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 $1,190–$3,937 (25th–75th percentile) across 2,696 hospitals · 6,694 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 physician fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$1,190
$2,292 typical
$3,937
The middle 50% of negotiated facility rates for this procedure, measured across 2,696 hospitals. The physician 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. | $2,292 |
| Physician fee Estimate national typical Medicare $181 × 1.22 commercial. | $221 |
| Likely subtotal | $2,513 |
Complete-episode estimate (typical)
~$2,513
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge
- 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 $1,190–$3,937.
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Physician 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 |
|---|---|---|---|---|---|---|---|
| Arkansas Children's Hospital Outpatient | Ambetter, Qualchoice Novasys | All Plans | — | $5,346.99 | $4,812.29 | 2026-07-15 | MRF ↗ |
| Arkansas Children's Hospital Outpatient | United Healthcare | All Plans | — | $5,346.99 | $4,812.29 | 2026-07-15 | MRF ↗ |
| O U MEDICAL CENTER Outpatient | Humana | Healthy Horizons Medicaid | — | $10,679.34 | $1,067.93 | 2026-07-18 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Cigna | Commercial | — | $3,912.00 | $2,347.20 | 2026-07-15 | MRF ↗ |
| Utmb Galveston Transplant Outpatient | Cigna | Hmo Ppo Pos | — | $19,691.85 | $8,933.06 | 2026-07-15 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $2.25 | $1,786.00 | $1,339.50 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $2.25 | $532.00 | $399.00 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $2.25 | $532.00 | $399.00 | 2026-07-01 | MRF ↗ |
| PEMISCOT COUNTY MEMORIAL HOSPITAL Outpatient | Cigna | Commercial | $3.20 | $382.00 | $267.40 | 2026-07-15 | MRF ↗ |
| PEMISCOT COUNTY MEMORIAL HOSPITAL Outpatient | Anthem Traditional | Commercial | $4.86 | $382.00 | $267.40 | 2026-07-15 | 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 ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $5.68 | $685.00 | $130.15 | 2026-05-20 | MRF ↗ |
| COMANCHE COUNTY MEDICAL CENTER Outpatient | MPI - ALL PLANS | MPI - ALL PLANS | $6.25 | $516.00 | $335.40 | 2026-05-07 | MRF ↗ |
| MOBRIDGE REGIONAL HOSPITAL - CAH Outpatient | SANFORD HEALTHPLAN-ALL PLANS | SANFORD HEALTHPLAN-ALL PLANS | $8.55 | $1,071.00 | $1,071.00 | 2026-07-16 | MRF ↗ |
| RARITAN BAY 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 | 2026-06-03 | 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 ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Medicare | Medicare | $17.66 | $1,243.00 | $932.25 | 2026-10-01 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Bcbs Medicare | Medicare | $17.66 | $1,243.00 | $932.25 | 2026-10-01 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Vaccn | Medicare | $17.66 | $1,243.00 | $932.25 | 2026-10-01 | MRF ↗ |
| WINNMED Outpatient | AETNA/FIRST HEALTH PHO | AETNA/FIRST HEALTH PHO | $19.59 | $791.00 | $553.70 | 2026-07-14 | MRF ↗ |
| WINNMED Outpatient | AETNA/FIRST HEALTH HMO | AETNA/FIRST HEALTH HMO | $19.59 | $791.00 | $553.70 | 2026-07-14 | MRF ↗ |
| WINNMED Outpatient | AETNA/FIRST HEALTH PPO-ALL OTHER PLANS | AETNA/FIRST HEALTH PPO-ALL OTHER PLANS | $19.59 | $791.00 | $553.70 | 2026-07-14 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | TRIWEST WELLMARK-ALL PLANS | TRIWEST WELLMARK-ALL PLANS | $19.73 | $54.80 | $49.32 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | VA CCN -ALL PLANS | VA CCN -ALL PLANS | $19.73 | $54.80 | $49.32 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | TRICARE- ALL PLANS | TRICARE- ALL PLANS | $19.73 | $54.80 | $49.32 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MEDICAL ASSOCIATES-ALL PLANS | MEDICAL ASSOCIATES-ALL PLANS | $19.73 | $54.80 | $49.32 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | WELLMARK MCR ADV- ALL PLANS | WELLMARK MCR ADV- ALL PLANS | $19.93 | $54.80 | $49.32 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | UHC MCR ADV | UHC MCR ADV | $20.32 | $54.80 | $49.32 | 2026-01-03 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Univera | Medicare Managed Care Plan | $20.43 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $20.43 | — | — | 2026-04-01 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Blue Cross | 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 | Molina | Mangaged Medicare | — | — | — | 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 | First Choice Select Health | Managed Medicaid | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | America'S First Choice | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Aetna | Managed Medicare | — | — | — | 2026-10-03 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE MCAL PROFEE ONLY | CENTRAL CA ALLIANCE MCAL PROFEE ONLY | $25.00 | $685.00 | $130.15 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CAL VIVA HLTH MCAL - ALL PLANS | CAL VIVA HLTH MCAL - ALL PLANS | $25.00 | $685.00 | $130.15 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | BC MCAL | BC MCAL | $25.00 | $685.00 | $130.15 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | MEDI-CAL | MEDI-CAL | $25.00 | $685.00 | $130.15 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | UPN MCAL PROFEE ONLY-ALL OTHER PLANS | UPN MCAL PROFEE ONLY-ALL OTHER PLANS | $25.00 | $685.00 | $130.15 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS | DIGNITY MCAL OP/PROFEE ONLY-ALL OTHER PLANS | $25.00 | $685.00 | $130.15 | 2026-05-20 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $27.00 | $200.00 | $150.00 | 2026-01-16 | MRF ↗ |
| ADVENTIST HEALTH CASTLE Outpatient | PACIFIC ADMIN PPO - ALL PLANS | PACIFIC ADMIN PPO - ALL PLANS | $29.27 | $497.00 | $159.04 | 2026-05-18 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | OSCAR-ALL PLANS | OSCAR-ALL PLANS | $29.59 | $54.80 | $49.32 | 2026-01-03 | MRF ↗ |
| DECATUR COUNTY MEMORIAL HOSPITAL Outpatient | UHC-ALL OTHER PLANS | UHC-ALL OTHER PLANS | $30.00 | $685.00 | $513.75 | 2026-03-18 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | KAISER MEDI-CAL | KAISER MEDI-CAL | $30.00 | $685.00 | $137.00 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $30.00 | $685.00 | $137.00 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | KERN HEALTH SYSTEMS MCAL-ALL PLANS | KERN HEALTH SYSTEMS MCAL-ALL PLANS | $31.25 | $685.00 | $130.15 | 2026-05-20 | MRF ↗ |
| PELLA REGIONAL HEALTH CENTER Outpatient | Wellmark Inc Dba Wellmark Blue Cross And Blue Shield Of Iowa | Ppo | $32.60 | $554.00 | $554.00 | 2026-07-15 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | MA-BEHAVIORAL HEALTH | $34.22 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $34.22 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $34.56 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE CCS PROFEE ONLY | CENTRAL CA ALLIANCE CCS PROFEE ONLY | $37.50 | $685.00 | $130.15 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P | CENTRAL CA ALLIANCE COMM PROFEE ONLY - ALL OTHER P | $37.50 | $685.00 | $130.15 | 2026-05-20 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | HEALTHNET | MEDICARE ADV. | $37.64 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $37.64 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $38.33 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MIDLANDS NEW BUSINESS | MIDLANDS NEW BUSINESS | $38.36 | $54.80 | $49.32 | 2026-01-03 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $38.94 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $38.94 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | HUMANA | MEDICARE ADV. | $39.33 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $39.33 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | HUMANA | MEDICARE ADV. | $39.33 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $39.33 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN LEBANON COMMUNITY HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $39.35 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| ISLAND HOSPITAL Outpatient | HUMANA COMM - ALL OTHER PLANS | HUMANA COMM - ALL OTHER PLANS | — | $434.00 | $434.00 | 2025-03-18 | MRF ↗ |
| ISLAND HOSPITAL Outpatient | MULTIPLAN - ALL PLANS | MULTIPLAN - ALL PLANS | $40.00 | $434.00 | $434.00 | 2025-03-18 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $41.50 | $200.00 | $150.00 | 2026-01-16 | MRF ↗ |
| CHAMBERS MEMORIAL HOSPITAL Outpatient | CARESOURCE MCAID | CARESOURCE MCAID | $42.02 | $1,118.36 | $559.18 | 2026-05-05 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PROVIDENCE | MEDICARE ADV. | $42.48 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $42.83 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $42.83 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | SAMARITAN | MEDICARE ADV. | $42.90 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $43.61 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $43.61 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $44.78 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| SAMARITAN PACIFIC COMMUNITY HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $44.78 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA HMO | AVERA HMO | $46.00 | $1,128.00 | $676.80 | 2025-12-20 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA ACA PPO - ALL OTHER PLANS | AVERA ACA PPO - ALL OTHER PLANS | $46.00 | $1,128.00 | $676.80 | 2025-12-20 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | REGENCE | MEDICARE ADV. | $46.73 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP EXCHANGE-INDIVIDUAL | $47.17 | $9,175.41 | $5,964.02 | 2024-12-30 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $47.24 | $54.80 | $49.32 | 2026-01-03 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | PACIFICSOURCE | MEDICARE ADV. | $47.58 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $47.84 | — | — | 2026-03-18 | MRF ↗ |
| COLUMBIA MEMORIAL HOSPITAL BothFacility | WASHINGTON STATE DSHS - Medicaid | WASHINGTON STATE DSHS - Medicaid | $47.89 | $313.00 | $250.40 | 2026-01-05 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA ASO PPO | AVERA ASO PPO | $48.00 | $1,128.00 | $676.80 | 2025-12-20 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $48.14 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $48.14 | — | — | 2026-03-18 | MRF ↗ |
| TRI-STATE MEMORIAL HOSPITAL BothFacility | Wellcare | PPO | $48.40 | $100.00 | $99.00 | 2026-06-26 | MRF ↗ |
| TRI-STATE MEMORIAL HOSPITAL BothFacility | Wellcare | HMO | $48.40 | $100.00 | $99.00 | 2026-06-26 | MRF ↗ |
| MARSHALL MEDICAL CENTER OutpatientFacility | MOUNTAIN VALLEY HEALTH PLAN | Medicaid | $48.58 | $27,156.72 | — | 2024-04-30 | MRF ↗ |
| SAMARITAN NORTH LINCOLN HOSPITAL OutpatientFacility | DEVOTED HEALTH | DEVOTED HEALTH MCR ADVANTAGE | $48.85 | $118.00 | $94.40 | 2026-01-31 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Medicare|Negotiated_Percentage | — | $49.00 | $403.00 | $241.80 | 2026-08-01 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | $17,411.25 | 2024-12-08 | MRF ↗ |
| S E LACKEY MEMORIAL HOSPITAL Outpatient | CIGNA COMM - ALL PLANS | CIGNA COMM - ALL PLANS | $50.00 | $530.00 | $530.00 | 2026-02-10 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | CENTRAL CA ALLIANCE CHDP PROFEE ONLY | CENTRAL CA ALLIANCE CHDP PROFEE ONLY | $50.00 | $685.00 | $130.15 | 2026-05-20 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| OKEENE MUNICIPAL HOSPITAL Outpatient | PREF COMMUNITY CHOICE PPO-ALL PLANS | PREF COMMUNITY CHOICE PPO-ALL PLANS | $51.00 | $340.00 | $272.00 | 2026-08-12 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MULTIPLAN-ALL PLANS | MULTIPLAN-ALL PLANS | $52.06 | $54.80 | $49.32 | 2026-01-03 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $52.09 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $52.41 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $52.41 | — | — | 2026-03-18 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | Ambetter | Commercial|All Plans | $52.78 | $280.00 | $49.00 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | Ambetter | Commercial|All Plans | $52.78 | $280.00 | $49.00 | 2026-02-28 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MIDLANDS CHOICE - ALL OTHER PLANS | MIDLANDS CHOICE - ALL OTHER PLANS | $53.16 | $54.80 | $49.32 | 2026-01-03 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | UHC MCR ADV | UHC MCR ADV | $53.38 | $157.00 | $94.20 | 2025-11-18 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA NONACA PPO | AVERA NONACA PPO | $54.00 | $1,128.00 | $676.80 | 2025-12-20 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Blue Cross | Blue Access & Small Group | $54.54 | — | — | 2026-07-18 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | Wellpoint | Commercial|Exchange | $54.60 | $280.00 | $49.00 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | Wellpoint | Commercial|Exchange | $54.60 | $280.00 | $49.00 | 2026-02-28 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | UNIVERSAL HC MCAL PROFEE | UNIVERSAL HC MCAL PROFEE | $55.00 | $685.00 | $130.15 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | BC MCAL | BC MCAL | $55.00 | $685.00 | $130.15 | 2026-05-19 | MRF ↗ |
| Madera Community Hospital Outpatient | MEDI-CAL | MEDI-CAL | $55.00 | $367.00 | $220.20 | 2026-07-30 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $55.00 | $685.00 | $130.15 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | KAISER MCAL | KAISER MCAL | $55.00 | $685.00 | $130.15 | 2026-05-19 | MRF ↗ |
| ADVENTIST HEALTH HANFORD Outpatient | MEDI-CAL | MEDI-CAL | $55.00 | $685.00 | $130.15 | 2026-05-19 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Blue Cross | Epo/Ppo/Hmo/Indemnity | $58.18 | — | — | 2026-07-18 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | First Health Network | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Montana Health CoOp | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Prime Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Interwest Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Coventry | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | UHC | Medicare Advantage | $59.52 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $59.52 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $59.52 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Tricare | All | $59.52 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Pacific Source | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | VA Health | All | $59.52 | — | — | 2026-03-28 | MRF ↗ |
| COLUMBIA MEMORIAL HOSPITAL BothFacility | WASHINGTON STATE DSHS - Medicaid | WASHINGTON STATE DSHS - Medicaid | $59.98 | $392.00 | $313.60 | 2026-01-05 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CELTIC CA HLTH WELL MCAL - ALL PLANS | CELTIC CA HLTH WELL MCAL - ALL PLANS | $60.00 | $685.00 | $116.45 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $60.00 | $685.00 | $116.45 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | CENTRAL CA ALLIANCE MCAL | CENTRAL CA ALLIANCE MCAL | $60.00 | $685.00 | $116.45 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | BC MCAL | BC MCAL | $60.00 | $685.00 | $116.45 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | MEDI-CAL | MEDI-CAL | $60.00 | $685.00 | $116.45 | 2026-05-23 | MRF ↗ |
| WYNN HOSPITAL Outpatient | UNITED HEALTHCARE ALTERNATE [100260] | UHC EMPIRE ALTERNATE [10026001] | $60.90 | $18,023.27 | $10,813.96 | 2025-01-17 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | TRICARE - ALL PLANS | TRICARE - ALL PLANS | $60.92 | $157.00 | $94.20 | 2025-11-18 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | BCBS | Medicare|All Plans | $61.60 | $280.00 | $49.00 | 2026-02-28 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | BCBS | Medicare|All Plans | $61.60 | $280.00 | $49.00 | 2026-02-28 | MRF ↗ |
| PALM BAY HOSPITAL Outpatient | United Healthcare | United Healthcare Florida Healthy Kids | $62.58 | $32,760.83 | $8,190.21 | 2026-07-15 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | UHC VA CCN | UHC VA CCN | $62.80 | $157.00 | $94.20 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | MOLINA MCR ADV | MOLINA MCR ADV | $62.80 | $157.00 | $94.20 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | IOWA TOTAL CARE MCR | IOWA TOTAL CARE MCR | $62.80 | $157.00 | $94.20 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | AMERIGROUP MCR ADV | AMERIGROUP MCR ADV | $62.80 | $157.00 | $94.20 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | IOWA TOTAL CARE COMM - ALL OTHER PLANS | IOWA TOTAL CARE COMM - ALL OTHER PLANS | $62.80 | $157.00 | $94.20 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | HUMANA MEDICARE-ALL PLANS | HUMANA MEDICARE-ALL PLANS | $62.80 | $157.00 | $94.20 | 2025-11-18 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | UNITED | Medicare|All Plans | $62.84 | $280.00 | $49.00 | 2026-02-28 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | UNITED | Medicare|All Plans | $62.84 | $280.00 | $49.00 | 2026-02-28 | MRF ↗ |
| NORTHWEST MISSISSISSIPPI REGIONAL MEDICAL CENTER Both | MS PHY CARE NTWRK MPCN | MS PHY CARE NTWK MPCN | $62.96 | $314.80 | $78.70 | 2026-09-14 | MRF ↗ |
| NORTHWEST MISSISSISSIPPI REGIONAL MEDICAL CENTER Both | MEDPARTNERS FIRST CHOICE | MEDPARTNERS FIRST CHOICE | $62.96 | $314.80 | $78.70 | 2026-09-14 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | AMERIVANTAGE | Medicare|All Plans | $63.45 | $280.00 | $49.00 | 2026-02-28 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | AMERIVANTAGE | Medicare|All Plans | $63.45 | $280.00 | $49.00 | 2026-02-28 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | MEDICARE HMO INDEPENDENT HLTH [13802] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | INDEPENDENT HEALTH ASSOCIATION,IN [138] | INDEPENDENT HEALTH ASSOC [13801] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 3&4 [18804] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK [11401] | — | $321.34 | $321.34 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN [10104] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK [11401] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK MEDICARE [11402] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | MVP [109] | MVP GOLD PPO [10921] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | WELLCARE MEDICARE HMO [122] | WELLCARE MEDICARE HMO [12201] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 1&2 [18803] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | FIDELIS EXCHANGE [157] | FIDELIS(INCLUDING GOLD,SILVER,BRONZE AND PLATINUM) [15701] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED HEALTHCARE [101] | UHC DUAL COMPLETE [10117] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK MEDICARE [11402] | — | $321.34 | $321.34 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED HEALTHCARE [101] | UNITED HEALTHCARE [10101] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | MVP [109] | MVP [10905] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | EXCELLUS HMO [104] | MEDICARE BLUE CHOICE [10406] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | VALUE OPTIONS [145] | VALUE OPTIONS OPTION [14503] | — | $321.34 | $321.34 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA MEDICAID MANAGED CARE [18801] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | VALUE OPTIONS [145] | VALUE OPTIONS [14501] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | VALUE OPTIONS [145] | VALUE OPTIONS OPTION [14503] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | VALUE OPTIONS [145] | VALUE OPTIONS GOLD [14502] | — | $321.34 | $321.34 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MAGNACARE [115] | MAGNACARE [11501] | — | $321.34 | $321.34 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 1&2 [18803] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | MAGNACARE [115] | MAGNACARE [11501] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | VALUE OPTIONS [145] | VALUE OPTIONS GOLD [14502] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | GENERIC CARRIER [107] | COMMERCIAL [10701] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN [10104] | $63.46 | $321.34 | $321.34 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | VALUE OPTIONS [145] | VALUE OPTIONS [14501] | — | $321.34 | $321.34 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK ESSENTIALS [11404] | — | $321.34 | $321.34 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | FIDELIS EXCHANGE [157] | FIDELIS ESSENTIAL 1&2 [15702] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | MVP [109] | MVP ESSENTIAL 1&2 [10911] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | GENERIC CARRIER [107] | COMMERCIAL [10701] | — | $321.34 | $321.34 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | EXCELLUS HMO [104] | EXCELLUS ESSENTIAL 1&2 [10413] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 3&4 [18804] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | GENERIC MEDICARE HMO [125] | GENERIC MEDICARE HMO [12505] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | MVP [109] | MVP ESSENTIAL 3&4 [10912] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | MVP [109] | MVP OPTION [10902] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | WELLCARE MEDICARE HMO [122] | WELLCARE DUAL [12205] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK MEDICARE [11402] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | WELLCARE MEDICARE HMO [122] | WELLCARE MEDICARE HMO [12201] | — | $64.27 | $64.27 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN [10104] | $63.46 | $321.34 | $321.34 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | GENERIC MEDICARE HMO [125] | GENERIC MEDICARE HMO [12505] | — | $321.34 | $321.34 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK MEDICARE [11402] | — | $321.34 | $321.34 | 2024-12-30 | 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.