5301 — Level 1 Upper Gi Procedures
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Level 1 Upper GI Procedures (OTHER 5301) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/5301?code_type=OTHER
MLA (9th ed.)
“Level 1 Upper GI Procedures (OTHER 5301) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/5301?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“Level 1 Upper GI Procedures (OTHER 5301) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/5301?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $911–$2,492 (25th–75th percentile) across 817 hospitals · 835 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 5301 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
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 |
|---|---|---|---|---|---|---|---|
| METRO NASHVILLE GENERAL HOSPITAL OutpatientFacility | Blue Cross | Medicaid Managed Care Plan | — | — | — | 2026-09-01 | MRF ↗ |
| USA HEALTH HCA PROVIDENCE HOSPITAL, LLC OutpatientFacility | Cigna | Healthsprings Seniors First | — | — | — | 2026-04-01 | MRF ↗ |
| BOONE HOSPITAL CENTER OutpatientFacility | Unitedhealthcare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| CLINTON REGIONAL HOSPITAL OutpatientFacility | Aetna | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| UCI HEALTH - FOUNTAIN VALLEY OutpatientFacility | Caloptima | Medi-Cal Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| UCI HEALTH-LAKEWOOD OutpatientFacility | Caloptima | Medi-Cal Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| UCI HEALTH - LOS ALAMITOS OutpatientFacility | Caloptima | Medi-Cal Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| UCI HEALTH-ORANGE OutpatientFacility | Caloptima | Medi-Cal Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| BOONE HOSPITAL CENTER OutpatientFacility | Bcbs | Anthem Healthy Blue Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| FREEMAN HEALTH SYSTEM - FREEMAN WEST OutpatientFacility | Medicaid Oklahoma Aetna | Medicaid Oklahoma Aetna | $4.00 | — | — | 2025-05-01 | MRF ↗ |
| FIRSTHEALTH MOORE REGIONAL HOSPITAL OutpatientFacility | Healthy Blue | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Aetna | Better Health Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| NAPLES COMMUNITY HOSPITAL OutpatientFacility | Simply Health | Medicaid Managed Care Plan-HMO | — | — | — | 2026-07-01 | MRF ↗ |
| BOONE HOSPITAL CENTER OutpatientFacility | Centene | Homestate Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Oklahoma Complete Health | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| SAINT FRANCIS HOSPITAL SOUTH, LLC OutpatientFacility | Aetna | Better Health Medicaid Managed Care | — | — | — | 2026-04-01 | MRF ↗ |
| HONORHEALTH MOUNTAIN VISTA MEDICAL CENTER OutpatientFacility | Unitedhealthcare | Community Plan Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| HONORHEALTH FLORENCE MEDICAL CENTER OutpatientFacility | Unitedhealthcare | Community Plan Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| SENTARA OBICI HOSPITAL OutpatientFacility | Unitedhealthcare | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| SENTARA OBICI HOSPITAL OutpatientFacility | Unitedhealthcare | Options Ppo | — | — | — | 2026-04-01 | MRF ↗ |
| MUSC MEDICAL CENTER OutpatientFacility | Cigna | Lifesource Transplant | — | — | — | 2026-04-01 | MRF ↗ |
| MIDLAND MEMORIAL HOSPITAL OutpatientFacility | Aetna Ppo | Ppo | — | — | — | 2026-04-01 | MRF ↗ |
| MIDLAND MEMORIAL HOSPITAL OutpatientFacility | Aetna Ppo | Ppo | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE ST. JUDE MEDICAL CENTER OutpatientFacility | Monarch | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PALOMAR MEDICAL CENTER POWAY OutpatientFacility | Medi-Cal | Medicaid -Traditional | $16.75 | — | — | 2025-11-01 | MRF ↗ |
| ALTA BATES SUMMIT MEDICAL CENTER OutpatientFacility | Alameda Alliance | Medi-Cal | — | — | — | 2026-04-01 | MRF ↗ |
| RIVERSIDE METHODIST HOSPITAL OutpatientFacility | Medigold | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| MIAMI VALLEY HOSPITAL OutpatientFacility | Uhc | United Healthcare River Valley | — | — | — | 2026-04-01 | MRF ↗ |
| MUSC HEALTH CHESTER MEDICAL CENTER OutpatientFacility | UnitedHealthCare | Marketplace Exchange | $21.57 | — | — | 2025-07-01 | MRF ↗ |
| METROHEALTH SYSTEM OutpatientFacility | Caresource | Dual Medicare/Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| SUMMA HEALTH SYSTEM OutpatientFacility | Bcbs | Anthem Pathway Exchange | — | — | — | 2026-04-01 | MRF ↗ |
| NEWPORT HOSPITAL OutpatientFacility | United Healthcare | Medicaid Managed Care Plan | $25.00 | — | — | 2025-01-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Anthem Health Plus | Essential Plan 200-250 | — | — | — | 2026-04-01 | MRF ↗ |
| SSM HEALTH ST MARY'S HOSPITAL - ST LOUIS OutpatientFacility | Bcbs | Anthem Pathway Exchange | — | — | — | 2026-04-01 | MRF ↗ |
| MEMORIAL HOSPITAL LOS BANOS OutpatientFacility | Ccah | Medi-Cal | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE ST MARY MEDICAL CENTER OutpatientFacility | Inland Empire Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| METRO NASHVILLE GENERAL HOSPITAL OutpatientFacility | Blue Cross | Network S Other Commercial Plan | — | — | — | 2026-09-01 | MRF ↗ |
| UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND OutpatientFacility | Contra Costa Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND OutpatientFacility | San Joaquin | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PALOMAR MEDICAL CENTER POWAY OutpatientFacility | Community Health Group | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| PROVIDENCE CEDARS SINAI TARZANA MEDICAL CENTER OutpatientFacility | Healthnet | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE ST. JUDE MEDICAL CENTER OutpatientFacility | Caloptima | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE LITTLE CO OF MARY MED CTR SAN PEDRO OutpatientFacility | Heritage Provider Network | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| KALEIDA HEALTH OutpatientFacility | Bcbs | Align - Healthnow Other Commercial Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE MISSION HOSPITAL OutpatientFacility | Monarch | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| MUSC HEALTH LANCASTER MEDICAL CENTER OutpatientFacility | Unitedhealthcare | Marketplace Exchange | — | — | — | 2026-04-01 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Private Healthcare Systems | Other | — | — | — | 2026-07-19 | MRF ↗ |
| WELLSTAR DOUGLAS MEDICAL CENTER OutpatientFacility | Sonder | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| VAUGHAN REGIONAL MEDICAL CENTER PARKWAY CAMPUS OutpatientFacility | Humana | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE SANTA ROSA MEMORIAL HOSPITAL OutpatientFacility | Partnership Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| USA HEALTH HCA PROVIDENCE HOSPITAL, LLC OutpatientFacility | Humana | Humana Hmo | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE LITTLE CO OF MARY MED CTR SAN PEDRO OutpatientFacility | Blue Cross | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| LAHEY HOSPITAL & MEDICAL CENTER, BURLINGTON OutpatientFacility | Tufts Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| Beth Israel Deaconess Med Ctr - Transplant Center OutpatientFacility | Tufts Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE HOLY CROSS MEDICAL CENTER OutpatientFacility | Blue Shield | Promise Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| HONORHEALTH FLORENCE MEDICAL CENTER OutpatientFacility | Arizona Complete Care | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| HONORHEALTH MOUNTAIN VISTA MEDICAL CENTER OutpatientFacility | Arizona Complete Care | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE QUEEN OF THE VALLEY MEDICAL CENTER OutpatientFacility | Partnership Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE QUEEN OF THE VALLEY MEDICAL CENTER OutpatientFacility | Partnership Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| NORTH MISSISSIPPI MEDICAL CENTER OutpatientFacility | Bcbs | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| BRIDGTON HOSPITAL OutpatientFacility | Wellcare | Wellcare Medicare Advantage | $60.61 | — | — | 2025-07-01 | MRF ↗ |
| PROVIDENCE HOLY CROSS MEDICAL CENTER OutpatientFacility | Heritage Provider Network | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE HOLY CROSS MEDICAL CENTER OutpatientFacility | La Care Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE ST JOSEPH HOSPITAL OutpatientFacility | Partnership Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE ST JOSEPH HOSPITAL OutpatientFacility | Partnership Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE REDWOOD MEMORIAL HOSPITAL OutpatientFacility | Partnership Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE REDWOOD MEMORIAL HOSPITAL OutpatientFacility | Partnership Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE CEDARS SINAI TARZANA MEDICAL CENTER OutpatientFacility | Molina Healthcare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| UCI HEALTH-ORANGE OutpatientFacility | Monarch Medical Group | Medi-Cal CalOptima Medicaid Managed Care Plan | $68.02 | — | — | 2024-07-01 | MRF ↗ |
| WELLSTAR PAULDING MEDICAL CENTER OutpatientFacility | Sonder | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| USA HEALTH HCA PROVIDENCE HOSPITAL, LLC OutpatientFacility | Blue Cross Blue Shield | Bcbs Medicare Advantage | — | — | — | 2026-04-01 | MRF ↗ |
| MEMORIAL HOSPITAL OutpatientFacility | Aetna | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| PETALUMA VALLEY HOSPITAL OutpatientFacility | Partnership Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE HOLY CROSS MEDICAL CENTER OutpatientFacility | Blue Cross | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| SAINT FRANCIS HOSPITAL, INC OutpatientFacility | Community Care | Select Ppo | — | — | — | 2026-04-01 | MRF ↗ |
| KALEIDA HEALTH OutpatientFacility | Bcbs - Wchob | Align - Healthnow Other Commercial Plan | — | — | — | 2026-04-01 | MRF ↗ |
| JPS HEALTH NETWORK OutpatientFacility | Aetna | Ppo/Pos/Epo | — | — | — | 2026-04-01 | MRF ↗ |
| JPS HEALTH NETWORK OutpatientFacility | Superior Health Plan | Exchange | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE CEDARS SINAI TARZANA MEDICAL CENTER OutpatientFacility | Heritage Provider Network | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| NEWPORT HOSPITAL OutpatientFacility | Neighborhood Health Plan Of Rhode Island | Medicaid Managed Care Plan | $79.00 | — | — | 2025-01-01 | MRF ↗ |
| PROVIDENCE CEDARS SINAI TARZANA MEDICAL CENTER OutpatientFacility | La Care Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE ST. JOSEPH HOSPITAL OutpatientFacility | Monarch | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE HOLY CROSS MEDICAL CENTER OutpatientFacility | Healthnet | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE ST VINCENT MEDICAL CENTER OutpatientFacility | Unitedhealthcare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| BETHESDA NORTH OutpatientFacility | CARESOURCE | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| BETHESDA BUTLER HOSPITAL OutpatientFacility | CARESOURCE | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| COVENANT MEDICAL CENTER OutpatientFacility | Bcbs | Par Traditional | — | — | — | 2026-04-01 | MRF ↗ |
| WINCHESTER HOSPITAL OutpatientFacility | Wellsense Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE MISSION HOSPITAL OutpatientFacility | Caloptima | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE ST MARY MEDICAL CENTER OutpatientFacility | Molina | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| KNOX COMMUNITY HOSPITAL OutpatientFacility | Bcbs | Anthem Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Humana | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| SAINT FRANCIS HOSPITAL SOUTH, LLC OutpatientFacility | Community Care | Other Senior Hmo | — | — | — | 2026-04-01 | MRF ↗ |
| SAINT FRANCIS HOSPITAL, INC OutpatientFacility | Community Care | Other Senior Hmo | — | — | — | 2026-04-01 | MRF ↗ |
| EL CAMINO HEALTH OutpatientFacility | Santa Clara Family Health Plan | Scfhp Managed Medi-Cal | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE ST. JOSEPH HOSPITAL OutpatientFacility | Caloptima | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Fidelis | Medicaid HMO | — | — | — | 2026-04-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Molina | Medicaid HMO | — | — | — | 2026-04-01 | MRF ↗ |
| MUSC HEALTH FLORENCE MEDICAL CENTER OutpatientFacility | Bcbs | Bluechoice/Blueoptions Exchange | — | — | — | 2026-04-01 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Healthpartners | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE LITTLE CO OF MARY MED CTR SAN PEDRO OutpatientFacility | Molina Healthcare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| SUTTER DELTA MEDICAL CENTER OutpatientFacility | Blue Shield | Medicare Adv_ Hmo / Ppo | — | — | — | 2026-04-01 | MRF ↗ |
| AULTMAN HOSPITAL OutpatientFacility | Prime Time Health Plan | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| JPS HEALTH NETWORK OutpatientFacility | Bcbs | Ppo/Pos | — | — | — | 2026-04-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Emblem Health - HIP | Medicaid HMO | — | — | — | 2026-04-01 | MRF ↗ |
| STANFORD HEALTH CARE OutpatientFacility | Health Plan Of San Mateo | Medi-Cal Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE HOLY CROSS MEDICAL CENTER OutpatientFacility | Molina Healthcare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Oklahoma Complete Health | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Humana | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| EMORY UNIVERSITY HOSPITAL OutpatientFacility | Bcbs | Blue Pathways Exchange | — | — | — | 2026-04-01 | MRF ↗ |
| EMORY UNIVERSITY HOSPITAL OutpatientFacility | Bcbs | Blue Pathways Exchange | — | — | — | 2026-04-01 | MRF ↗ |
| Integris Baptist Medical Center OutpatientFacility | Oklahoma Complete Health | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PENN HIGHLANDS ELK OutpatientFacility | Amerihealth Caritas | All Plans | $114.18 | — | — | 2025-08-01 | MRF ↗ |
| Integris Baptist Medical Center OutpatientFacility | Cigna | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| UCI HEALTH-ORANGE OutpatientFacility | CalOptima | Medi-Cal Medicaid Managed Care Plan | $115.13 | — | — | 2024-07-01 | MRF ↗ |
| KECK HOSPITAL OF USC OutpatientFacility | Pacific Pace | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Humana | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY MEDICAL CENTER OF EL PASO Outpatient | Bcbs Hmo | Commercial | $120.45 | — | — | 2026-07-15 | MRF ↗ |
| Foundation Surgical Hospital Of El Paso Outpatient | Bcbs Hmo | Commercial | $120.45 | — | — | 2026-05-09 | MRF ↗ |
| UNIVERSITY MEDICAL CENTER OF EL PASO Outpatient | Bcbs Ppo & Traditional | Commercial | $120.45 | — | — | 2026-07-15 | MRF ↗ |
| Foundation Surgical Hospital Of El Paso Outpatient | Bcbs Ppo & Traditional | Commercial | $120.45 | — | — | 2026-05-09 | MRF ↗ |
| UCI HEALTH-LAKEWOOD OutpatientFacility | Caloptima | Monarch Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| UCI HEALTH-ORANGE OutpatientFacility | Caloptima | Monarch Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| UCI HEALTH - LOS ALAMITOS OutpatientFacility | Caloptima | Monarch Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| UCI HEALTH - FOUNTAIN VALLEY OutpatientFacility | Caloptima | Monarch Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| SWEDISH HOSPITAL OutpatientFacility | Countycare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| MOUNT SINAI WEST OutpatientFacility | Emblem | Emblem Medicaid - Slw | — | — | — | 2026-04-01 | MRF ↗ |
| PALOMAR MEDICAL CENTER POWAY OutpatientFacility | Community Health Group | Medicaid Managed Care Plan – Hmo | $124.30 | — | — | 2025-11-01 | MRF ↗ |
| PAOLI HOSPITAL OutpatientFacility | UPMC | For You Medicaid Managed Care Plan | $124.37 | — | — | 2025-07-01 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Tufts | Direct Other Commercial Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Commonwealth Care Alliance | PPO Medicare Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Blue Cross | HMO | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Allways | Commercial | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Cigna | All Commercial Plans | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | BCBS | Medicare Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Aetna | All Commercial Plans | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Health New England | Be Healthy ACO Medicaid Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Tufts | All Commercial Plans | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Tufts | Direct Other Commercial Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Health New England | Self Funded Employer Sponsored Other Commercial Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Health New England | Self Funded Employer Sponsored Other Commercial Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Fallon | Summit Medicare Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Harvard Pilgrim | All Commercial Plans | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Health New England | Be Healthy ACO Medicaid Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Health New England | Fully Insured Other Commercial Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Health New England | ASO GIC Other Commercial Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Health New England | Fully Insured Other Commercial Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Fallon | Summit Medicare Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Unicare | All Commercial Plans | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Optum VA CCN | Government | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Blue Cross | PPA | — | — | — | 2025-10-15 | MRF ↗ |
| MEMORIAL HERMANN - TEXAS MEDICAL CENTER OutpatientFacility | Cigna | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Wellsense | Medicaid Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| Memorial Hermann Hospital OutpatientFacility | Cigna | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Optum VA CCN | Government | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Commonwealth Care Alliance | PPO Medicare Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Health New England | ASO GIC Other Commercial Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Fallon | Navicare HMO Medicare Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Serenity Pace | Medicare Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | UnitedHealthCare | All Commercial Plans | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Blue Cross | PPA | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Cigna | All Commercial Plans | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Aetna | All Commercial Plans | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Allways | Commercial | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Harvard Pilgrim | All Commercial Plans | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Health New England | Medicare Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Blue Cross | HMO | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Wellsense | Medicaid Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Serenity Pace | Medicare Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Unicare | All Commercial Plans | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | BCBS | Medicare Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Tufts | ACO/MCO Medicaid Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Tufts | ACO/MCO Medicaid Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Health New England | Medicare Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Tufts | All Commercial Plans | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | Fallon | Navicare HMO Medicare Managed Care Plan | — | — | — | 2025-10-15 | MRF ↗ |
| BAYSTATE NOBLE HOSPITAL OutpatientFacility | UnitedHealthCare | All Commercial Plans | — | — | — | 2025-10-15 | MRF ↗ |
| KNOX COMMUNITY HOSPITAL OutpatientFacility | Aetna | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| KNOX COMMUNITY HOSPITAL OutpatientFacility | Humana | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| KNOX COMMUNITY HOSPITAL OutpatientFacility | Medical Mutual | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| KNOX COMMUNITY HOSPITAL OutpatientFacility | Medigold | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| KNOX COMMUNITY HOSPITAL OutpatientFacility | Unitedhealthcare | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| ADVENTHEALTH OCALA OutpatientFacility | Unitedhealthcare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| Foundation Surgical Hospital Of El Paso Outpatient | Bcbs Ppo & Traditional | Commercial | $128.48 | — | — | 2026-05-09 | MRF ↗ |
| UNIVERSITY MEDICAL CENTER OF EL PASO Outpatient | Bcbs Hmo | Commercial | $128.48 | — | — | 2026-07-15 | MRF ↗ |
| UNIVERSITY MEDICAL CENTER OF EL PASO Outpatient | Bcbs Ppo & Traditional | Commercial | $128.48 | — | — | 2026-07-15 | MRF ↗ |
| Foundation Surgical Hospital Of El Paso Outpatient | Bcbs Hmo | Commercial | $128.48 | — | — | 2026-05-09 | MRF ↗ |
| CAROLINA PINES REGIONAL MEDICAL CENTER OutpatientFacility | BCBS | Exchange | — | — | — | 2025-01-01 | MRF ↗ |
| PENINSULA MEDICAL CENTER OutpatientFacility | United | Hmo / Ppo | — | — | — | 2026-04-01 | MRF ↗ |
| SUMMA HEALTH SYSTEM OutpatientFacility | Medical Mutual | Aca Exchange | — | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY MEDICAL CENTER OutpatientFacility | Big Spring State | All Commercial Plans | $130.05 | — | — | 2026-01-01 | MRF ↗ |
| KNOX COMMUNITY HOSPITAL OutpatientFacility | Caresource | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| ADVENTHEALTH FISH MEMORIAL OutpatientFacility | Unitedhealthcare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE LITTLE COMPANY OF MARY MED CTR TORRANCE OutpatientFacility | Heritage Provider Network | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE LITTLE COMPANY OF MARY MED CTR TORRANCE OutpatientFacility | Heritage Provider Network | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| KNOX COMMUNITY HOSPITAL OutpatientFacility | Bcbs | Anthem All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| ST JOSEPH REGIONAL MEDICAL CENTER OutpatientFacility | UnitedHealthCare | Medicare Managed Care Plan | — | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH REGIONAL MEDICAL CENTER OutpatientFacility | UnitedHealthCare | Medicare Managed Care Plan | — | — | — | 2026-04-01 | 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.