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 $4,546–$11,178 (25th–75th percentile) across 1,749 hospitals · 3,590 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
$4,546
$7,714 typical
$11,178
The middle 50% of negotiated facility rates for this procedure, measured across 1,749 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. | $7,714 |
| 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 | $9,910 |
Surgical episode (typical)
~$9,910
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)
~$13,695
- 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 |
|---|---|---|---|---|---|---|---|
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | 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 INDEMNITY [1601006] | $8.84 | $4,519.00 | $4,519.00 | 2026-01-01 | 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] | 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 ↗ |
| 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 ↗ |
| 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 | 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 ↗ |
| 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 ↗ |
| 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 | 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 | 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 | 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 ↗ |
| 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 | ALIGN SENIOR CARE [250524] | ALIGN MEDICARE REPLACEMENT [25052401] | $10.39 | $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 ↗ |
| 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 ↗ |
| 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 ↗ |
| 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 ↗ |
| 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 ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE WASHINGTON [3050609] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE SOUTHERN CA [3050602] | $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 | MEDICARE [10001] | MEDICARE PART B [1000103] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE NORTHWEST [3050608] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | GENERIC FIRST AID [30063] | FIRST AID WORK COMP [3006301] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE HAWAII [3050606] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | MEDICARE PART A [1000101] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP CAL MEDI-CONNECT MEDICARE ADVANTAGE [10512] | IEHP INLAND VALLEY IPA MEDICARE ADV [1051203] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | CHAMPVA [80001] | VHA OFFICE OF COMMUNITY CARE [8000101] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | 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 | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE NORTHERN CA [3050601] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE COLORADO [3050604] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | ASCEND HOSPICE [32000] | ASCEND HOSPICE [3200001] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | MEDICARE PART A & B [1000102] | $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 | MOLINA MCAL HMO [20503] | MOLINA MCAL HMO [2050301] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE GEORGIA [3050605] | $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 ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER OUT OF AREA MEDICARE ADVANTAGE [3050603] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP CAL MEDI-CONNECT MEDICARE ADVANTAGE [10512] | IEHP LASALLE MED ASSOC MEDICARE ADV [1051204] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADV MID-ATLANTIC STATES [3050607] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | VETERANS ADMINISTRATION [80002] | VETERANS ADMINISTRATION [8000201] | $12.57 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | FIDELIS CARE MEDICAID ADVANTAGE | FIDELIS MEDICAID EPP 1 & 2 QHP | $13.64 | — | $9,267.82 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | FIDELIS CARE MEDICAID ADVANTAGE | FIDELIS MEDICAID ESS PLAN 3 &4 | $13.64 | — | $9,267.82 | 2026-03-31 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE COLORADO [3050604] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP [20502] | IEHP INLAND VALLEY IPA [2050203] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP [20502] | IEHP LASALLE MEDICAL ASSOCIATES [2050204] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | VETERANS ADMINISTRATION [80002] | VETERANS ADMINISTRATION [8000201] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP CAL MEDI-CONNECT MEDICARE ADVANTAGE [10512] | IEHP LASALLE MED ASSOC MEDICARE ADV [1051204] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE NORTHWEST [3050608] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | CHAMPVA [80001] | VHA OFFICE OF COMMUNITY CARE [8000101] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER OUT OF AREA MEDICARE ADVANTAGE [3050603] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP [20502] | INLAND EMPIRE HEALTH PLAN [2050201] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE WASHINGTON [3050609] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE GEORGIA [3050605] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE HAWAII [3050606] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE SOUTHERN CA [3050602] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | IEHP CAL MEDI-CONNECT MEDICARE ADVANTAGE [10512] | IEHP INLAND VALLEY IPA MEDICARE ADV [1051203] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | MEDICARE PART A [1000101] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | MEDICARE PART B [1000103] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MOLINA MCAL HMO [20503] | MOLINA MCAL HMO [2050301] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | RAILROAD MEDICARE [1000104] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | ASCEND HOSPICE [32000] | ASCEND HOSPICE [3200001] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADV MID-ATLANTIC STATES [3050607] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDICARE ADVANTAGE- AFTER 10/01/2021 [30506] | KAISER MEDICARE ADVANTAGE NORTHERN CA [3050601] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | MEDICARE [10001] | MEDICARE PART A & B [1000102] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | GENERIC FIRST AID [30063] | FIRST AID WORK COMP [3006301] | $16.90 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| MERCY MEDICAL CTR OutpatientFacility | CARELON HEALTH MEDICAID | CARELON MEDICAID | $20.29 | — | $10,626.38 | 2026-03-31 | MRF ↗ |
| MERCY MEDICAL CTR OutpatientFacility | WELLSENSE HEALTH PLAN | WELLSENSE SILVER | $22.22 | — | $10,626.38 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $22.73 | — | $9,267.82 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID ESSENTIAL 1 2 3 4 | $22.73 | — | $9,267.82 | 2026-03-31 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB ROGR OK MANAGED MEDICAID | $23.15 | $23,952.60 | $15,569.19 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | HUMANA MEDICAID CONTRACTED [320486] | HB ROGR OK MANAGED MEDICAID | $23.15 | $23,952.60 | $15,569.19 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB ROGR OK MANAGED MEDICAID | $23.15 | $23,952.60 | $15,569.19 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | MEDICAID [20240] | HB ROGR OKLAHOMA MEDICAID | $23.15 | $23,952.60 | $15,569.19 | 2026-03-13 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Medicare Ppo | $29.07 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Health Options Inc | Bcbs Health Options Medicare | $29.07 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $29.71 | $16,503.00 | $7,262.33 | 2024-12-31 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | $55,971.00 | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | $55,971.00 | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Careplus | Careplus | $36.72 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $37.54 | $3,201.00 | $608.19 | 2026-01-25 | MRF ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Aetna Health | Aetna Medicare | $45.90 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | $55,971.00 | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $61.13 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | UHC | Medicare Advantage | $61.13 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | VA Health | All | $61.13 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Tricare | All | $61.13 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $61.13 | — | — | 2026-03-28 | MRF ↗ |
| JOHN MUIR MEDICAL CENTER - WALNUT CREEK CAMPUS Outpatient | CONTRA COSTA COUNTY JAIL [1012104] | CCC JAIL [101210401] | $63.98 | $158,132.23 | $71,159.50 | 2026-03-23 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Msmc | Cigna | $64.26 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Humana | Humana Humx | $65.79 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Oscar Health (Hie) | Oscar Health (Hie) | $68.85 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Dimension Health | Dimension Plus | $68.85 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Outpatient | UCARE MEDICAID [16041] | UCARE MA [1604102] | $69.82 | — | $4,728.00 | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UCARE MEDICAID [16041] | UCARE MN CARE [1604103] | $69.82 | $4,519.00 | $4,519.00 | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UCARE MEDICAID [16041] | UCARE CONNECT [1604101] | $69.82 | $4,519.00 | $4,519.00 | 2026-01-01 | MRF ↗ |
| HOSPITAL FOR SPECIAL SURGERY OutpatientFacility | BLUE CROSS BLUE SHIELD NY [1022] | BCBS INDIVIDUAL NETWORK [102218] | $70.35 | — | $23,694.95 | 2026-04-01 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Aetna Health | Aetna Workers Comp | $71.91 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Network Blue | $84.15 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Ppo | $84.15 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Blue Cross Blue Shield Of Florida | Bcbs Traditional | $84.15 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Health Options Inc | Bcbs Health Options Hmo | $84.15 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MERCY HOSPITAL OKLAHOMA CITY, INC OutpatientFacility | MEDICAID [20240] | HB OKLC OK MEDICAID (SOONERCARE) | $89.56 | $72,624.85 | $47,206.15 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL OKLAHOMA CITY, INC OutpatientFacility | HUMANA MEDICAID CONTRACTED [320486] | HB OKLC OK MEDICAID (SOONERCARE) | $89.56 | $72,624.85 | $47,206.15 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL OKLAHOMA CITY, INC OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB OKLC OK MEDICAID (SOONERCARE) | $89.56 | $72,624.85 | $47,206.15 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL OKLAHOMA CITY, INC OutpatientFacility | OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB OKLC OK MEDICAID (SOONERCARE) | $89.56 | $72,624.85 | $47,206.15 | 2026-03-12 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $90.02 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $90.59 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $90.59 | — | — | 2026-03-18 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Dimension Health | Dimension International | $91.80 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDI-CAL- AFTER 10/01/21 [30505] | KAISER MEDI-CAL HMO [3050501] | $92.44 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Corvel Healthcare | Corvel Healthcare | $92.49 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UCARE MEDICARE [16042] | UCARE MSHO [1604204] | $92.98 | $4,519.00 | $4,519.00 | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | PRIME WEST MEDICARE [16030] | PRIME WEST MSHO [1603001] | $92.98 | $4,519.00 | $4,519.00 | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UCARE MEDICARE [16042] | UCARE CONNECT PLUS MEDICARE [1604201] | $92.98 | $4,519.00 | $4,519.00 | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UCARE MEDICARE [16042] | UCARE MEDICARE PLANS [1604203] | $92.98 | $4,519.00 | $4,519.00 | 2026-01-01 | 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 ↗ |
| RIDGEVIEW MEDICAL CENTER Outpatient | UNITED HEALTHCARE MEDICARE [16044] | UNITED HEALTHCARE MEDICARE ADVANTAGE [1604401] | $95.76 | — | $4,728.00 | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Inpatient | UNITED HEALTHCARE MEDICARE [16044] | UNITED HEALTHCARE MEDICARE SOLUTIONS [1604402] | $95.76 | $4,519.00 | $4,519.00 | 2026-01-01 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Care Management Network | Care Management Network | $99.45 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Aetna Health | Aetna | $99.45 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Workmans Compensation | Workmans Compensation | $99.45 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $103.17 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $103.82 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $103.82 | — | — | 2026-03-18 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | BCBS-MI | BCBSMIMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Enlyte/Genex/Coventry | CoventryAKAGenexWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Prime Health Services | PrimeHealthServicesMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Longevity Health Plan | LongevityHealthPlan | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Employers Choice Network | EmployersChoiceNetworkWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaHIX | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Community Care | CommunityCareComm | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Mclaren Health Plan | McLarenMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Mclaren Health Plan | McLarenMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Centene | AmbetterHIX | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Mclaren Health Plan | McLarenAdvantagePPO | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Mclaren Health Plan | McLarenCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHPICigna | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Humana | HumanaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Prime Health Services | PrimeHealthServicesWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Wellcare | MeridianMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | MidwestMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthSBDHMOPPO | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthCigna | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Humana | HumanaCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Naphcare Inc. | NaphCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Wellcare | CenteneHNWellcareMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Multiplan | MultiplanWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Commonwealth Care Alliance | CommonwealthCareAllianceMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | BCBS-MI | BCBSMIBCNMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | BCBS-MI | BCBSMICommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Amerihealth | AmerihealthCaritasMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | American Health Plan | AmericanHealthPlanMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | United Healthcare | UnitedCommunityPlanMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Zing Health | ZingHealthMedicareNonNarrow | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Aetna | AetnaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | United Healthcare | HealthSmartMgdWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Centene | CenteneHNWellcareMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Aetna | AetnaMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | AllyAlign Health | AllyAlignHealthMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Amerihealth | BlueCrossCompleteMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Contigo Health | ContigoHealthWCfkaThreeRiversWC | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Priority Health | PriorityHealthSEMIPartnersNet | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | United Healthcare | UnitedMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Aetna | AetnaExistingBusiness | — | — | — | 2025-01-31 | MRF ↗ |
| EISENHOWER MEDICAL CENTER Inpatient | KAISER MEDI-CAL- AFTER 10/01/21 [30505] | KAISER MEDI-CAL HMO [3050501] | $105.65 | $3,364.00 | $2,186.60 | 2026-04-02 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | COMMUNITY CARE IPA [1131] | Community Care IPA Medi-Cal Managed Care | $106.00 | $114,699.53 | $63,084.74 | 2026-04-01 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Corvel Healthcare | Corvel Healthcare | $106.72 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Dimension Health | Dimension | $107.10 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Cigna Behavioral Health | Cigna Behavioral Health | $107.10 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Behavioral Services Network | Behavioral Services Network | $107.10 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Beech Street | Beech Street | $107.10 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Inpatient | Coventry | Coventry | $108.63 | $153.00 | $153.00 | 2026-05-22 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $112.33 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $113.04 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $113.04 | — | — | 2026-03-18 | MRF ↗ |
| MOUNT SINAI MEDICAL CENTER OF FLORIDA, INC Outpatient | Workmans Compensation | Workmans Compensation | $114.75 | $153.00 | $153.00 | 2026-05-22 | 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.