55867 — Laps Surg Prst8ect Smpl Stot
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). LAPS SURG PRST8ECT SMPL STOT (CPT 55867) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/55867?code_type=CPT
MLA (9th ed.)
“LAPS SURG PRST8ECT SMPL STOT (CPT 55867) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/55867?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“LAPS SURG PRST8ECT SMPL STOT (CPT 55867) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/55867?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $5,155–$13,672 (25th–75th percentile) across 1,476 hospitals · 2,411 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 55867 — 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
$5,155
$10,249 typical
$13,672
The middle 50% of negotiated facility rates for this procedure, measured across 1,476 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. | $10,249 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $946 × 1.22 commercial. | $1,154 |
| Likely subtotal | $11,403 |
Surgical episode (typical)
~$11,403
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)
~$15,187
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 |
|---|---|---|---|---|---|---|---|
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $23,126.00 | $13,875.60 | 2026-05-22 | MRF ↗ |
| MERCY MEDICAL CTR OutpatientFacility | CARELON HEALTH MEDICAID | CARELON MEDICAID | $7.94 | — | $18,086.48 | 2026-03-31 | MRF ↗ |
| MERCY MEDICAL CTR OutpatientFacility | WELLSENSE HEALTH PLAN | WELLSENSE SILVER | $8.69 | — | $18,086.48 | 2026-03-31 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $16.60 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $16.60 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $16.60 | — | — | 2026-04-01 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $16.60 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $16.60 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $16.60 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $16.60 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $16.60 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $16.60 | — | — | 2026-04-01 | MRF ↗ |
| JOHN MUIR MEDICAL CENTER - CONCORD CAMPUS Outpatient | BLUE SHIELD PPO [1006104] | BLUE SHIELD PPO [100610402] | $22.10 | $169,208.59 | $76,143.87 | 2026-03-23 | MRF ↗ |
| JOHN MUIR MEDICAL CENTER - CONCORD CAMPUS Outpatient | BLUE SHIELD PPO [1006104] | BLUE SHIELD PPO [100610402] | $27.20 | $144,733.91 | $65,130.26 | 2026-03-23 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | $48,792.00 | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | $48,792.00 | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | $58,278.00 | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | $58,278.00 | 2024-12-08 | MRF ↗ |
| JOHN MUIR MEDICAL CENTER - CONCORD CAMPUS Outpatient | CONTRA COSTA COUNTY JAIL [1012104] | CCC JAIL [101210401] | $40.80 | $144,733.91 | $65,130.26 | 2026-03-23 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Sunshine State Oncology | Medicaid HMO | $46.47 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Medicaid HMO | $46.47 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Healthy Kids | $46.47 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Molina Oncology | Healthy Kids | $47.80 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Molina Oncology | Medicaid HMO | $47.80 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Community Care Plan Oncology | Medicaid HMO | $48.68 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Amerihealth Caritas Oncology | Medicaid HMO | $48.68 | — | — | 2025-08-01 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | $48,792.00 | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | $58,278.00 | 2024-12-08 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $53.97 | $29,982.00 | $9,977.13 | 2024-12-31 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Outpatient | CIGNA [100009] | HB CIGNA EPO ADULT LOCATIONS | $56.26 | $27,006.87 | $5,941.51 | 2026-03-19 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Florida Community Care Oncology | Medicaid HMO | $58.42 | — | — | 2025-08-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $85.16 | — | — | 2026-04-14 | MRF ↗ |
| JOHN MUIR MEDICAL CENTER - CONCORD CAMPUS Outpatient | CONTRA COSTA COUNTY JAIL [1012104] | CCC JAIL [101210401] | $87.64 | $169,208.59 | $76,143.87 | 2026-03-23 | MRF ↗ |
| MERCY HOSPITAL OKLAHOMA CITY, INC OutpatientFacility | MEDICAID [20240] | HB OKLC ARK MEDICAID | $90.58 | $32,475.70 | $21,109.20 | 2026-03-12 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $108.21 | — | — | 2026-04-14 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $108.25 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $108.25 | — | — | 2026-04-01 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | UHC COMMUNITY MEDICAID [2175] | HB XR UHC INDIANA PATHWAYS MEDICAID | $120.43 | $52,340.61 | $32,623.53 | 2025-12-19 | MRF ↗ |
| ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL OutpatientFacility | Wellpoint | NJ Family Care | $124.78 | — | — | 2026-03-04 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $130.00 | $3,570.00 | $963.90 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | UNIVERSAL IPA MCAL OP/PROFEE ONLY | UNIVERSAL IPA MCAL OP/PROFEE ONLY | $130.00 | $3,570.00 | $963.90 | 2026-01-31 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Medicaid HMO | $134.77 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Sunshine State Oncology | Medicaid HMO | $134.77 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare Oncology | Healthy Kids | $134.77 | — | — | 2025-08-01 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $136.93 | — | — | 2026-04-14 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Molina Oncology | Healthy Kids | $138.63 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Molina Oncology | Medicaid HMO | $138.63 | — | — | 2025-08-01 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $139.26 | — | — | 2026-04-14 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Amerihealth Caritas Oncology | Medicaid HMO | $141.19 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Community Care Plan Oncology | Medicaid HMO | $141.19 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Aetna Oncology | Medicare Advantage | $144.71 | — | — | 2025-08-01 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Aetna | HMO/PPO (MMG) | $144.71 | — | — | 2025-10-24 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | BCBS MEDICAID CONTRACTED [320046] | HB JOPL KANCARE HEALTHY BLUE MEDICAID | $155.59 | $40,241.36 | $26,156.88 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | KANCARE CONTRACTED [320213] | HB JOPL KANCARE UHC MEDCAID | $155.59 | $40,241.36 | $26,156.88 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | BCBS MEDICAID CONTRACTED [320046] | HB SPRG KANCARE HEALTHY BLUE MEDICAID | $155.59 | $49,279.99 | $32,031.99 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | KANCARE [20213] | HB JOPL AETNA BETTER HEALTH (KANCARE) | $155.59 | $40,241.36 | $26,156.88 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | KANCARE CONTRACTED [320213] | HB JOPL AETNA BETTER HEALTH (KANCARE) | $155.59 | $40,241.36 | $26,156.88 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | BCBS MEDICAID CONTRACTED [320046] | HB SPRG KANCARE HEALTHY BLUE MEDICAID | $155.59 | $49,279.99 | $32,031.99 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | KANCARE CONTRACTED [320213] | HB JOPL KANCARE HEALTHY BLUE MEDICAID | $155.59 | $40,241.36 | $26,156.88 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | KANCARE [20213] | HB JOPL KANCARE UHC MEDCAID | $155.59 | $40,241.36 | $26,156.88 | 2026-03-13 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $156.66 | — | — | 2025-12-31 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Aetna Oncology | Commercial | $162.07 | — | — | 2025-08-01 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Peak Health | Medicare | $162.16 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | United Healthcare | Medicare | $162.16 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Humana | Medicare | $162.16 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Highmark Blue Cross | Medicare | $162.16 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Highmark Blue Cross | Ppo/Pos | $162.16 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Peia | Other Governmental | $162.16 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Aetna | Medicare | $162.16 | — | — | 2026-05-06 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Blue Cross Oncology | Medicare Advantage | $162.25 | — | — | 2025-08-01 | MRF ↗ |
| Shepherd Center Outpatient | Medicare | Commercial | $167.59 | — | — | 2026-05-06 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Devoted | Medicare Advantage (MMG) | $169.17 | — | — | 2025-10-24 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Devoted | Medicare Advantage Prevailing (MMG) | $169.17 | — | — | 2025-10-24 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Humana | Medicare Advantage (MMG) | $169.17 | — | — | 2025-10-24 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Florida Community Care Oncology | Medicaid HMO | $169.43 | — | — | 2025-08-01 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Outpatient | Humana | HMO/PPO | $170.24 | — | — | 2025-10-24 | MRF ↗ |
| LIBERTY HOSPITAL Outpatient | Blue Cross Blue Shield | Freedom Network Select | $171.55 | — | — | 2026-05-26 | MRF ↗ |
| LIBERTY HOSPITAL Outpatient | Blue Cross Blue Shield | Freedom Network | $171.55 | — | — | 2026-05-26 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | United Healthcare Oncology | Medicare Advantage | $171.95 | — | — | 2025-08-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $172.14 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $172.14 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $172.14 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $172.14 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $172.14 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $172.14 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $172.14 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $172.14 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $172.14 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $172.14 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $172.14 | — | — | 2026-04-14 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | ALBANY COUNTY CORRECTIONAL FACILITY | ALBANY CORRECTIONAL FACILITY | $176.15 | — | $18,061.27 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | ALBANY COUNTY CORRECTIONAL FACILITY | ALBANY CORRECTIONAL FACILITY | $176.15 | — | $17,401.20 | 2026-03-31 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE DUAL | — | $29,888.48 | $19,427.51 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | MOLINA HEALTHCARE OF NY [188] | MOLINA ESSENTIALS 3&4 | — | $29,888.48 | $19,427.51 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UNITED HEALTHCARE|UHC - GENERIC|UHC EMPIRE PLAN (KINGSTON)|UNITEDHEALTHCARE OXFORD|UNITED MEDICAL RESOURCES (UMR)|UHC CHPS|UHC STUDENT RESOURCES|UHC SUREST|UNITED HEALTHCARE SHARED SERVICES | — | $29,888.48 | $19,427.51 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | WELLCARE MEDICARE HMO [122] | WELLCARE MEDICARE HMO | — | $29,888.48 | $19,427.51 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN|UHC COMMUNITY MEDICAID DENTAL|UHC ESSENTIAL 1&2|UHC CHPS|UHC ESSENTIAL 3&4 | — | $29,888.48 | $19,427.51 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MVP [109] | MVP ROCHESTER|MVP|CIGNA|GWH CIGNA|NALC CIGNA | — | $29,888.48 | $19,427.51 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED BEHAVORIAL HEALTH [120] | UNITED BEHAVORIAL HEALTH|MH OPTUM COMMERCIAL | — | $29,888.48 | $19,427.51 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | HUMANA MEDICARE HMO|GENERIC MEDICARE HMO|ELDERPLAN|CDPHP MEDICARE HMO | — | $29,888.48 | $19,427.51 | 2024-12-30 | MRF ↗ |
| NEWARK-WAYNE COMMUNITY HOSPITAL Outpatient | EXCELLUS HMO [104] | BLUE CHOICE OPTION|CHILD HEALTH PLUS|UNIVERA MYHEALTH PLUS|EXCELLUS ESSENTIAL 1&2|EXCELLUS ESSENTIAL 3&4|UNIVERA MYHEALTH|UNIVERA ESSENTIAL 1&2|HEALTHY NY|UNIVERA ESSENTIAL 1&2 | — | $29,888.48 | $19,427.51 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MULTIPLAN [141] | MULTIPLAN | — | $29,888.48 | $19,427.51 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | FIDELIS MEDICARE [176] | FIDELIS MEDICARE|FIDELIS DUAL ADVANTAGE | — | $29,888.48 | $19,427.51 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE|TRICARE FOR LIFE|MARTINS POINT/US FAMILY | — | $29,888.48 | $19,427.51 | 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.