55868 — Lap Srg Prst8ct Lymph Nod Bx
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Lap srg prst8ct lymph nod bx (CPT 55868) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/55868?code_type=CPT
MLA (9th ed.)
“Lap srg prst8ct lymph nod bx (CPT 55868) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/55868?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“Lap srg prst8ct lymph nod bx (CPT 55868) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/55868?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $9,438–$16,136 (25th–75th percentile) across 731 hospitals · 839 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 55868 — 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 fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$9,438
$11,502 typical
$16,136
The middle 50% of negotiated facility rates for this procedure, measured across 731 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. | $11,502 |
| Surgeon (professional fee) Estimate national typical Medicare $1,108 × 1.22 commercial. | $1,351 |
| Anesthesia Estimate national typical 00865, ~90 min typical. Medicare $266 × 3.14 commercial. | $837 |
| Likely subtotal | $13,690 |
Surgical episode (typical)
~$13,690
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge (see the recovery plan below)
- 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 $9,438–$16,136.
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.
Recovery cost modeled
~$3,785
With your recovery plan (typical)
~$17,475
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
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| O'connor Hospital BothFacility | KAISER MEDI-CAL MC [410] | KAISER MEDI-CAL MC [410002] | $23.77 | $72,947.00 | $51,062.90 | 2026-09-01 | MRF ↗ |
| SANTA CLARA VALLEY MEDICAL CENTER BothFacility | KAISER MEDI-CAL MC [410] | KAISER MEDI-CAL MC [410002] | $23.77 | $72,947.00 | $51,062.90 | 2026-09-01 | MRF ↗ |
| O'connor Hospital BothFacility | CENTRAL CA ALLIANCE [340] | CENTRAL CA ALLIANCE [340001] | $23.77 | $72,947.00 | $51,062.90 | 2026-09-01 | MRF ↗ |
| St. Louise Regional Hospital BothFacility | KAISER MEDI-CAL MC [410] | KAISER MEDI-CAL MC [410002] | $23.77 | $72,947.00 | $51,062.90 | 2026-09-01 | MRF ↗ |
| St. Louise Regional Hospital BothFacility | CENTRAL CA ALLIANCE [340] | CENTRAL CA ALLIANCE [340001] | $23.77 | $72,947.00 | $51,062.90 | 2026-09-01 | MRF ↗ |
| SANTA CLARA VALLEY MEDICAL CENTER BothFacility | CENTRAL CA ALLIANCE [340] | CENTRAL CA ALLIANCE [340001] | $23.77 | $72,947.00 | $51,062.90 | 2026-09-01 | MRF ↗ |
| INTERMOUNTAIN HEALTH LAYTON HOSPITAL Outpatient | Intermountain Caregiver Plan | Med Network | — | — | — | 2026-07-31 | MRF ↗ |
| INTERMOUNTAIN HEALTH LAYTON HOSPITAL Outpatient | Selecthealth | Selectcare | — | — | — | 2026-07-31 | MRF ↗ |
| MCKAY-DEE HOSPITAL Outpatient | Selecthealth | Fehbp | — | — | — | 2026-07-31 | MRF ↗ |
| LDS HOSPITAL Outpatient | Selecthealth | Selectcare | — | — | — | 2026-08-01 | MRF ↗ |
| INTERMOUNTAIN HEALTH UTAH VALLEY HOSPITAL Outpatient | Selecthealth | Fehbp | — | — | — | 2026-08-01 | MRF ↗ |
| INTERMOUNTAIN MEDICAL CENTER Outpatient | Intermountain Caregiver Plan | Med Network | — | — | — | 2026-07-17 | MRF ↗ |
| RIVERTON HOSPITAL Outpatient | Intermountain Caregiver Plan | Share Network | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH LAYTON HOSPITAL Outpatient | Intermountain Caregiver Plan | Share Network | — | — | — | 2026-07-31 | MRF ↗ |
| LDS HOSPITAL Outpatient | Intermountain Caregiver Plan | Share Network | — | — | — | 2026-08-01 | MRF ↗ |
| MCKAY-DEE HOSPITAL Outpatient | Selecthealth | Selectvalue | — | — | — | 2026-07-31 | MRF ↗ |
| OREM COMMUNITY HOSPITAL Outpatient | Selecthealth | Commercial | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN MEDICAL CENTER Outpatient | Intermountain Caregiver Plan | Share Network | — | — | — | 2026-07-17 | MRF ↗ |
| MCKAY-DEE HOSPITAL Outpatient | Intermountain Caregiver Plan | Share Network | — | — | — | 2026-07-31 | MRF ↗ |
| INTERMOUNTAIN HEALTH UTAH VALLEY HOSPITAL Outpatient | Intermountain Caregiver Plan | Share Network | — | — | — | 2026-08-01 | MRF ↗ |
| OREM COMMUNITY HOSPITAL Outpatient | Selecthealth | Fehbp | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH UTAH VALLEY HOSPITAL Outpatient | Selecthealth | Selectvalue | — | — | — | 2026-08-01 | MRF ↗ |
| INTERMOUNTAIN HEALTH UTAH VALLEY HOSPITAL Outpatient | Intermountain Caregiver Plan | Med Network | — | — | — | 2026-08-01 | MRF ↗ |
| INTERMOUNTAIN HEALTH ALTA VIEW HOSPITAL Outpatient | Selecthealth | Fehbp | — | — | — | 2026-08-01 | MRF ↗ |
| OREM COMMUNITY HOSPITAL Outpatient | Intermountain Caregiver Plan | Share Network | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH LAYTON HOSPITAL Outpatient | Selecthealth | Fehbp | — | — | — | 2026-07-31 | MRF ↗ |
| RIVERTON HOSPITAL Outpatient | Selecthealth | Selectvalue | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH UTAH VALLEY HOSPITAL Outpatient | Selecthealth | Selectcare | — | — | — | 2026-08-01 | MRF ↗ |
| RIVERTON HOSPITAL Outpatient | Selecthealth | Selectshare | — | — | — | 2026-07-15 | MRF ↗ |
| MCKAY-DEE HOSPITAL Outpatient | Intermountain Caregiver Plan | Med Network | — | — | — | 2026-07-31 | MRF ↗ |
| RIVERTON HOSPITAL Outpatient | Selecthealth | Selectmed/Chip | — | — | — | 2026-07-15 | MRF ↗ |
| MCKAY-DEE HOSPITAL Outpatient | Selecthealth | Selectcare | — | — | — | 2026-07-31 | MRF ↗ |
| INTERMOUNTAIN MEDICAL CENTER Outpatient | Selecthealth | Selectcare | — | — | — | 2026-07-17 | MRF ↗ |
| INTERMOUNTAIN MEDICAL CENTER Outpatient | Selecthealth | Commercial | — | — | — | 2026-07-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH ALTA VIEW HOSPITAL Outpatient | Selecthealth | Commercial | — | — | — | 2026-08-01 | MRF ↗ |
| OREM COMMUNITY HOSPITAL Outpatient | Selecthealth | Selectshare | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN MEDICAL CENTER Outpatient | Selecthealth | Selectvalue | — | — | — | 2026-07-17 | MRF ↗ |
| LDS HOSPITAL Outpatient | Selecthealth | Fehbp | — | — | — | 2026-08-01 | MRF ↗ |
| INTERMOUNTAIN HEALTH ALTA VIEW HOSPITAL Outpatient | Intermountain Caregiver Plan | Share Network | — | — | — | 2026-08-01 | MRF ↗ |
| OREM COMMUNITY HOSPITAL Outpatient | Selecthealth | Selectcare | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ALTA VIEW HOSPITAL Outpatient | Intermountain Caregiver Plan | Med Network | — | — | — | 2026-08-01 | MRF ↗ |
| INTERMOUNTAIN HEALTH UTAH VALLEY HOSPITAL Outpatient | Selecthealth | Selectshare | — | — | — | 2026-08-01 | MRF ↗ |
| INTERMOUNTAIN HEALTH ALTA VIEW HOSPITAL Outpatient | Selecthealth | Selectshare | — | — | — | 2026-08-01 | MRF ↗ |
| INTERMOUNTAIN MEDICAL CENTER Outpatient | Selecthealth | Selectshare | — | — | — | 2026-07-17 | MRF ↗ |
| LDS HOSPITAL Outpatient | Selecthealth | Commercial | — | — | — | 2026-08-01 | MRF ↗ |
| INTERMOUNTAIN HEALTH UTAH VALLEY HOSPITAL Outpatient | Selecthealth | Selectmed/Chip | — | — | — | 2026-08-01 | MRF ↗ |
| INTERMOUNTAIN HEALTH LAYTON HOSPITAL Outpatient | Selecthealth | Selectshare | — | — | — | 2026-07-31 | MRF ↗ |
| OREM COMMUNITY HOSPITAL Outpatient | Selecthealth | Selectvalue | — | — | — | 2026-07-15 | MRF ↗ |
| LDS HOSPITAL Outpatient | Intermountain Caregiver Plan | Med Network | — | — | — | 2026-08-01 | MRF ↗ |
| OREM COMMUNITY HOSPITAL Outpatient | Intermountain Caregiver Plan | Med Network | — | — | — | 2026-07-15 | MRF ↗ |
| RIVERTON HOSPITAL Outpatient | Intermountain Caregiver Plan | Med Network | — | — | — | 2026-07-15 | MRF ↗ |
| LDS HOSPITAL Outpatient | Selecthealth | Selectvalue | — | — | — | 2026-08-01 | MRF ↗ |
| INTERMOUNTAIN HEALTH ALTA VIEW HOSPITAL Outpatient | Selecthealth | Selectvalue | — | — | — | 2026-08-01 | MRF ↗ |
| INTERMOUNTAIN HEALTH LAYTON HOSPITAL Outpatient | Selecthealth | Commercial | — | — | — | 2026-07-31 | MRF ↗ |
| INTERMOUNTAIN HEALTH ALTA VIEW HOSPITAL Outpatient | Selecthealth | Selectcare | — | — | — | 2026-08-01 | MRF ↗ |
| RIVERTON HOSPITAL Outpatient | Selecthealth | Selectcare | — | — | — | 2026-07-15 | MRF ↗ |
| RIVERTON HOSPITAL Outpatient | Selecthealth | Fehbp | — | — | — | 2026-07-15 | MRF ↗ |
| LDS HOSPITAL Outpatient | Selecthealth | Selectshare | — | — | — | 2026-08-01 | MRF ↗ |
| MCKAY-DEE HOSPITAL Outpatient | Selecthealth | Selectshare | — | — | — | 2026-07-31 | MRF ↗ |
| INTERMOUNTAIN HEALTH LAYTON HOSPITAL Outpatient | Selecthealth | Selectvalue | — | — | — | 2026-07-31 | MRF ↗ |
| MCKAY-DEE HOSPITAL Outpatient | Selecthealth | Commercial | — | — | — | 2026-07-31 | MRF ↗ |
| INTERMOUNTAIN MEDICAL CENTER Outpatient | Selecthealth | Fehbp | — | — | — | 2026-07-17 | MRF ↗ |
| O'connor Hospital BothFacility | BLUE CROSS MEDI-CAL MC [320] | BLUE CROSS MCMC [320001] | $45.01 | $72,947.00 | $51,062.90 | 2026-09-01 | MRF ↗ |
| St. Louise Regional Hospital BothFacility | BLUE CROSS MEDI-CAL MC [320] | BLUE CROSS MCMC [320001] | $45.01 | $72,947.00 | $51,062.90 | 2026-09-01 | MRF ↗ |
| SANTA CLARA VALLEY MEDICAL CENTER BothFacility | BLUE CROSS MEDI-CAL MC [320] | BLUE CROSS MCMC [320001] | $45.01 | $72,947.00 | $51,062.90 | 2026-09-01 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | HUMANA MEDICAID CONTRACTED [320486] | HB ROGR OK MANAGED MEDICAID | $54.00 | $39,543.89 | $25,703.53 | 2026-06-08 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | MEDICAID [20240] | HB ROGR OKLAHOMA MEDICAID | $54.00 | $39,543.89 | $25,703.53 | 2026-06-08 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB ROGR OK MANAGED MEDICAID | $54.00 | $39,543.89 | $25,703.53 | 2026-06-08 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB ROGR OK MANAGED MEDICAID | $54.00 | $39,543.89 | $25,703.53 | 2026-06-08 | MRF ↗ |
| SHERIDAN MEMORIAL HOSPITAL Outpatient | BLUE CROSS WYOMING-ALL PLANS | BLUE CROSS WYOMING-ALL PLANS | $80.00 | $2,706.00 | $2,164.80 | 2026-10-02 | MRF ↗ |
| SANTA CLARA VALLEY MEDICAL CENTER BothFacility | SANTA CLARA FAMILY HEALTH PLAN MC [205] | SANTA CLARA FAMILY HEALTH PLAN MC [205001] | $82.85 | $72,947.00 | $51,062.90 | 2026-09-01 | MRF ↗ |
| O'connor Hospital BothFacility | SANTA CLARA FAMILY HEALTH PLAN MC [205] | SANTA CLARA FAMILY HEALTH PLAN MC [205001] | $82.85 | $72,947.00 | $51,062.90 | 2026-09-01 | MRF ↗ |
| St. Louise Regional Hospital BothFacility | SANTA CLARA FAMILY HEALTH PLAN MC [205] | SANTA CLARA FAMILY HEALTH PLAN MC [205001] | $82.85 | $72,947.00 | $51,062.90 | 2026-09-01 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Mvp | Medicare Advantage | $169.11 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Bcbs | Medicare Advantage | $169.11 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Aetna | Medicare Advantage | $169.11 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Cdphp | Commercial | $169.11 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Cdphp | Medicare Advantage | $169.11 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Humana | Medicare Advantage | $169.11 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Fidelis | Medicare Advantage | $169.11 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Wellcare | Medicare Advantage | $169.11 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Uhc | Medicare Advantage | $169.11 | — | — | 2026-10-12 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Blue Cross Oncology UPW | Medicare Advantage | $183.20 | — | — | 2026-06-30 | MRF ↗ |
| JOHN MUIR MEDICAL CENTER - CONCORD CAMPUS Outpatient | CONTRA COSTA COUNTY JAIL [1012104] | CCC JAIL [101210401] | $185.47 | $232,741.44 | $104,733.65 | 2026-03-23 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | ARKANSAS DEPARTMENT OF HEALTH [20036] | HB ROGR ARKANSAS MEDICAID | $193.80 | $39,543.89 | $25,703.53 | 2026-06-08 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | SUMMIT COMMUNITY CARE [20368] | HB ROGR ARKANSAS MEDICAID | $193.80 | $39,543.89 | $25,703.53 | 2026-06-08 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | SUMMIT COMMUNITY CARE CONTRACTED [320368] | HB ROGR SUMMIT | $193.80 | $39,543.89 | $25,703.53 | 2026-06-08 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | MEDICAID [20240] | HB ROGR ARKANSAS MEDICAID | $193.80 | $39,543.89 | $25,703.53 | 2026-06-08 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Aetna Oncology UPW | Medicare Advantage | $196.03 | — | — | 2026-06-30 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | CARESOURCE MEDICAID CONTRACTED [320460] | HB ROGR CARESOURCE MEDICAID | $197.68 | $39,543.89 | $25,703.53 | 2026-06-08 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | CARESOURCE MEDICAID [20460] | HB ROGR CARESOURCE MEDICAID | $197.68 | $39,543.89 | $25,703.53 | 2026-06-08 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Bcbs | Commercial | $202.94 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Mvp | Commercial | $233.38 | — | — | 2026-10-12 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | EMPOWER HEALTHCARE SOLUTIONS MEDICAID CONTRACTED [320118] | HB ROGR PASSE EMPOWER | $246.13 | $39,543.89 | $25,703.53 | 2026-06-08 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Uhc | Commercial | $258.74 | — | — | 2026-10-12 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | TUFTS CONNCARE/QHP [8020] | BMC HB TUFTS SUBSIDIZED PLANS | $431.24 | $15,925.00 | $7,166.25 | 2026-03-13 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid | Medicaid Nhhf | $433.49 | $4,717.00 | $1,415.10 | 2026-07-15 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | ARKANSAS TOTAL CARE CONTRACTED [320039] | HB ROGR PASSE AR TOTAL CARE | $439.93 | $39,543.89 | $25,703.53 | 2026-06-08 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | ARKANSAS TOTAL CARE [20039] | HB ROGR PASSE AR TOTAL CARE | $439.93 | $39,543.89 | $25,703.53 | 2026-06-08 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid | Medicaid-Trad | $471.70 | $4,717.00 | $1,415.10 | 2026-07-15 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid-Amerihealth | Medicaid-Amerihealth | $476.42 | $4,717.00 | $1,415.10 | 2026-07-15 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | AITHER HEALTH CONTRACTED [320449] | HB ROGR DEC LACLEDE - NEW 07.01.25 | $546.00 | $39,543.89 | $25,703.53 | 2026-06-08 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | YUZU HEALTH CONTRACTED [320521] | HB ROGR DEC LEVEL HEALTH - NEW 01.01.26 | $546.00 | $39,543.89 | $25,703.53 | 2026-06-08 | MRF ↗ |
| Utmb Galveston Transplant Inpatient | Cigna | Medicare | $550.25 | $3,738.00 | $1,888.46 | 2026-07-15 | MRF ↗ |
| Utmb Galveston Transplant Inpatient | Blue Cross | Medicare | $550.25 | $3,738.00 | $1,888.46 | 2026-07-15 | MRF ↗ |
| Utmb Galveston Transplant Inpatient | Veteran'S Administration | Triwest | $550.25 | $3,738.00 | $1,888.46 | 2026-07-15 | MRF ↗ |
| Utmb Galveston Transplant Inpatient | Wellpoint | Medicare | $577.77 | $3,738.00 | $1,888.46 | 2026-07-15 | MRF ↗ |
| Utmb Galveston Transplant Inpatient | Wellcare | Medicare | $577.77 | $3,738.00 | $1,888.46 | 2026-07-15 | MRF ↗ |
| Utmb Galveston Transplant Both | Superior | Medicaid Foster Care | $598.08 | $3,738.00 | $1,888.46 | 2026-07-15 | MRF ↗ |
| Utmb Galveston Transplant Both | Superior | Medicaid | $598.08 | $3,738.00 | $1,888.46 | 2026-07-15 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid | Medicaid-Wellsense | $602.36 | $4,717.00 | $1,415.10 | 2026-07-15 | MRF ↗ |
| Utmb Galveston Transplant Inpatient | Community Health Choice | Marketplace Plans | $632.79 | $3,738.00 | $1,888.46 | 2026-07-15 | MRF ↗ |
| Utmb Galveston Transplant Both | United Healthcare | Medicare | $654.15 | $3,738.00 | $1,888.46 | 2026-07-15 | MRF ↗ |
| T J SAMSON COMMUNITY HOSPITAL Outpatient | UHC ALL PAYER - ALL PLANS | UHC ALL PAYER - ALL PLANS | $669.25 | $2,677.00 | $1,740.05 | 2026-04-23 | MRF ↗ |
| T J SAMSON COMMUNITY HOSPITAL Outpatient | UHC ALL PAYER - ALL PLANS | UHC ALL PAYER - ALL PLANS | $669.25 | $2,677.00 | $1,740.05 | 2026-04-23 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $685.76 | — | — | 2026-09-15 | MRF ↗ |
| Utmb Galveston Transplant Inpatient | Oscar | All Contracted Plans | $687.82 | $3,738.00 | $1,888.46 | 2026-07-15 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MEDICAID [20240] | HB STLO MO MEDICAID | $696.40 | $38,741.32 | $25,181.86 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MO MEDICAID BH CARVE OUT [320315] | HB SAMC MO MEDICAID | $696.40 | $28,798.93 | $18,719.30 | 2026-06-10 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MEDICAID [20240] | HB SAMC MO MEDICAID | $696.40 | $28,798.93 | $18,719.30 | 2026-06-10 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MO MEDICAID BH CARVE OUT [320315] | HB STLO MO MEDICAID | $696.40 | $38,741.32 | $25,181.86 | 2026-06-04 | MRF ↗ |
| Utmb Galveston Transplant Inpatient | Curative | All Contracted Plans | $721.27 | $3,738.00 | $1,888.46 | 2026-07-15 | MRF ↗ |
| Utmb Galveston Transplant Outpatient | Curative | All Contracted Plans | $728.91 | $3,738.00 | $1,888.46 | 2026-07-15 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MEDICAID PENDING [20241] | HB SAMC HOME STATE HEALTH PLAN MANAGED MEDICAID | $738.18 | $28,798.93 | $18,719.30 | 2026-06-10 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | HOME STATE MEDICAID CONTRACTED [320189] | HB SAMC HOME STATE HEALTH PLAN MANAGED MEDICAID | $738.18 | $28,798.93 | $18,719.30 | 2026-06-10 | MRF ↗ |
| CORPUS CHRISTI MEDICAL CENTER,THE Outpatient | Amerigroup | MCD | $800.00 | — | — | 2026-03-01 | MRF ↗ |
| CORPUS CHRISTI MEDICAL CENTER,THE Outpatient | Amerigroup | CHIP | $800.00 | — | — | 2026-03-01 | MRF ↗ |
| CORPUS CHRISTI MEDICAL CENTER,THE Outpatient | MultiPlan PHCS | PPO | — | — | — | 2026-03-01 | MRF ↗ |
| CORPUS CHRISTI MEDICAL CENTER,THE Outpatient | Amerigroup | MCD | $800.00 | — | — | 2026-03-01 | MRF ↗ |
| CORPUS CHRISTI MEDICAL CENTER,THE Outpatient | MultiPlan PHCS | PPO | — | — | — | 2026-03-01 | MRF ↗ |
| CORPUS CHRISTI MEDICAL CENTER,THE Outpatient | Amerigroup | CHIP | $800.00 | — | — | 2026-03-01 | MRF ↗ |
| CORPUS CHRISTI MEDICAL CENTER,THE Outpatient | Amerigroup | MCD | $800.00 | — | — | 2026-03-01 | MRF ↗ |
| CORPUS CHRISTI MEDICAL CENTER,THE Outpatient | Amerigroup | CHIP | $800.00 | — | — | 2026-03-01 | MRF ↗ |
| CORPUS CHRISTI MEDICAL CENTER,THE Outpatient | MultiPlan PHCS | PPO | — | — | — | 2026-03-01 | MRF ↗ |
| Utmb Galveston Transplant Both | Utmb Multi-Share | All Contracted Plans | $803.67 | $3,738.00 | $1,888.46 | 2026-07-15 | MRF ↗ |
| TRISTAR NORTHCREST MEDICAL CENTER Outpatient | United | MCD | $825.00 | — | — | 2026-03-01 | MRF ↗ |
| Utmb Galveston Transplant Outpatient | Community Health Choice | Marketplace Plans | $841.05 | $3,738.00 | $1,888.46 | 2026-07-15 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | HOME STATE MEDICAID CONTRACTED [320189] | HB STLO HOME STATE HEALTH PLAN MANAGED MEDICAID | $842.64 | $38,741.32 | $25,181.86 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MEDICAID PENDING [20241] | HB STLO HOME STATE HEALTH PLAN MANAGED MEDICAID | $842.64 | $38,741.32 | $25,181.86 | 2026-06-04 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE COLORADO [3050604] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER COLORADO [4000605] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER GEORGIA [4000611] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE GEORGIA [3050605] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADV MID-ATLANTIC STATES [3050607] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE SOUTHERN CA [3050602] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER MID ATLANTIC STATES [4000608] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE NORTHERN CA [3050601] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER OUT OF AREA [4000603] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER EPO [4000604] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER WASHINGTON [4000610] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER HAWAII [4000607] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER SOUTHERN CA [4000602] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER NORTHWEST [4000609] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE HAWAII [3050606] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE WASHINGTON [3050609] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER OUT OF AREA MEDICARE ADVANTAGE [3050603] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE NORTHWEST [3050608] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDI-CAL- AFTER 10/01/21 [30505] | KAISER MEDI-CAL HMO [3050501] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER-AFTER 10/01/2021 [40006] | KAISER NORTHERN CA [4000601] | $848.83 | $3,395.31 | — | 2026-04-02 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Bcbs | Medicare Advantage | $877.28 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Uhc | Medicare Advantage | $877.28 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Cdphp | Medicare Advantage | $877.28 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Cdphp | Commercial | $877.28 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Humana | Medicare Advantage | $877.28 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Mvp | Medicare Advantage | $877.28 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Wellcare | Medicare Advantage | $877.28 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Fidelis | Medicare Advantage | $877.28 | — | — | 2026-10-12 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Aetna | Medicare Advantage | $877.28 | — | — | 2026-10-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | UNITED HEALTHCARE MEDICAID CONTRACTED [320397] | HB STLO UHC MANAGED MEDICAID | $905.32 | $38,741.32 | $25,181.86 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | UNITED HEALTHCARE MEDICAID CONTRACTED [320397] | HB SAMC UHC MANAGED MEDICAID | $905.32 | $28,798.93 | $18,719.30 | 2026-06-10 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | Superior Health Plan | CHIP | $929.00 | — | — | 2026-03-01 | MRF ↗ |
| HEART HOSPITAL OF AUSTIN Outpatient | Superior Health Plan | STAR | $929.00 | — | — | 2026-03-01 | MRF ↗ |
| HEART HOSPITAL OF AUSTIN Outpatient | Superior Health Plan | STARPLUS | $929.00 | — | — | 2026-03-01 | MRF ↗ |
| HEART HOSPITAL OF AUSTIN Outpatient | Superior Health Plan | CHPFC | $929.00 | — | — | 2026-03-01 | MRF ↗ |
| HEART HOSPITAL OF AUSTIN Outpatient | Superior Health Plan | CHIP | $929.00 | — | — | 2026-03-01 | MRF ↗ |
| ST DAVID'S MEDICAL CENTER Outpatient | Superior Health Plan | STARPLUS | $929.00 | — | — | 2026-03-01 | MRF ↗ |
| ST DAVID'S MEDICAL CENTER Outpatient | Superior Health Plan | CHPFC | $929.00 | — | — | 2026-03-01 | MRF ↗ |
| ST DAVID'S MEDICAL CENTER Outpatient | Superior Health Plan | STAR | $929.00 | — | — | 2026-03-01 | MRF ↗ |
| ST DAVID'S MEDICAL CENTER Outpatient | Superior Health Plan | CHIP | $929.00 | — | — | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | Superior Health Plan | STARPLUS | $929.00 | — | — | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | Superior Health Plan | CHPFC | $929.00 | — | — | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | Superior Health Plan | STAR | $929.00 | — | — | 2026-03-01 | MRF ↗ |
| HOLY FAMILY HOSPITAL Outpatient | Tufts Health Plan | Tufts Health Plan | $931.45 | — | — | 2026-07-15 | MRF ↗ |
| HOLY FAMILY HOSPITAL Outpatient | Tufts Medicare Preferred | Tufts Medicare Preferred | $931.45 | — | — | 2026-07-15 | MRF ↗ |
| Utmb Galveston Transplant Both | Cigna | Hmo Ppo Pos | $934.50 | $3,738.00 | $1,888.46 | 2026-07-15 | MRF ↗ |
| HCA HOUSTON HEALTHCARE SOUTHEAST Outpatient | Superior Health Plan | STARPLUS | $948.00 | — | — | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CONROE Outpatient | Superior Health Plan | STARKids | $948.00 | — | — | 2026-03-01 | MRF ↗ |
| MEDICAL CITY DENTON Outpatient | Superior Health Plan | STARHealth | $948.00 | — | — | 2026-03-01 | MRF ↗ |
| TEXAS ORTHOPEDIC HOSPITAL Outpatient | Superior Health Plan | CHIP | $948.00 | — | — | 2026-03-01 | MRF ↗ |
| MEDICAL CITY DECATUR Outpatient | Superior Health Plan | STARPLUS | $948.00 | — | — | 2026-03-01 | MRF ↗ |
| TEXAS ORTHOPEDIC HOSPITAL Outpatient | Superior Health Plan | STARKids | $948.00 | — | — | 2026-03-01 | MRF ↗ |
| TEXAS ORTHOPEDIC HOSPITAL Outpatient | Superior Health Plan | STAR | $948.00 | — | — | 2026-03-01 | MRF ↗ |
| MEDICAL CITY DENTON Outpatient | Superior Health Plan | MCDSTAR | $948.00 | — | — | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE KINGWOOD Outpatient | Superior Health Plan | STARKids | $948.00 | — | — | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE TOMBALL Outpatient | Superior Health Plan | CHPFC | $948.00 | — | — | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE SOUTHEAST Outpatient | Superior Health Plan | CHPFC | $948.00 | — | — | 2026-03-01 | MRF ↗ |
| MEDICAL CITY DECATUR Outpatient | Superior Health Plan | MCDSTAR | $948.00 | — | — | 2026-03-01 | MRF ↗ |
| MEDICAL CITY DECATUR Outpatient | Superior Health Plan | STARHealth | $948.00 | — | — | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE SOUTHEAST Outpatient | Superior Health Plan | STAR | $948.00 | — | — | 2026-03-01 | MRF ↗ |
| TEXAS ORTHOPEDIC HOSPITAL Outpatient | Superior Health Plan | CHPFC | $948.00 | — | — | 2026-03-01 | 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.