55250 — Removal Of Sperm Duct(s)
Cite this view
HANK Price Transparency. (n.d.). REMOVAL OF SPERM DUCT(S) (HCPCS 55250) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/55250?code_type=HCPCS
“REMOVAL OF SPERM DUCT(S) (HCPCS 55250) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/55250?code_type=HCPCS. Accessed .
“REMOVAL OF SPERM DUCT(S) (HCPCS 55250) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/55250?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,082–$3,293 (25th–75th percentile) across 2,246 hospitals · 6,505 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 55250 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
What the whole episode might cost
Your hospital facility price plus the separately-billed professional fees a complete episode adds. The facility figure is an actual negotiated rate from our data; the surgeon and anesthesia fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
The middle 50% of negotiated facility rates for this procedure, measured across 2,246 hospitals. The surgeon and anesthesia fees are modeled estimates added on top.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $2,139 |
| Surgeon (professional fee) Estimate national typical Medicare $218 × 1.22 commercial. | $266 |
| Anesthesia Estimate national typical Generic anesthesia (~90 min typical, median CMS base units). Medicare $225 × 3.14 commercial. Approximate — no procedure-specific anesthesia mapping for this code. | $708 |
| Likely subtotal | $3,113 |
Your recovery plan — adjust to what your doctor told you
After your procedure, recovery care is billed separately. We pre-fill the typical plan; change it to your situation.
- The anesthesia component is a generic, approximate estimate — no procedure-specific anesthesia mapping exists for this code, so a typical anesthesia for this procedure type is shown.
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Surgeon (professional fee) (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
- Anesthesia (estimate)
- base_units_version: CY2022 file (base units unchanged for CY2026 per CMS) · anesthesia_cf: $20.49754 (National) · cf_rule: CMS-1832-F · multiplier_source: AJMC/Duffy 2016-2017 (PMID 34156223) national · basis: generic surgical anesthesia — 5 base units (typical CMS value) × ~90 min; approximate, NOT a procedure-specific crosswalk
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 |
|---|---|---|---|---|---|---|---|
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Health Options Inc | Bcbs Health Options Medicare | $0.19 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Medicare Ppo | $0.19 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Careplus | Careplus | $0.24 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Aetna Health | Aetna Medicare | $0.30 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Msmc | Cigna | $0.42 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Humana | Humana Humx | $0.43 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Oscar Health (Hie) | Oscar Health (Hie) | $0.45 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Dimension Health | Dimension Plus | $0.45 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Aetna Health | Aetna Workers Comp | $0.47 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Ppo | $0.55 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Network Blue | $0.55 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Health Options Inc | Bcbs Health Options Hmo | $0.55 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Traditional | $0.55 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Dimension Health | Dimension International | $0.60 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Corvel Healthcare | Corvel Healthcare | $0.60 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Aetna Health | Aetna | $0.65 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Care Management Network | Care Management Network | $0.65 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Workmans Compensation | Workmans Compensation | $0.65 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Beech Street | Beech Street | $0.70 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Corvel Healthcare | Corvel Healthcare | $0.70 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Behavioral Services Network | Behavioral Services Network | $0.70 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Dimension Health | Dimension | $0.70 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Cigna Behavioral Health | Cigna Behavioral Health | $0.70 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Coventry | Coventry | $0.71 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Beech Street | Beech Street | $0.75 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Seasons Hospice | Seasons Hospice | $0.75 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Workmans Compensation | Workmans Compensation | $0.75 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Multiplan | Multiplan | $0.75 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Workers Compensation | $0.76 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Blue Cross Blue Shield Of Florida | Bcbs Workers Compensation | $0.80 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | First Health Network | First Health | $0.85 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Wellcare | Wellcare | $0.85 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Aetna International Ppo | Aetna International Ppo | $0.85 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | United Healthcare | United Behavioral Medicaid | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Management Systems | Nch Careplus Medicare | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Mental Health Associates | Mental Health Associates | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Humana Behavioral Health | Humana Behavioral Health Medicare | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Management Systems | Nch Simply Medicare | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Management Systems | Nch Coventry Medicare | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | University Of Miami Behavioral Health | University Of Miami Behavioral Health | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Humana Behavioral Health | Humana Behavioral Health | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Devoted Medicare | Nch Devoted Medicare Med Onc | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Devoted Medicare | Nch Devoted Medicare Rad Onc | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | United Healthcare | United Behavioral | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | New Directions Behavioral Health | New Directions Behavioral Health | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | United Healthcare | United Behavioral Medicare | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Value Options | Value Options Behavioral Health | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Magellan Behavioral Health | Magellan Behavioral Health | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Cenpatico Behavioral Health | Cenpatico Behavioral Health | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Miscellaneous Insurances | Miscellaneous Insurances | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Tricare | Tricare | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Nch Devoted Medicare | Nch Devoted Medicare Rad Onc | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Nch Management Systems | Nch Humana Medicare | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Rehab Ppo | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Vitas Healthcare Of Fl | Vitas | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Concordia Behavioral Health | Concordia Behavioral Health | $1.00 | $1.00 | $1.00 | 2026-05-22 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $2.01 | $192.95 | $192.95 | 2026-04-24 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $2.74 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $2.74 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $2.74 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $2.82 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $2.89 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $2.96 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| GROSSMONT HOSPITAL Outpatient | Health Net | Health Net Individual - HMO | $3.03 | $7,159.00 | $5,369.25 | 2026-04-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $3.22 | $764.00 | $573.00 | 2025-03-07 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $3.56 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $3.56 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $3.63 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $3.63 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $3.63 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $3.63 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $3.71 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $3.78 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $3.85 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $4.00 | $741.00 | $703.95 | 2026-02-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $6.55 | $590.00 | $112.10 | 2026-01-25 | MRF ↗ |
| Ventura County Medical Center - Santa Paula Hospital Outpatient | UHC MCR ADV | UHC MCR ADV | $6.55 | $3,821.00 | $1,910.50 | 2026-03-23 | MRF ↗ |
| OTTAWA COUNTY HEALTH CENTER Outpatient | CHOICECARE MCR ADV - ALL PLANS | CHOICECARE MCR ADV - ALL PLANS | $6.55 | $470.00 | $470.00 | 2026-03-09 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Blue Cross | Blue Cross - MCS | $6.58 | $7,159.00 | $5,369.25 | 2026-04-01 | MRF ↗ |
| UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER UM [121] Plans | $9.31 | $16,814.70 | $16,814.70 | 2026-03-26 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $10.26 | $986.35 | $986.35 | 2026-04-24 | 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 | $13.10 | $500.00 | $500.00 | 2026-02-13 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | TRIWEST WELLMARK-ALL PLANS | TRIWEST WELLMARK-ALL PLANS | $13.50 | $37.50 | $33.75 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | TRICARE- ALL PLANS | TRICARE- ALL PLANS | $13.50 | $37.50 | $33.75 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | VA CCN -ALL PLANS | VA CCN -ALL PLANS | $13.50 | $37.50 | $33.75 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MEDICAL ASSOCIATES-ALL PLANS | MEDICAL ASSOCIATES-ALL PLANS | $13.50 | $37.50 | $33.75 | 2026-01-03 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Outpatient | United Healthcare Medicare | Medicare Advantage | $13.60 | $611.00 | $366.60 | 2026-02-12 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Outpatient | United Healthcare Medicare | Medicare Advantage | $13.60 | $611.00 | $366.60 | 2026-02-12 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | WELLMARK MCR ADV- ALL PLANS | WELLMARK MCR ADV- ALL PLANS | $13.64 | $37.50 | $33.75 | 2026-01-03 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | UHC MCR ADV | UHC MCR ADV | $13.91 | $37.50 | $33.75 | 2026-01-03 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | UHC COMMUNITY MEDICAID [2175] | HB XR UHC INDIANA PATHWAYS MEDICAID | $16.63 | $18,419.19 | $11,323.19 | 2025-12-19 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $18.85 | — | — | 2026-04-14 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | OSCAR-ALL PLANS | OSCAR-ALL PLANS | $20.25 | $37.50 | $33.75 | 2026-01-03 | MRF ↗ |
| UMASS MEMORIAL HEALTH - HARRINGTON HOSPITAL Outpatient | TUFTS MEDICAID [10908] | All TUFTS TOGETHER HR [124] Plans | $20.82 | $5,304.08 | $5,304.08 | 2026-04-03 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL AETNA CARE [700912] | $20.91 | $70,424.77 | $70,424.77 | 2026-03-23 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 1&2|MVP ESSENTIAL 3&4 | $22.08 | $8,936.75 | $5,808.89 | 2024-12-30 | MRF ↗ |
| UNITED MEMORIAL MEDICAL CENTER Outpatient | MVP [109] | MVP ESSENTIAL 1&2 | $22.08 | $9,152.13 | $5,948.88 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP OPTION|MVP CHILD HEALTH PLUS | $22.08 | $8,936.75 | $5,808.89 | 2024-12-30 | MRF ↗ |
| UNITED MEMORIAL MEDICAL CENTER Outpatient | MVP [109] | MVP OPTION|MVP CHILD HEALTH PLUS|MVP ESSENTIAL 3&4 | $22.08 | $9,152.13 | $5,948.88 | 2024-12-30 | MRF ↗ |
| UNITED MEMORIAL MEDICAL CENTER Outpatient | MVP [109] | MVP EXCHANGE-INDIVIDUAL | $22.08 | $9,152.13 | $5,948.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MVP [109] | MVP ESSENTIAL 3&4 | $22.08 | $8,936.75 | $5,808.89 | 2024-12-30 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | BLUE CROSS NY EXCELLUS [200041] | EXCELLUS HEALTHY NY EPO [20004107] | $23.40 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | EXCELLUS HMO MEDICAID APG [350082] | EXCELLUS ESSENTIAL PLAN APG [35008202] | $23.40 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | BLUE CROSS NY EXCELLUS [200041] | EXCELLUS HEALTHY NY EPO [20004107] | $23.40 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | EXCELLUS HMO MEDICAID APG [350082] | EXCELLUS HMO MEDICAID APG [35008201] | $23.40 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | BLUE CROSS NY EXCELLUS MEDICAID [350081] | EXCELLUS CHILD HEALTH PLUS [35008101] | $23.40 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | BLUE CROSS NY EXCELLUS MEDICAID [350081] | EXCELLUS HMO MEDICAID [35008103] | $23.40 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | EXCELLUS HMO MEDICAID APG [350082] | EXCELLUS CHILD HEALTH PLUS APG [35008203] | $23.40 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | EXCELLUS HMO MEDICAID APG [350082] | EXCELLUS ESSENTIAL PLAN APG [35008202] | $23.40 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | EXCELLUS HMO MEDICAID APG [350082] | EXCELLUS CHILD HEALTH PLUS APG [35008203] | $23.40 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | EXCELLUS HMO MEDICAID APG [350082] | EXCELLUS HMO MEDICAID APG [35008201] | $23.40 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | BLUE CROSS NY EXCELLUS MEDICAID [350081] | EXCELLUS CHILD HEALTH PLUS [35008101] | $23.40 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | BLUE CROSS NY EXCELLUS MEDICAID [350081] | EXCELLUS HMO MEDICAID [35008103] | $23.40 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | BLUE CROSS NY EXCELLUS MEDICAID [350081] | EXCELLUS ESSENTIAL PLAN [35008102] | $23.40 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | BLUE CROSS NY EXCELLUS MEDICAID [350081] | EXCELLUS ESSENTIAL PLAN [35008102] | $23.40 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL AETNA BETTER HEALTH MEDICAID [300612] | $23.55 | $70,424.77 | $70,424.77 | 2026-03-23 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MVP [109] | MVP EXCHANGE-INDIVIDUAL | $23.58 | $8,936.75 | $5,808.89 | 2024-12-30 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $23.75 | — | — | 2026-04-01 | MRF ↗ |
| LEXINGTON REGIONAL HEALTH CENTER OutpatientFacility | BCBS | ALL PRODUCTS | $23.75 | $25.00 | $24.00 | 2025-12-28 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $23.75 | — | — | 2026-04-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $23.95 | — | — | 2026-04-14 | MRF ↗ |
| LEXINGTON REGIONAL HEALTH CENTER OutpatientFacility | UHC | ALL PRODUCTS | $24.00 | $25.00 | $24.00 | 2025-12-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE CROSS [1013] | BLUE CROSS MEDI-CAL UNLISTED IPA [10130011] | $25.00 | $7,433.00 | $4,088.15 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MEDI-CAL [2001] | MEDI-CAL | $25.00 | $7,433.00 | $4,088.15 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | COMMUNITY ELDERCARE [1027] | MEDI-CAL | $25.00 | $7,433.00 | $4,088.15 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | AETNA [1003] | AETNA MEDI-CAL | $25.00 | $7,433.00 | $4,088.15 | 2026-04-01 | MRF ↗ |
| LEXINGTON REGIONAL HEALTH CENTER OutpatientFacility | MIDLANDS CHOICE | ALL PRODUCTS | $25.00 | $25.00 | $24.00 | 2025-12-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MEDI-CAL [1048] | MEDI-CAL | $25.00 | $7,433.00 | $4,088.15 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE CROSS [1013] | MEDI-CAL | $25.00 | $7,433.00 | $4,088.15 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CAREMORE [2028] | MEDI-CAL | $25.00 | $7,433.00 | $4,088.15 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BRAND NEW DAY [1089] | MEDI-CAL | $25.00 | $7,433.00 | $4,088.15 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE SHIELD PROMISE [1017] | BLUE SHIELD PROMISE (FKA CARE1ST HEALTHPLAN MEDI-CAL) | $25.00 | $7,433.00 | $4,088.15 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | XIMED [2016] | MEDI-CAL | $25.00 | $7,433.00 | $4,088.15 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | VANTAGE [1092] | PROSPECT VANTAGE MEDICAL GROUP MEDI-CAL | $25.00 | $7,433.00 | $4,088.15 | 2026-04-01 | MRF ↗ |
| MITCHELL COUNTY REGIONAL HEALTH Outpatient | MIDLANDS NEW BUSINESS | MIDLANDS NEW BUSINESS | $26.25 | $37.50 | $33.75 | 2026-01-03 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICARE LABS [7009] | JVHL UNITED HEALTHCARE CARE [700909] | $26.38 | $70,424.77 | $70,424.77 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL MEDICAID LABS [3006] | JVHL UNITED HEALTHCARE CARE [300609] | $26.38 | $70,424.77 | $70,424.77 | 2026-03-23 | MRF ↗ |
| HURLEY MEDICAL CENTER Outpatient | JVHL LABS [1068] | JVHL UNITED HEALTHCARE LABS [106809] | $26.38 | $70,424.77 | $70,424.77 | 2026-03-23 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | HEALTHNET- ALL OTHER PLANS | HEALTHNET- ALL OTHER PLANS | $26.97 | $62.00 | $11.78 | 2026-01-25 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | WESTERN GROWERS/PINNACLE- ALL PLANS | WESTERN GROWERS/PINNACLE- ALL PLANS | $28.52 | $62.00 | $11.78 | 2026-01-25 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | $13,287.75 | 2024-12-08 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STATE FARM AUTO INSURANCE NF [800026] | NF STATE FARM AUTO INSURANCE [80002601] | $28.74 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | LIBERTY MUTUAL AUTO INSURANCE [800008] | NF LIBERTY MUTUAL AUTO INS [80000801] | $28.74 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | MET LIFE AUTO INSURANCE [800009] | NF MET LIFE AUTO INS [80000901] | $28.74 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | STATE FARM AUTO INSURANCE NF [800026] | NF STATE FARM AUTO INSURANCE [80002601] | $28.74 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | UTICA NATIONAL NO FAULT [800007] | NF UTICA NATIONAL INS [80000701] | $28.74 | $11,961.16 | $7,176.70 | 2025-01-17 | MRF ↗ |
| St Elizabeth Medical Center Outpatient | ALLSTATE AUTO INSURANCE [800001] | NF ALLSTATE [80000101] | $28.74 | $11,961.16 | $7,176.70 | 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.