54161 — Circum 28 Days Or Older
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). CIRCUM 28 DAYS OR OLDER (CPT 54161) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/54161?code_type=CPT
MLA (9th ed.)
“CIRCUM 28 DAYS OR OLDER (CPT 54161) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/54161?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“CIRCUM 28 DAYS OR OLDER (CPT 54161) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/54161?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,233–$3,874 (25th–75th percentile) across 2,203 hospitals · 5,952 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 54161 — 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
$1,233
$2,316 typical
$3,874
The middle 50% of negotiated facility rates for this procedure, measured across 2,203 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. | $2,316 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $181 × 1.22 commercial. | $221 |
| Likely subtotal | $2,537 |
Surgical episode (typical)
~$2,537
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)
~$6,322
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 |
|---|---|---|---|---|---|---|---|
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $10,679.34 | $1,067.93 | 2026-05-06 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $10,679.34 | $1,067.93 | 2026-05-14 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $10,679.34 | $1,067.93 | 2026-05-22 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $0.18 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCY HOSPITAL OKLAHOMA CITY, INC OutpatientFacility | LONGEVITY HEALTH PLAN [10477] | HB OKLC MANAGED MEDICARE | $0.30 | $9,067.79 | $5,894.06 | 2026-03-12 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Cigna | Commercial | — | $3,912.00 | $2,347.20 | 2026-05-22 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $2.25 | $532.00 | $399.00 | 2025-03-07 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (INDEPENDENCE) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | KAISER DOMESTIC | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CT (ANTHEM) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | WC DOMESTIC | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BCN DOMESTIC | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - LA | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - FEDERAL | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NM | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - CA | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OH (ANTHEM) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VT | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (ANTHEM) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MD (CAREFIRST) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AR | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (ANTHEM) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - KY (ANTHEM) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE DISTINCTION TRANSPLANT | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WI (ANTHEM) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - SD (WELLMARK) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MI | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - HI | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - GA (ANTHEM) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WA (PREMERA) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - SC | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WY | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NJ (HORIZON) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK WESTERN | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CARE NETWORK | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NE | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NV (ANTHEM) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OR (REGENCE) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MS | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MO (ANTHEM) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ME (ANTHEM) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ID | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (CAREFIRST) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AK (PREMERA) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AL | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - WA (REGENCE) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS DOMESTIC | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NH (ANTHEM) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - OK | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - RI | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CA (ANTHEM) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - KS | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - WV (HIGHMARK) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - TX | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (CAPITAL) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - ND | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - AZ | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - ID (REGENCE) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK HMO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - DE (HIGHMARK) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - TN | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MN | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BCBS GENERIC | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IN (ANTHEM) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - UT (REGENCE) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - DC (CAREFIRST) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (EXCELLUS) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK NORTHEASTERN | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MT | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - NC | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | PRE-EMPLOYMENT | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE SHIELD - PA (HIGHMARK) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - MA | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL ALTERNATE | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - CO (ANTHEM) | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER OutpatientFacility | BLUE CROSS - FL | WELLMARK PPO | $2.46 | — | $15,355.61 | 2026-03-31 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS TOGETHER W CHA [75001] | CHA HB MEDICAID-STANDARD | $4.44 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB MEDICAID-STANDARD | $4.44 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS GENERAL BRIGHAM [50021] | CHA HB MEDICAID-STANDARD | $4.44 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS HEALTH [70001] | CHA HB MEDICAID-STANDARD | $4.44 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB MEDICAID-STANDARD | $4.44 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | UNITED HEALTH [40002] | CHA HB MEDICAID-STANDARD | $4.44 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BOSTON MEDICAL CENTER - WELLSENSE [50003] | CHA HB MEDICAID-STANDARD | $4.44 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OOS MEDICAID [70002] | CHA HB MEDICAID-STANDARD | $4.44 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | AARP [40001] | CHA HB MEDICARE MANAGED CARE - UHC | $4.54 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | UNITED HEALTH [40002] | CHA HB MEDICARE MANAGED CARE - UHC | $4.54 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | RR MEDICARE [60002] | CHA HB MEDICARE | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | CHAMPVA [85001] | CHA HB TRICARE | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HEALTH SAFETY NET [80001] | CHA HB HEALTH SAFETY NET | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | ELDER SERVICE PLAN [65002] | CHA HB ELDER SERVICE PLAN | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER GOV'T PAYOR [85003] | CHA HB TRICARE | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | COMMONWEALTH CARE ALLIANCE [65001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TRICARE [85002] | CHA HB TRICARE | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BOSTON MEDICAL CENTER - WELLSENSE [50003] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HEALTH SAFETY NET [80001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BCBS - OUT OF STATE [10002] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | BCBS - MA [10001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS HEALTH PLAN [30001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HPHC [20001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | TUFTS HEALTH PLAN [30001] | CHA HB Tufts Health Plan Medicare Preferred | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MASS GENERAL BRIGHAM [50021] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | CIGNA [50005] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | SENIOR WHOLE HEALTH [65003] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | AETNA [50001] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | HUMANA [50008] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER COMMERCIAL PAYOR [50015] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB FALLON | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | FALLON [50006] | CHA HB FALLON CAREPLUS | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB MEDICARE MANAGED CARE 100 PCT | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | MEDICARE [60001] | CHA HB MEDICARE | $5.04 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $5.68 | $501.00 | $95.19 | 2026-01-25 | MRF ↗ |
| COMANCHE COUNTY MEDICAL CENTER Outpatient | MPI - ALL PLANS | MPI - ALL PLANS | $6.25 | $516.00 | $335.40 | 2026-05-07 | MRF ↗ |
| VALLEY MEDICAL CENTER Outpatient | GREAT WEST [190102] | CIGNA.COMMERCIAL.FACILITY.VMC | $6.56 | $20,904.83 | $14,633.38 | 2026-03-12 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | CIGNA | CIGNA COMMERCIAL-ALLEG | $7.20 | $28.78 | $28.78 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | CIGNA | CIGNA COMMERCIAL-PPO | $7.20 | $28.78 | $28.78 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | CIGNA | CIGNA COMMERCIAL-BH | $7.20 | $28.78 | $28.78 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | CIGNA | CIGNA COMMERCIAL-ALLEG | $7.20 | $28.78 | $28.78 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | CIGNA | CIGNA COMMERCIAL-PPO | $7.20 | $28.78 | $28.78 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | CIGNA | CIGNA COMMERCIAL | $7.20 | $28.78 | $28.78 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | CIGNA | CIGNA COMMERCIAL-BH | $7.20 | $28.78 | $28.78 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | CIGNA | CIGNA COMMERCIAL | $7.20 | $28.78 | $28.78 | 2026-03-27 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Outpatient | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB TUFTS HEALTH PUBLIC PLANS QHP NON-SUBSIDIZED | $8.13 | $4,422.31 | $4,422.31 | 2026-03-20 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | BCBS MEDICARE [250503] | BCBS MEDICARE REPLACEMENT [25050301] | $10.20 | $22,412.58 | $4,482.52 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | CIGNA MCR HMO/PPO [250525] | MEDICARE REPLACEMENT [25052501] | $10.20 | $22,412.58 | $4,482.52 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | WELLCARE HEALTH PLAN [250516] | MEDICARE REPLACEMENT [25051601] | $10.20 | $22,412.58 | $4,482.52 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | AETNA COVENTRY MCR REPLACEMENT [250518] | AETNA MEDICARE [25051801] | $10.38 | $22,412.58 | $4,482.52 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | UNITED HEALTH MCR HMO/PPO [250515] | UHC MEDICARE REPLACEMENT [25051501] | $10.38 | $22,412.58 | $4,482.52 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | HUMANA GOLD [250508] | PFFS MEDICARE REPLACEMENT [25050801] | $10.38 | $22,412.58 | $4,482.52 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | FREEDOM HEALTH [250505] | FREEDOM HLTH MEDICARE REPLACEMENT [25050501] | $10.39 | $22,412.58 | $4,482.52 | 2026-03-26 | MRF ↗ |
| CAPE CORAL HOSPITAL OutpatientFacility | ALIGN SENIOR CARE [250524] | ALIGN MEDICARE REPLACEMENT [25052401] | $10.39 | $22,412.58 | $4,482.52 | 2026-03-26 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $10.47 | $5,816.00 | $2,036.51 | 2024-12-31 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $11.36 | $814.00 | $814.00 | 2026-02-13 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | UNITED HEALTHCARE | UNITED COMMERCIAL | $12.95 | $28.78 | $28.78 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | HUMANA | HUMANA COMMERCIALEXCHHMO | $12.95 | $28.78 | $28.78 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | HUMANA | HUMANA COMMERCIALEXCHHMO | $12.95 | $28.78 | $28.78 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | HUMANA | HUMANA COMMERCIALEXCHPPO | $12.95 | $28.78 | $28.78 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | HUMANA | HUMANA COMMERCIALEXCHPPO | $12.95 | $28.78 | $28.78 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | UNITED HEALTHCARE | UNITED COMMERCIAL | $12.95 | $28.78 | $28.78 | 2026-03-27 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $16.13 | — | — | 2026-04-14 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | SEDGWICK [700027] | WC SEDGWICK [70002701] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS WORK COMP [700028] | WC TRAVELERS [70002801] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | GALLAGHER BASSETT WORK COMP [700013] | WC GALLAGHER BASSETT [70001301] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA SEMC EMPLOYEE [70005902] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NY CTRL MUTUAL NF [800004] | NF NY CTRL MUTUAL [80000401] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL WORK COMP [700016] | WC LIBERTY MUTUAL [70001601] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | GEICO AUTO INSURANCE [800003] | NF GEICO AUTO INSURANCE [80000301] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL WORK COMP [700016] | WC LIBERTY MUTUAL [70001601] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | CHARTIS WC [700029] | WC CHARTIS [70002901] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STATE FARM AUTO INSURANCE NF [800026] | NF STATE FARM AUTO INSURANCE [80002601] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STRATEGIC COMP SERVICES [700061] | WC STRATEGIC COMP SERVICES [70006101] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NYSIF [700058] | WC NY STATE INSURANCE FUND [70005801] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ERIE INS NF [800002] | NF ERIE INS [80000201] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC TRAVELER'S SEMC EMPLOYEE [70005904] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | SEDGWICK [700027] | WC SEDGWICK [70002701] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | NCA WC [700057] | WC NCA [70005701] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA FSLH EMPLOYEE [70005901] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | TRAVELERS WORK COMP [700028] | WC TRAVELERS [70002801] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL AUTO INSURANCE [800008] | NF LIBERTY MUTUAL AUTO INS [80000801] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ESIS WORK COMP [700010] | WC ESIS [70001001] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | HARTFORD INS WC [700055] | WC HARTFORD INS [70005501] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | CORVEL CORP WC [700054] | WC CORVEL CORP [70005401] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MVHS WORKMANS COMPENSATION [700059] | WC PMA SEMC EMPLOYEE [70005902] | $18.81 | $18,023.27 | $10,813.96 | 2025-01-17 | 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.