5524 — Level 4 Imaging Without Contrast
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Level 4 Imaging without Contrast (OTHER 5524) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/5524?code_type=OTHER
MLA (9th ed.)
“Level 4 Imaging without Contrast (OTHER 5524) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/5524?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“Level 4 Imaging without Contrast (OTHER 5524) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/5524?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $533–$1,255 (25th–75th percentile) across 792 hospitals · 941 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 5524 — 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 |
|---|---|---|---|---|---|---|---|
| O U MEDICAL CENTER | Healthchoice Ppo | — | $0.33 | $3.25 | $0.33 | 2026-07-31 | 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 - FOUNTAIN VALLEY 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 ↗ |
| O U MEDICAL CENTER | Medica Harmony Sync | — | $0.68 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| O U MEDICAL CENTER | Bright Health Plan | — | $0.68 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| PENN HIGHLANDS BROOKVILLE OutpatientFacility | Geisinger Family Medicaid Hmo | All Plans | $1.00 | — | — | 2025-08-01 | MRF ↗ |
| O U MEDICAL CENTER | Cigna All Other Ppo | — | $1.13 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| O U MEDICAL CENTER | Healthcare Highways Chicksaw Nation | — | $1.14 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| O U MEDICAL CENTER | Healthcare Highways Norman Regional | — | $1.14 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| O U MEDICAL CENTER | Aetna Hmo | — | $1.23 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| O U MEDICAL CENTER | Healthcare Highways D1 | — | $1.30 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| O U MEDICAL CENTER | Globalhealth Hmo | — | $1.30 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| UCI HEALTH-LAKEWOOD 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 ↗ |
| UCI HEALTH - LOS ALAMITOS OutpatientFacility | Caloptima | Medi-Cal Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| UCI HEALTH - FOUNTAIN VALLEY OutpatientFacility | Caloptima | Medi-Cal Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| O U MEDICAL CENTER | Healthcare Highways D2 | — | $1.63 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| O U MEDICAL CENTER | Coventry Ppo | — | $1.72 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| O U MEDICAL CENTER | Cigna Open Access | — | $1.72 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| O U MEDICAL CENTER | Cigna Ppo Payor Solutions Strategic Alliances | — | $1.89 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| O U MEDICAL CENTER | Aetna Ec Mc Pos | — | $1.92 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| O U MEDICAL CENTER | First Health Ppo | — | $2.18 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| O U MEDICAL CENTER | Humana Choicecare Ppo | — | $2.28 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| O U MEDICAL CENTER | Preferred Community Choice | — | $2.60 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| O U MEDICAL CENTER | Quiktrip | — | $2.67 | $3.25 | $0.33 | 2026-07-31 | MRF ↗ |
| SAINT JOSEPH'S HOSPITAL OF ATLANTA, INC OutpatientFacility | CareSource | Medicaid Managed Care Plan | $3.00 | — | — | 2024-09-01 | MRF ↗ |
| FIRSTHEALTH MOORE REGIONAL HOSPITAL OutpatientFacility | Healthy Blue | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| CHEROKEE MEDICAL CENTER OutpatientFacility | Aetna | Sc Preferred Other Commercial Plan | — | — | — | 2026-04-01 | MRF ↗ |
| BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH OutpatientFacility | Aetna | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| SSM HEALTH SAINT LOUIS UNIVERSITY HOSPITAL OutpatientFacility | Bcbs | Community Il Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PALOMAR MEDICAL CENTER POWAY OutpatientFacility | Medi-Cal | Medicaid -Traditional | $13.56 | — | — | 2025-11-01 | MRF ↗ |
| PAOLI HOSPITAL OutpatientFacility | Blue Cross | Dvaco Other Commercial Plan | — | — | — | 2026-04-01 | MRF ↗ |
| BRYN MAWR HOSPITAL OutpatientFacility | Blue Cross | Dvaco Other Commercial Plan | — | — | — | 2026-04-01 | MRF ↗ |
| RIDDLE MEMORIAL HOSPITAL OutpatientFacility | Blue Cross | Dvaco Other Commercial Plan | — | — | — | 2026-04-01 | MRF ↗ |
| RIDDLE MEMORIAL HOSPITAL OutpatientFacility | Blue Cross | DVACO Other Commercial Plan | $15.00 | — | — | 2025-07-01 | MRF ↗ |
| BRYN MAWR HOSPITAL OutpatientFacility | Blue Cross | Dvaco Other Commercial Plan | — | — | — | 2026-04-01 | MRF ↗ |
| BRYN MAWR HOSPITAL OutpatientFacility | Blue Cross | Dvaco Other Commercial Plan | — | — | — | 2026-04-01 | MRF ↗ |
| MAIN LINE HOSPITAL LANKENAU OutpatientFacility | Blue Cross | Dvaco Other Commercial Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PAOLI HOSPITAL OutpatientFacility | Blue Cross | DVACO Other Commercial Plan | $15.00 | — | — | 2025-07-01 | MRF ↗ |
| RIDDLE MEMORIAL HOSPITAL OutpatientFacility | Blue Cross | Dvaco Other Commercial Plan | — | — | — | 2026-04-01 | MRF ↗ |
| ADVENTHEALTH TAMPA OutpatientFacility | Sunshine State Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| NORTH MISSISSIPPI MEDICAL CENTER OutpatientFacility | Bcbs | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| NEWPORT HOSPITAL OutpatientFacility | United Healthcare | Medicaid Managed Care Plan | $18.88 | — | — | 2025-01-01 | MRF ↗ |
| NORTHWEST COMMUNITY HOSPITAL 1 OutpatientFacility | Bcbs | Hmo | — | — | — | 2026-04-01 | MRF ↗ |
| INGALLS MEMORIAL HOSPITAL OutpatientFacility | Bcbs | Hmo | — | — | — | 2026-04-01 | MRF ↗ |
| ORLANDO HEALTH BAYFRONT HOSPITAL OutpatientFacility | Florida Community Care | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| EXETER HOSPITAL INC OutpatientFacility | Harvard Pilgrim Healthcare | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| SENTARA NORTHERN VIRGINIA MEDICAL CENTER OutpatientFacility | Humana | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| Endeavor Health Glenbrook Hospital OutpatientFacility | BCBS | HMO | — | — | — | 2026-04-01 | MRF ↗ |
| Endeavor Health Glenbrook Hospital OutpatientFacility | Bcbs | Hmo | — | — | — | 2026-04-01 | MRF ↗ |
| Endeavor Health Highland Park Hospital OutpatientFacility | BCBS | HMO | — | — | — | 2026-04-01 | MRF ↗ |
| Skokie Hospital OutpatientFacility | Bcbs | Hmo | — | — | — | 2026-04-01 | MRF ↗ |
| ORLANDO HEALTH SOUTH LAKE HOSPITAL OutpatientFacility | Multiplan | Ppo | — | — | — | 2026-04-01 | MRF ↗ |
| SWEDISH HOSPITAL OutpatientFacility | Bcbs | Hmo | — | — | — | 2026-04-01 | MRF ↗ |
| NORTHSHORE UNIVERSITY HEALTHSYSTEM - EVANSTON HOSPITAL OutpatientFacility | Bcbs | Hmo | — | — | — | 2026-04-01 | MRF ↗ |
| SSM HEALTH ST MARY'S HOSPITAL - MADISON OutpatientFacility | Wps | Statewide Other Commercial Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE CEDARS SINAI TARZANA MEDICAL CENTER OutpatientFacility | Blue Cross | Anthem Vivity City Of La Other Commercial Plan | — | — | — | 2026-04-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Anthem | Essential Plan 200-250 | — | — | — | 2026-04-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Anthem | Essential Plan 1-2 | — | — | — | 2026-04-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Anthem | Essential Plan 3-4 | — | — | — | 2026-04-01 | MRF ↗ |
| Endeavor Health Highland Park Hospital OutpatientFacility | Bcbs | Hmo | — | — | — | 2026-04-01 | MRF ↗ |
| SHELBY BAPTIST MEDICAL CENTER OutpatientFacility | Multiplan | Ppo | — | — | — | 2026-04-01 | MRF ↗ |
| ORLANDO HEALTH SOUTH LAKE HOSPITAL OutpatientFacility | Multiplan | Ppo | — | — | — | 2026-04-01 | MRF ↗ |
| Orlando Health Dr. P. Phillips Hospital OutpatientFacility | Unitedhealthcare | International Other Commercial Plan | — | — | — | 2026-04-01 | MRF ↗ |
| EDWARD HOSPITAL OutpatientFacility | Bcbs | Hmo | — | — | — | 2026-04-01 | MRF ↗ |
| FREEMAN NEOSHO HOSPITAL OutpatientFacility | Uhc Ppo 30555 | All Plans | $27.00 | — | — | 2025-05-01 | MRF ↗ |
| WEST CHESTER HOSPITAL OutpatientFacility | Aetna | Aetna Rental Network - Nab/First Health All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| CLINTON REGIONAL HOSPITAL OutpatientFacility | Aetna | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Molina | Medicaid HMO | — | — | — | 2026-04-01 | MRF ↗ |
| WELLSTAR DOUGLAS MEDICAL CENTER OutpatientFacility | Sonder | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| WELLSTAR PAULDING MEDICAL CENTER OutpatientFacility | Sonder | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| WELLSTAR WEST GEORGIA MEDICAL CENTER OutpatientFacility | Sonder | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| ST ELIZABETH EDGEWOOD OutpatientFacility | Humana | Other Plan | $35.54 | — | — | 2024-07-01 | MRF ↗ |
| ST ELIZABETH GRANT OutpatientFacility | Humana | Other Plan | $35.54 | — | — | 2024-07-01 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| HOUSTON METHODIST CLEAR LAKE HOSPITAL OutpatientFacility | Multiplan | Ppo | — | — | — | 2026-04-01 | MRF ↗ |
| MEMORIALCARE LONG BEACH MEDICAL CENTER OutpatientFacility | Blue Shield | Promise Health Plan Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| MEMORIALCARE LONG BEACH MEDICAL CENTER OutpatientFacility | Blue Shield | Promise Health Plan Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| GRACE SURGICAL HOSPITAL OutpatientFacility | Humana | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| BOONE HOSPITAL CENTER OutpatientFacility | Aetna | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| OSF ST FRANCIS HOSPITAL AND MEDICAL GROUP OutpatientFacility | UnitedHealthCare | Medicare Managed Care Plan | — | — | — | 2026-03-31 | MRF ↗ |
| SWEDISH HOSPITAL OutpatientFacility | Bcbs | Hmo | — | — | — | 2026-04-01 | MRF ↗ |
| COREWELL HEALTH TRENTON HOSPITAL OutpatientFacility | Priority Health | Exchange | — | — | — | 2026-04-01 | MRF ↗ |
| MEMORIALCARE SADDLEBACK MEDICAL CENTER OutpatientFacility | Healthnet | Hmo/Ppo | — | — | — | 2026-04-01 | MRF ↗ |
| MEMORIALCARE SADDLEBACK MEDICAL CENTER OutpatientFacility | Healthnet | Hmo/Ppo | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE ST. JOSEPH HOSPITAL OutpatientFacility | Caloptima | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| NORTHWEST COMMUNITY HOSPITAL 1 OutpatientFacility | Meridian | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| SENTARA WILLIAMSBURG REGIONAL MEDICAL CENTER OutpatientFacility | Humana | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| NORTHWEST COMMUNITY HOSPITAL 1 OutpatientFacility | Countycare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| EDWARD HOSPITAL OutpatientFacility | Meridian | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Emblem Health - HIP | Medicaid HMO | — | — | — | 2026-04-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Metroplus | Essential Plan 1-2 | — | — | — | 2026-04-01 | MRF ↗ |
| NORTHWEST COMMUNITY HOSPITAL 1 OutpatientFacility | Aetna | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| NORTHWEST COMMUNITY HOSPITAL 1 OutpatientFacility | Bcbs | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| NORTHWEST COMMUNITY HOSPITAL 1 OutpatientFacility | Youthcare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Molina | Essential Plan 1-2 | — | — | — | 2026-04-01 | MRF ↗ |
| LEGACY EMANUEL MEDICAL CENTER OutpatientFacility | Bcbs | Regence - Legacy Lhp All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| OHIOHEALTH O'BLENESS HOSPITAL OutpatientFacility | The Health Plan | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| LEGACY MOUNT HOOD MEDICAL CENTER OutpatientFacility | Bcbs | Regence - Legacy Lhp All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| LEGACY EMANUEL MEDICAL CENTER OutpatientFacility | BCBS | Regence - Legacy LHP All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Private Healthcare Systems | Other | — | — | — | 2026-07-19 | MRF ↗ |
| LEGACY EMANUEL MEDICAL CENTER OutpatientFacility | Bcbs | Regence - Legacy Lhp All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| MIDLAND MEMORIAL HOSPITAL OutpatientFacility | Aetna Medicare | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| MIDLAND MEMORIAL HOSPITAL OutpatientFacility | Aetna Medicare | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| WELLSTAR WEST GEORGIA MEDICAL CENTER OutpatientFacility | Cigna | Ppo | — | — | — | 2026-04-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Anthem | Medicaid HMO | — | — | — | 2026-04-01 | MRF ↗ |
| CLINTON MEMORIAL HOSPITAL OutpatientFacility | Other | Mdsave | $51.40 | — | — | 2025-01-01 | MRF ↗ |
| SWEDISH HOSPITAL OutpatientFacility | BCBS | HMO | — | — | — | 2026-04-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Metroplus | Medicaid HMO | — | — | — | 2026-04-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Anthem Health Plus | Medicaid HMO | — | — | — | 2026-04-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Metroplus | Exchange Plan | — | — | — | 2026-04-01 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Fidelis | Medicaid HMO | — | — | — | 2026-04-01 | MRF ↗ |
| COVENANT HOSPITAL PLAINVIEW OutpatientFacility | Amerigroup | Starkids Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| COVENANT HOSPITAL PLAINVIEW OutpatientFacility | Amerigroup | Starkids Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| EMORY HILLANDALE HOSPITAL OutpatientFacility | Cigna | Hmo/Pos | — | — | — | 2026-04-01 | MRF ↗ |
| EMORY HILLANDALE HOSPITAL OutpatientFacility | Cigna | Hmo/Pos | — | — | — | 2026-04-01 | MRF ↗ |
| MOUNT AUBURN HOSPITAL OutpatientFacility | Harvard Pilgrim Healthcare | Self Insured All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| RIVERSIDE METHODIST HOSPITAL OutpatientFacility | Devoted Health | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| ADVENTHEALTH WATERMAN OutpatientFacility | Unitedhealthcare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| AULTMAN HOSPITAL OutpatientFacility | Multiplan | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| JPS HEALTH NETWORK OutpatientFacility | Bcbs | Blue Advantage Other Commercial Plan | — | — | — | 2026-04-01 | MRF ↗ |
| ADVENTHEALTH HEART OF FLORIDA OutpatientFacility | Unitedhealthcare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| UCI HEALTH-ORANGE OutpatientFacility | CalOptima | Medi-Cal Medicaid Managed Care Plan | $61.31 | — | — | 2024-07-01 | MRF ↗ |
| ADVENTHEALTH DAYTONA BEACH OutpatientFacility | Unitedhealthcare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| ST ELIZABETH GRANT OutpatientFacility | Mutual Of Omaha | All Plans | $63.00 | — | — | 2024-07-01 | MRF ↗ |
| ST ELIZABETH EDGEWOOD OutpatientFacility | Mutual Of Omaha | All Plans | $63.00 | — | — | 2024-07-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Allwell | Allwell Medicare Adv | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | United Healthcare | Uhc Cip Mcr Adv | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Humana | Humana Mcr Adv | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Blue Cross | Health Advantage | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Ambetter | Ambetter Metallic | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Blue Cross | Bc Hmo | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Blue Cross | Bc Metallic | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Blue Cross | Bc Federal Emp | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Health Cost Sol | Ark Dept Of Correct | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Cigna Health Plan | Cigna Hmo | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Aarp | Aarp Mcr Complete | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Qualchoice | Qualchoice Mgd Care | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Umr | Umr | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Blue Cross | Bc Jrmc | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | United Healthcare | United Hlthcare Hmo | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Aetna | Aetna Traditional | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Wellcare | Wellcare | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Passe Mcd Advantage | Arkansas Total Care | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | Blue Cross Mcare Mc | Bc Medicare Mgd Care | — | — | — | 2025-01-01 | MRF ↗ |
| JEFFERSON REGIONAL MEDICAL CENTER OutpatientFacility | United Healthcare | Uhc Mcr Adv | — | — | — | 2025-01-01 | MRF ↗ |
| ADVENTHEALTH OCALA OutpatientFacility | Unitedhealthcare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| UCI HEALTH-LAKEWOOD OutpatientFacility | Family Choice Medical Group | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| UCI HEALTH - LOS ALAMITOS OutpatientFacility | Family Choice Medical Group | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| UCI HEALTH-ORANGE OutpatientFacility | Family Choice Medical Group | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| UCI HEALTH - FOUNTAIN VALLEY OutpatientFacility | Family Choice Medical Group | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| MARION GENERAL HOSPITAL OutpatientFacility | Unitedhealthcare | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| COVENANT MEDICAL CENTER OutpatientFacility | Scott And White | Individual Bsw Premier Exchange | — | — | — | 2026-04-01 | MRF ↗ |
| SPECTRUM HEALTH OutpatientFacility | Mclaren Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| Devos Childrens Hospital - Transplant Unit OutpatientFacility | Mclaren Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| Corewell Health Helen DeVos Children's Hospital OutpatientFacility | Mclaren Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| Corewell Health Blodgett Hospital OutpatientFacility | Mclaren Health Plan | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND OutpatientFacility | Cigna | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND OutpatientFacility | Blue Cross | Anthem All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND OutpatientFacility | Aetna | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND OutpatientFacility | Blue Shield | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND OutpatientFacility | Unitedhealthcare | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| LEGACY GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | Bcbs | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| ST ELIZABETH GRANT OutpatientFacility | International Benefit Administrators Phcs | All Plans | $71.33 | — | — | 2024-07-01 | MRF ↗ |
| ST ELIZABETH EDGEWOOD OutpatientFacility | International Benefit Administrators Phcs | All Plans | $71.33 | — | — | 2024-07-01 | MRF ↗ |
| SUMMIT HEALTHCARE REGIONAL MEDICAL CENTER OutpatientFacility | Centene | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| COVENANT HOSPITAL PLAINVIEW OutpatientFacility | Amerigroup | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| COVENANT HOSPITAL PLAINVIEW OutpatientFacility | Amerigroup | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| LEGACY GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | Healthnet | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| LEGACY MOUNT HOOD MEDICAL CENTER OutpatientFacility | Healthnet | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| LEGACY MOUNT HOOD MEDICAL CENTER OutpatientFacility | Healthnet | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| LEGACY MOUNT HOOD MEDICAL CENTER OutpatientFacility | Healthnet | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| Johns Hopkins All Children's Hospital OutpatientFacility | Multiplan | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| ST ELIZABETH GRANT OutpatientFacility | Reserve National First Health | All Plans | $75.00 | — | — | 2024-07-01 | MRF ↗ |
| ST ELIZABETH EDGEWOOD OutpatientFacility | Reserve National First Health | All Plans | $75.00 | — | — | 2024-07-01 | MRF ↗ |
| Orlando Health Dr. P. Phillips Hospital OutpatientFacility | Phcs | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE NEWBERG MEDICAL CENTER OutpatientFacility | Moda | Oebb All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| WELLSTAR KENNESTONE REGIONAL MEDICAL CENTER OutpatientFacility | Peachstate | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| WELLSTAR KENNESTONE REGIONAL MEDICAL CENTER OutpatientFacility | Amerigroup | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| MARION GENERAL HOSPITAL OutpatientFacility | Humana | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| MEMORIAL HOSPITAL OutpatientFacility | Aetna | All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| AdventHealth Palm Coast OutpatientFacility | Unitedhealthcare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| LEGACY MERIDIAN PARK MEDICAL CENTER OutpatientFacility | Bcbs | Regence - Legacy Lhp All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| AULTMAN HOSPITAL OutpatientFacility | Prime Time Health Plan | Medicare Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| AULTMAN HOSPITAL OutpatientFacility | Prime Time Health Plan | Medicare Managed Care Plan | $80.00 | — | — | 2025-01-01 | MRF ↗ |
| LEGACY MERIDIAN PARK MEDICAL CENTER OutpatientFacility | Bcbs | Regence - Legacy Lhp All Commercial Plans | — | — | — | 2026-04-01 | MRF ↗ |
| ADVENTHEALTH NEW SMYRNA BEACH OutpatientFacility | Unitedhealthcare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| PROVIDENCE MISSION HOSPITAL OutpatientFacility | Monarch | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| SENTARA RMH MEDICAL CENTER OutpatientFacility | Unicare | Medicaid Managed Care Plan | — | — | — | 2026-04-01 | MRF ↗ |
| MARIETTA MEMORIAL HOSPITAL OutpatientFacility | The Health Plan | Medicaid Managed Care Plan | $82.44 | — | — | 2026-01-01 | MRF ↗ |
| LOGAN REGIONAL MEDICAL CENTER OutpatientFacility | Unicare Medicaid | Unicare Medicaid | $83.20 | — | — | 2025-01-01 | MRF ↗ |
| PIKEVILLE MEDICAL CENTER OutpatientFacility | Unicare | Medicaid Managed Care Plan | $83.20 | — | — | 2025-07-01 | MRF ↗ |
| LOGAN HEALTH MEDICAL CENTER OutpatientFacility | Pacificsource | Ppo | — | — | — | 2026-04-01 | MRF ↗ |
| MARIETTA MEMORIAL HOSPITAL OutpatientFacility | Unicare | Medicaid Managed Care Plan | $84.09 | — | — | 2026-01-01 | MRF ↗ |
| UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND OutpatientFacility | Sutter East Bay Medical Foundation | Other Noncommercial | — | — | — | 2026-04-01 | MRF ↗ |
| GRAND LAKE HEALTH SYSTEM OutpatientFacility | Buckeye Ambetter | Exchange | — | — | — | 2026-04-01 | MRF ↗ |
| ADVENTHEALTH WESLEY CHAPEL OutpatientFacility | Unitedhealthcare | Medicaid 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.