63042 — Laminotomy Single Lumbar
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). LAMINOTOMY SINGLE LUMBAR (HCPCS 63042) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/63042?code_type=HCPCS
MLA (9th ed.)
“LAMINOTOMY SINGLE LUMBAR (HCPCS 63042) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/63042?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“LAMINOTOMY SINGLE LUMBAR (HCPCS 63042) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/63042?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,914–$11,106 (25th–75th percentile) across 2,055 hospitals · 3,534 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 63042 — 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
$3,914
$7,513 typical
$11,106
The middle 50% of negotiated facility rates for this procedure, measured across 2,055 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. | $7,513 |
| Surgeon (professional fee) Estimate national typical Medicare $1,220 × 1.22 commercial. | $1,488 |
| 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 | $9,709 |
Surgical episode (typical)
~$9,709
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 $3,914–$11,106.
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)
~$13,494
- 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 |
|---|---|---|---|---|---|---|---|
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | HEALTHSMART | HEALTHSMART WORKERS COMP | $0.17 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | HEALTHSMART | HEALTHSMART WORKERS COMP | $0.22 | — | — | 2026-05-20 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Carolina Complete Health | Managed Medicaid | $0.28 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | United Healthcare | Compass | $0.35 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Healthy Blue | Managed Medicaid | $0.37 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | United Healthcare | Managed Medicaid | $0.37 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Wellcare | Managed Medicaid | $0.37 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Aetna Nc State Health Plan | Commercial | $0.48 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Aetna New Business | Commerical | $0.58 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Aetna | Commercial | $0.58 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Medcost | Commercial | $0.60 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Cigna | Commercial | $0.60 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Nc | Commercial | $0.64 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| NORTHRIDGE HOSPITAL MEDICAL CENTER Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Humana | Commercial | $0.75 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Humana Choicecare | Commercial | $0.75 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | United Healthcare | Commercial | $0.77 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Multiplan | Commercial | $0.82 | $1.00 | $0.60 | 2026-08-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| SHELBY BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW BUSINESS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE COMMERCIAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| PRINCETON BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| PRINCETON BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW BUSINESS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE COMMERCIAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| SHELBY BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| CITIZENS BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| CITIZENS BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| OPTIM MEDICAL CENTER - TATTNALL Outpatient | Centene Peach State | Managed Medicaid | — | $60,000.00 | $60,000.00 | 2026-07-15 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $6.20 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $6.20 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $6.20 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $6.20 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $6.20 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $6.20 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $6.20 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $6.20 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $6.20 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $6.20 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $6.58 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $6.58 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $6.58 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $6.58 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $6.58 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $6.58 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $6.58 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $6.58 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $6.58 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $6.58 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $7.14 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $7.14 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $7.14 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $7.14 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $7.14 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $7.14 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $7.14 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $7.14 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $7.14 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $7.14 | — | — | 2026-05-20 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UNITED HEALTHCARE [16010] | UMR LABOR CARE [1601010] | $8.84 | $4,519.00 | $4,519.00 | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Outpatient | UNITED HEALTHCARE [16010] | UMR [1601009] | $8.84 | — | $4,728.00 | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UNITED HEALTHCARE [16010] | SUREST UNITED HEALTHCARE [1601008] | $8.84 | $4,519.00 | $4,519.00 | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UNITED HEALTHCARE [16010] | UNITED HEALTHCARE [1601005] | $8.84 | $4,519.00 | $4,519.00 | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Outpatient | UNITED HEALTHCARE [16010] | UNITEDHEALTH INTEGRATED SERVICES [1601007] | $8.84 | — | $4,728.00 | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UNITED HEALTHCARE [16010] | UNITED HEALTHCARE INDEMNITY [1601006] | $8.84 | $4,519.00 | $4,519.00 | 2026-01-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $9.19 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $9.19 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $9.19 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $9.19 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $9.19 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $9.19 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $9.19 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $9.19 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $9.19 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $9.19 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $9.77 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $9.77 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $9.77 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $9.77 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $9.77 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $9.77 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $9.77 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $9.77 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $9.77 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $9.77 | — | — | 2026-05-20 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | BCBS MEDICARE [250503] | BCBS MEDICARE REPLACEMENT [25050301] | $10.20 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | CIGNA MCR HMO/PPO [250525] | MEDICARE REPLACEMENT [25052501] | $10.20 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | WELLCARE HEALTH PLAN [250516] | MEDICARE REPLACEMENT [25051601] | $10.20 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | WELLCARE HEALTH PLAN [250516] | MEDICARE REPLACEMENT [25051601] | $10.20 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | CIGNA MCR HMO/PPO [250525] | MEDICARE REPLACEMENT [25052501] | $10.20 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | BCBS MEDICARE [250503] | BCBS MEDICARE REPLACEMENT [25050301] | $10.20 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $10.33 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $10.33 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $10.33 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $10.33 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $10.33 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $10.33 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $10.33 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $10.33 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $10.33 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $10.33 | — | — | 2026-05-20 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | UNITED HEALTH MCR HMO/PPO [250515] | UHC MEDICARE REPLACEMENT [25051501] | $10.38 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | HUMANA GOLD [250508] | PFFS MEDICARE REPLACEMENT [25050801] | $10.38 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | UNITED HEALTH MCR HMO/PPO [250515] | UHC MEDICARE REPLACEMENT [25051501] | $10.38 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | HUMANA GOLD [250508] | PFFS MEDICARE REPLACEMENT [25050801] | $10.38 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | AETNA COVENTRY MCR REPLACEMENT [250518] | AETNA MEDICARE [25051801] | $10.38 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | AETNA COVENTRY MCR REPLACEMENT [250518] | AETNA MEDICARE [25051801] | $10.38 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | FREEDOM HEALTH [250505] | FREEDOM HLTH MEDICARE REPLACEMENT [25050501] | $10.39 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| Rehabilitation Hospital of Fort Myers OutpatientFacility | ALIGN SENIOR CARE [250524] | ALIGN MEDICARE REPLACEMENT [25052401] | $10.39 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | FREEDOM HEALTH [250505] | FREEDOM HLTH MEDICARE REPLACEMENT [25050501] | $10.39 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| GULF COAST MEDICAL CENTER LEE HEALTH OutpatientFacility | ALIGN SENIOR CARE [250524] | ALIGN MEDICARE REPLACEMENT [25052401] | $10.39 | $53,495.72 | $10,699.14 | 2026-03-26 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $10.71 | — | $9,267.82 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $10.71 | — | $9,267.82 | 2026-03-31 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $10.90 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $10.90 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $10.90 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $10.90 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $10.90 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $10.90 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $10.90 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $10.90 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $10.90 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $10.90 | — | — | 2026-05-20 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | UHC COMMUNITY MEDICAID [2175] | HB XR UHC INDIANA PATHWAYS MEDICAID | $11.14 | $22,401.15 | $14,312.16 | 2025-12-19 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $11.27 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $11.27 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $11.27 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $11.27 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $11.27 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $11.27 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $11.27 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $11.27 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $11.27 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $11.27 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $11.84 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $11.84 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $11.84 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $11.84 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $11.84 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $11.84 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $11.84 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $11.84 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $11.84 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $11.84 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $12.22 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $12.22 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $12.22 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $12.22 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $12.22 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $12.22 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $12.22 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $12.22 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $12.22 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $12.22 | — | — | 2026-05-20 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | RAILROAD MEDICARE [1000104] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP [20502] | IEHP INLAND VALLEY IPA [2050203] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP [20502] | INLAND EMPIRE HEALTH PLAN [2050201] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP [20502] | IEHP LASALLE MEDICAL ASSOCIATES [2050204] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | 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.