59426 — Antepartum Care Only
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). ANTEPARTUM CARE ONLY (HCPCS 59426) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/59426?code_type=HCPCS
MLA (9th ed.)
“ANTEPARTUM CARE ONLY (HCPCS 59426) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/59426?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“ANTEPARTUM CARE ONLY (HCPCS 59426) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/59426?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $802–$2,737 (25th–75th percentile) across 1,362 hospitals · 3,362 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 59426 — 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 the surgeon's fee are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$802
$1,440 typical
$2,737
The middle 50% of negotiated facility rates for this procedure, measured across 1,362 hospitals. The the surgeon's fee 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. | $1,440 |
| Surgeon (professional fee) Estimate national typical Medicare $718 × 1.22 commercial. | $876 |
| Likely subtotal | $2,316 |
Surgical episode (typical)
~$2,316
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 |
|---|---|---|---|---|---|---|---|
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Aetna | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | Community Coffee Group | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | VA CCN | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | HMO | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | USA Managed Care Organization | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | First Health | Aetna Medical Rental Network | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | Community Plan | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Aetna | Better Health | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Womans Hospital Employees | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | Exchange Compass | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Medical Cost Containment Professionals | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Amerihealth Caritas | Medicaid | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | HS Technology | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Louisiana Healthcare Connection | Medicaid | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Three Rivers Provider Network | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Humana | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Peoples Health | Medicare Enrollees | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Gilsbar 360 | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Vantage Health Plan | Commercial | — | — | — | 2026-03-01 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Cigna | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | PPOplus Llc | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | First Choice | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Humana | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Vantage Health Plan Inc. | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Wellcare | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Multiplan/PHCS | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Humana | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | United Healthcare | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | First Choice | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Vantage Health Plan Inc. | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | United Healthcare | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Wellcare | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Cigna | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Multiplan/PHCS | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | PPOplus Llc | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Vantage Health Plan | PPACAMetalTierPlan | — | — | — | 2026-03-01 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| Willis-knighton Medical Center OutpatientFacility | Bcbs | All Commercial Plans | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| TRINITY MEDICAL CTR EAST &TRINITY MEDICAL CTR WEST Outpatient | Humana | Commercial|All Plans | — | — | — | 2026-02-28 | MRF ↗ |
| TRINITY MEDICAL CTR EAST &TRINITY MEDICAL CTR WEST Outpatient | AultCare | Commercial|All Plans | — | — | — | 2026-02-28 | MRF ↗ |
| TRINITY MEDICAL CTR EAST &TRINITY MEDICAL CTR WEST Outpatient | AultCare | Commercial|All Plans | — | — | — | 2026-02-28 | MRF ↗ |
| TRINITY MEDICAL CTR EAST &TRINITY MEDICAL CTR WEST Outpatient | Humana | Commercial|All Plans | — | — | — | 2026-02-28 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| HANCOCK COUNTY HEALTH SYSTEM Outpatient | WELLMARK HMO-ALL OTHER PLANS | WELLMARK HMO-ALL OTHER PLANS | $0.80 | $462.00 | $346.50 | 2026-03-26 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $3.40 | $1,890.00 | — | 2024-12-31 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $4.55 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $4.55 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $4.55 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $4.67 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $4.80 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $4.92 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $5.90 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $5.90 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $6.03 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $6.03 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $6.03 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $6.03 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $6.15 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $6.27 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $6.40 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $6.64 | $1,230.00 | $1,168.50 | 2026-02-20 | MRF ↗ |
| MAGEE WOMENS HOSPITAL OF UPMC HEALTH SYSTEM OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.77 | $2,131.00 | $1,278.60 | 2026-03-06 | MRF ↗ |
| MAGEE WOMENS HOSPITAL OF UPMC HEALTH SYSTEM OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.77 | $2,131.00 | $1,278.60 | 2026-03-06 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | TEXAS CHILDRENS HP - ALL PLANS | TEXAS CHILDRENS HP - ALL PLANS | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | AMERIGROUP STAR | AMERIGROUP STAR | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | TEXAS CHILDRENS HP - ALL PLANS | TEXAS CHILDRENS HP - ALL PLANS | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | SCOTT & WHITE CHIP/STAR-ALL PLANS | SCOTT & WHITE CHIP/STAR-ALL PLANS | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | AMERIGROUP STAR PLUS | AMERIGROUP STAR PLUS | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | UHC STAR/CHIP | UHC STAR/CHIP | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | COMM HEALTH CHIP | COMM HEALTH CHIP | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | COMM HEALTH PERINATAL-ALL OTHER PLANS | COMM HEALTH PERINATAL-ALL OTHER PLANS | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | COMM HEALTH CHIP | COMM HEALTH CHIP | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | AMERIGROUP STAR | AMERIGROUP STAR | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | AMERIGROUP CHIP | AMERIGROUP CHIP | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | MOLINA CHIP/STAR-ALL PLANS | MOLINA CHIP/STAR-ALL PLANS | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | COMM HEALTH PERINATAL-ALL OTHER PLANS | COMM HEALTH PERINATAL-ALL OTHER PLANS | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | SUPERIOR CHIP/STAR | SUPERIOR CHIP/STAR | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | UHC STAR PLUS | UHC STAR PLUS | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | AMERIGROUP STAR PLUS | AMERIGROUP STAR PLUS | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | MOLINA CHIP/STAR-ALL PLANS | MOLINA CHIP/STAR-ALL PLANS | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | UHC STAR/CHIP | UHC STAR/CHIP | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | AMERIGROUP STAR KIDS | AMERIGROUP STAR KIDS | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | AMERIGROUP CHIP | AMERIGROUP CHIP | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | AMERIGROUP STAR KIDS | AMERIGROUP STAR KIDS | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | SCOTT & WHITE CHIP/STAR-ALL PLANS | SCOTT & WHITE CHIP/STAR-ALL PLANS | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | SUPERIOR CHIP/STAR | SUPERIOR CHIP/STAR | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | UHC STAR PLUS | UHC STAR PLUS | $20.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | COMM HEALTH STAR | COMM HEALTH STAR | $21.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | COMM HEALTH MCAID HMO | COMM HEALTH MCAID HMO | $21.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | COMM HEALTH MCAID HMO | COMM HEALTH MCAID HMO | $21.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | COMM HEALTH STAR | COMM HEALTH STAR | $21.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| LEXINGTON REGIONAL HEALTH CENTER OutpatientFacility | BCBS | ALL PRODUCTS | $23.75 | $25.00 | $24.00 | 2025-12-28 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Cigna | EvernorthBehavioralHealth | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | BCBS-MA | BCBSMAHMO | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Commonwealth Care Alliance | CommonwealthCareAllianceMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Fallon | FallonMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | BCBS-MA | BCBSMAPreferredProviderArrangement | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Aetna | AetnaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Aetna | AetnaCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Beacon Health Options | BeaconHealthOptionsBehavioralCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Corvel | CorvelWC | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Contigo Health | ContigoHealthWCfkaThreeRiversWC | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Humana | HumanaCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Mass General Brigham | MassGeneralBrighamHMO | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Mass Advantage | MassAdvantage | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Braintree Rehab | BraintreeRehab | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | St. Patricks Manor | St.PatricksManor | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Wellcare | CenteneHNWellcareMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Anthem Affiliates | Unicare | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Point32Health | TuftsPPO | $23.88 | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Healthy Start | HealthyStart | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | EternalHealth | EternalHealthMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Point32Health | HarvardPilgrimStrideMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Point32Health | TuftsPublicPlanHIXUnsubsidized | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Point32Health | TuftsSelectHMO | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Point32Health | TuftsPublicPlanHIXSubsidized | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Point32Health | TuftsSelectPPO | — | — | — | 2025-01-31 | MRF ↗ |
| METROWEST MEDICAL CENTER Outpatient | Point32Health | HarvardPilgrimPPO | — | — | — | 2025-01-31 | MRF ↗ |
| LEXINGTON REGIONAL HEALTH CENTER OutpatientFacility | UHC | ALL PRODUCTS | $24.00 | $25.00 | $24.00 | 2025-12-28 | MRF ↗ |
| LEXINGTON REGIONAL HEALTH CENTER OutpatientFacility | MIDLANDS CHOICE | ALL PRODUCTS | $25.00 | $25.00 | $24.00 | 2025-12-28 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $25.33 | $2,435.15 | $2,435.15 | 2026-04-24 | MRF ↗ |
| STEELE MEMORIAL MEDICAL CENTER Outpatient | SELECT HEALTH INC - ALL OTHER PLANS | SELECT HEALTH INC - ALL OTHER PLANS | $26.02 | $1,563.00 | $1,172.25 | 2026-02-26 | MRF ↗ |
| TUFTS MEDICAL CENTER Both | TUFTS HEALTH PLAN [100263] | HB XR THP SELECT HMO POS TMC | $26.67 | $1,607.00 | $1,124.90 | 2026-04-01 | MRF ↗ |
| TUFTS MEDICAL CENTER Both | TUFTS HEALTH PLAN [100263] | HB XR TUFTS HEALTH PLAN SPIRIT TMC | $27.38 | $1,607.00 | $1,124.90 | 2026-04-01 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Horizon | Horizon NJ Health - Medicaid | $28.17 | $134.00 | — | 2025-08-07 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Horizon | Horizon NJ Health - Medicaid | $28.17 | $134.00 | — | 2025-08-07 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Non-Contracted Medicaid | Non-Contracted Medicaid - 90 Percent | $28.37 | $134.00 | — | 2025-08-07 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Non-Contracted Medicaid | Non-Contracted Medicaid - 90 Percent | $28.37 | $134.00 | — | 2025-08-07 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| STEELE MEMORIAL MEDICAL CENTER Outpatient | INTERWEST HEALTH - ALL PLANS | INTERWEST HEALTH - ALL PLANS | $29.20 | $1,563.00 | $1,172.25 | 2026-02-26 | MRF ↗ |
| TUFTS MEDICAL CENTER Both | CIGNA [100009] | HB XR THP PPO TMC | $29.64 | $1,607.00 | $1,124.90 | 2026-04-01 | MRF ↗ |
| TUFTS MEDICAL CENTER Both | TUFTS HEALTH PLAN [100263] | HB XR THP PPO TMC | $29.64 | $1,607.00 | $1,124.90 | 2026-04-01 | MRF ↗ |
| TUFTS MEDICAL CENTER Both | TUFTS HEALTH PLAN [100263] | HB XR THP HMO POS IN IPA TMC | $29.64 | $1,607.00 | $1,124.90 | 2026-04-01 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Both | BCBS - MA [10001] | CHA HB BCBS INDEMNITY | $29.70 | $1,000.00 | $1,000.00 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Both | BCBS - OUT OF STATE [10002] | CHA HB BCBS INDEMNITY | $29.70 | $1,000.00 | $1,000.00 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Both | BCBS - OUT OF STATE [10002] | CHA HB BCBS PPO | $29.70 | $1,000.00 | $1,000.00 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Both | BCBS - MA [10001] | CHA HB BCBS PPO | $29.70 | $1,000.00 | $1,000.00 | 2026-03-20 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Upmc | All Commercial Plans | $30.62 | — | — | 2026-04-01 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Both | BCBS - OUT OF STATE [10002] | CHA HB BCBS HMO BLUE | $30.92 | $1,000.00 | $1,000.00 | 2026-03-20 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Both | BCBS - MA [10001] | CHA HB BCBS HMO BLUE | $30.92 | $1,000.00 | $1,000.00 | 2026-03-20 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Blue Cross Blue Shield | Minnesota Health Care Programs | $31.34 | $131.00 | $111.35 | 2026-02-12 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Wellpoint Amerigroup | Wellpoint Amerigroup Medicaid | $31.52 | $134.00 | — | 2025-08-07 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Traditional Medicaid | Traditional Medicaid | $31.52 | $134.00 | — | 2025-08-07 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | UHC | UHC Medicaid | $31.52 | $134.00 | — | 2025-08-07 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Wellpoint Amerigroup | Wellpoint Amerigroup Medicaid | $31.52 | $134.00 | — | 2025-08-07 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | UHC | UHC Medicaid | $31.52 | $134.00 | — | 2025-08-07 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Wellcare | Wellcare Medicaid | $31.52 | $134.00 | — | 2025-08-07 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Traditional Medicaid | Traditional Medicaid | $31.52 | $134.00 | — | 2025-08-07 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Wellcare | Wellcare Medicaid | $31.52 | $134.00 | — | 2025-08-07 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Tufts | PPO | $32.02 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Tufts | PPO | $32.02 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Tufts | HMO | $32.02 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Tufts | POS | $32.02 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Tufts | HMO | $32.02 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Tufts | POS | $32.02 | — | — | 2025-04-16 | MRF ↗ |
| SAINT ANNE'S HOSPITAL OutpatientFacility | Tufts Health Plan | Hmo/Ppo | $32.83 | — | — | 2026-04-01 | 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 ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Blue Cross Blue Shield | Minnesota Health Care Programs | $33.73 | $141.00 | $119.85 | 2026-02-12 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center Commercial | $33.86 | — | — | 2026-04-14 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Aetna Better Health | Aetna Better Health - Medi Medi | $34.67 | $134.00 | — | 2025-08-07 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Aetna Better Health | Aetna Better Health - Medicaid | $34.67 | $134.00 | — | 2025-08-07 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Aetna Better Health | Aetna Better Health - Behavioral Health | $34.67 | $134.00 | — | 2025-08-07 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Aetna Better Health | Aetna Better Health - Behavioral Health | $34.67 | $134.00 | — | 2025-08-07 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Aetna Better Health | Aetna Better Health - Medicaid | $34.67 | $134.00 | — | 2025-08-07 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Aetna Better Health | Aetna Better Health - Medi Medi | $34.67 | $134.00 | — | 2025-08-07 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Both | TUFTS HEALTH PLAN [100263] | HB XR TUFTS HEALTH PLAN SPIRIT PPO MWF | $35.19 | $1,041.00 | $728.70 | 2026-04-01 | MRF ↗ |
| MELROSEWAKEFIELD HEALTHCARE Both | TUFTS HEALTH PLAN [100263] | HB XR TUFTS HEALTH PLAN SPIRIT PPO MWF | $35.19 | $1,041.00 | $728.70 | 2026-04-01 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Medica | MHSO Medicare Cost & Select | — | $151.00 | $128.35 | 2026-02-12 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Medica | Medicare Advantage | — | $151.00 | $128.35 | 2026-02-12 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Medica | Commercial | — | $151.00 | $128.35 | 2026-02-12 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Blue Cross Blue Shield | Minnesota Health Care Programs | $36.12 | $151.00 | $128.35 | 2026-02-12 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Medica | Choice Care | — | $151.00 | $128.35 | 2026-02-12 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Medica | Minnesota Health Care Programs | — | $151.00 | $128.35 | 2026-02-12 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $36.42 | $3,427.00 | $3,427.00 | 2026-02-13 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Both | TUFTS HEALTH PLAN [100263] | HB XR THP SELECT HMO POS MWF | $37.25 | $1,041.00 | $728.70 | 2026-04-01 | MRF ↗ |
| MELROSEWAKEFIELD HEALTHCARE Both | TUFTS HEALTH PLAN [100263] | HB XR THP SELECT HMO POS MWF | $37.25 | $1,041.00 | $728.70 | 2026-04-01 | MRF ↗ |
| CAMBRIDGE HEALTH ALLIANCE Both | OTHER TUFTS HEALTH PUBLIC PLAN [75002] | CHA HB TUFTS HEALTH PUBLIC PLANS QHP SUBSIDIZED | $37.27 | $1,000.00 | $1,000.00 | 2026-03-20 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | VA Health | All | $37.52 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $37.52 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $37.52 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Tricare | All | $37.52 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | UHC | Medicare Advantage | $37.52 | — | — | 2026-03-28 | MRF ↗ |
| MELROSEWAKEFIELD HEALTHCARE Both | TUFTS HEALTH PLAN [100263] | HB XR THP PPO MWF | $38.23 | $1,041.00 | $728.70 | 2026-04-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Both | TUFTS HEALTH PLAN [100263] | HB XR THP PPO MWF | $38.23 | $1,041.00 | $728.70 | 2026-04-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Both | TUFTS HEALTH PLAN [100263] | HB XR THP POS MWF | $38.23 | $1,041.00 | $728.70 | 2026-04-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Both | CIGNA [100009] | HB XR THP PPO MWF | $38.23 | $1,041.00 | $728.70 | 2026-04-01 | MRF ↗ |
| MELROSEWAKEFIELD HEALTHCARE Both | TUFTS HEALTH PLAN [100263] | HB XR THP POS MWF | $38.23 | $1,041.00 | $728.70 | 2026-04-01 | MRF ↗ |
| MELROSEWAKEFIELD HEALTHCARE Both | CIGNA [100009] | HB XR THP PPO MWF | $38.23 | $1,041.00 | $728.70 | 2026-04-01 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Blue Cross Blue Shield | Minnesota Health Care Programs | $39.23 | $164.00 | $139.40 | 2026-02-12 | MRF ↗ |
| Tyler Memorial Hospital OutpatientFacility | — | — | — | — | — | 2026-01-01 | MRF ↗ |
| SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS Outpatient | Keenan | Keenan | $40.20 | $134.00 | — | 2025-08-07 | 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.