-23 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | EXCELLUS HMO [104] | MEDICARE BLUE CHOICE [10406] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | MVP [109] | MVP DUAL ACCESS [10916] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | MVP [109] | MVP ESSENTIAL 3&4 [10912] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | GENERIC MEDICARE HMO [12505] | — | $1,424.39 | $1,424.39 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN [10104] | $223.02 | $1,424.39 | $1,424.39 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | WELLCARE MEDICARE HMO [122] | WELLCARE MEDICARE HMO [12201] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | FIDELIS EXCHANGE [157] | FIDELIS ESSENTIAL 1&2 [15702] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK [11401] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK ESSENTIALS [11404] | — | $1,424.39 | $1,424.39 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | FIDELIS EXCHANGE [157] | FIDELIS(INCLUDING GOLD,SILVER,BRONZE AND PLATINUM) [15701] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | MEDICARE HMO INDEPENDENT HLTH [13802] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | INDEPENDENT HEALTH ASSOC [13801] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | MVP [109] | MVP [10905] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | WELLCARE MEDICARE HMO [122] | WELLCARE DUAL [12205] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE [10301] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | EMBLEM GHI [113] | EMBLEM GHI [11301] | — | $1,424.39 | $1,424.39 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 3&4 [18804] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | FIDELIS MEDICARE [176] | FIDELIS MEDICARE [17601] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED HEALTHCARE [101] | UNITED HEALTHCARE [10101] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED BEHAVORIAL HEALTH [120] | UNITED BEHAVORIAL HEALTH [12001] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK ESSENTIALS [11404] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK [11401] | — | $1,424.39 | $1,424.39 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED HEALTHCARE [101] | UHC MEDICARE COMPLETE [10116] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK MEDICARE [11402] | — | $1,424.39 | $1,424.39 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK MEDICARE [11402] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA MEDICAID MANAGED CARE [18801] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | AETNA [100] | AETNA [10001] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE [10301] | — | $1,424.39 | $1,424.39 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | FIDELIS MEDICARE [176] | FIDELIS DUAL ADVANTAGE [17605] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | MULTIPLAN [141] | MULTIPLAN [14101] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | FIDELIS CARE NEW YORK [112] | FIDELIS CARE NEW YORK [11201] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED HEALTHCARE [101] | UHC DUAL COMPLETE [10117] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | AETNA [100] | AETNA MEDICARE ADVANTAGE [10009] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | GENERIC CARRIER [107] | COMMERCIAL [10701] | — | $1,424.39 | $1,424.39 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED BEHAVORIAL HEALTH [120] | UNITED BEHAVORIAL HEALTH [12001] | — | $1,424.39 | $1,424.39 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | GENERIC MEDICARE HMO [12505] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN [10104] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 1&2 [18803] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | GENERIC CARRIER [107] | COMMERCIAL [10701] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | MULTIPLAN [141] | MULTIPLAN [14101] | — | $1,424.39 | $1,424.39 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | EMBLEM GHI [113] | EMBLEM GHI [11301] | — | $284.88 | $284.88 | 2024-12-30 | MRF ↗ |
| LAC/RANCHO LOS AMIGOS NATIONAL REHABILITATION CTR Outpatient | [Medi-Cal Managed Care] | [Blue Shield Promise] [Term Jan 2026-May 2026] | $227.29 | — | — | 2026-07-15 | MRF ↗ |
| LAC/RANCHO LOS AMIGOS NATIONAL REHABILITATION CTR Outpatient | [Medi-Cal Managed Care] | [Blue Shield Promise] [Term Jun 2026-Dec 2026] | $227.29 | — | — | 2026-07-15 | MRF ↗ |
| Lac Harbor-ucla Medical Center Outpatient | [Medi-Cal Managed Care] | [Blue Shield Promise] [Term Jan 2026-May 2026] | $227.29 | — | — | 2026-09-20 | MRF ↗ |
| LOS ANGELES GENERAL MEDICAL CENTER Outpatient | [Medi-Cal Managed Care] | [Blue Shield Promise] [Term Jan 2026-May 2026] | $227.29 | — | — | 2026-09-20 | MRF ↗ |
| Lac Harbor-ucla Medical Center Outpatient | [Medi-Cal Managed Care] | [Blue Shield Promise] [Term Jun 2026-Dec 2026] | $227.29 | — | — | 2026-09-20 | MRF ↗ |
| LOS ANGELES GENERAL MEDICAL CENTER Outpatient | [Medi-Cal Managed Care] | [Blue Shield Promise] [Term Jun 2026-Dec 2026] | $227.29 | — | — | 2026-09-20 | MRF ↗ |
| LAC/OLIVE VIEW-UCLA MEDICAL CENTER Outpatient | [Medi-Cal Managed Care] | [Blue Shield Promise] [Term Jan 2026-May 2026] | $227.29 | — | — | 2026-07-15 | MRF ↗ |
| LAC/OLIVE VIEW-UCLA MEDICAL CENTER Outpatient | [Medi-Cal Managed Care] | [Blue Shield Promise] [Term Jun 2026-Dec 2026] | $227.29 | — | — | 2026-07-15 | 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.