631 — Hernia
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). HERNIA (EAPG 631) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/631?code_type=EAPG
MLA (9th ed.)
“HERNIA (EAPG 631) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/631?code_type=EAPG. Accessed .
Chicago (notes-bibliography)
“HERNIA (EAPG 631) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/631?code_type=EAPG.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $144–$348 (25th–75th percentile) across 73 hospitals · 92 payers.
“Negotiated” is the hospital’s negotiated facility rate for this EAPG 631 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
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 |
|---|---|---|---|---|---|---|---|
| SAUK PRAIRIE HOSPITAL OutpatientFacility | GHC | Managed Medicaid | $30.32 | — | — | 2026-01-29 | MRF ↗ |
| SAUK PRAIRIE HOSPITAL OutpatientFacility | Humana | Managed Medicaid | $30.32 | — | — | 2026-01-29 | MRF ↗ |
| SAUK PRAIRIE HOSPITAL OutpatientFacility | Anthem BCBS | Managed Medicaid | $30.32 | — | — | 2026-01-29 | MRF ↗ |
| SAUK PRAIRIE HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $30.32 | — | — | 2026-01-29 | MRF ↗ |
| SAUK PRAIRIE HOSPITAL OutpatientFacility | Quartz | Managed Medicaid | $30.32 | — | — | 2026-01-29 | MRF ↗ |
| SAUK PRAIRIE HOSPITAL OutpatientFacility | Dean Health Plan | Managed Medicaid | $30.32 | — | — | 2026-01-29 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY OutpatientFacility | United Healthcare Insurance Company | WI MEDICAID UHC COMMUNITY PLAN | $65.75 | — | — | 2026-03-24 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY OutpatientFacility | My Choice Wisconsin | WI MEDICAID MYCHOICE WI-CARE WI | $65.75 | — | — | 2026-03-24 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY OutpatientFacility | Chorus Community Health Plan | WI MEDICAID CHORUS COMMUNITY HEALTH PLANS (CCHP) | $67.07 | — | — | 2026-03-24 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY OutpatientFacility | Molina Healthcare of Wisconsin | WI MEDICAID MOLINA HEALTHCARE | $71.67 | — | — | 2026-03-24 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY OutpatientFacility | Managed Health Services | WI MEDICAID MANAGED HEALTH SERVICES & NETWORK HEALTH | $71.67 | — | — | 2026-03-24 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY OutpatientFacility | My Choice Wisconsin | WI MEDICAID TRILOGY | $73.65 | — | — | 2026-03-24 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY OutpatientFacility | Anthem Blue Cross Blue Shield | WI MEDICAID ANTHEM | $75.62 | — | — | 2026-03-24 | MRF ↗ |
| UNITYPOINT HEALTH - MERITER OutpatientFacility | Anthem Blue Cross and Blue Shield | Managed Medicaid | $80.12 | — | — | 2026-01-28 | MRF ↗ |
| UNITYPOINT HEALTH - MERITER OutpatientFacility | GHC - Eau Claire | Managed Medicaid | $80.12 | — | — | 2026-01-28 | MRF ↗ |
| UNITYPOINT HEALTH - MERITER OutpatientFacility | My Choice | Managed Medicaid | $80.12 | — | — | 2026-01-28 | MRF ↗ |
| UNITYPOINT HEALTH - MERITER OutpatientFacility | GHC - South Central WI | Managed Medicaid | $80.12 | — | — | 2026-01-28 | MRF ↗ |
| UNITYPOINT HEALTH - MERITER OutpatientFacility | GHC - South Central WI | Managed Medicaid | $80.12 | — | — | 2026-01-28 | MRF ↗ |
| UNITYPOINT HEALTH - MERITER OutpatientFacility | Anthem Blue Cross and Blue Shield | Managed Medicaid | $80.12 | — | — | 2026-01-28 | MRF ↗ |
| UNITYPOINT HEALTH - MERITER OutpatientFacility | My Choice | Managed Medicaid | $80.12 | — | — | 2026-01-28 | MRF ↗ |
| UNITYPOINT HEALTH - MERITER OutpatientFacility | GHC - Eau Claire | Managed Medicaid | $80.12 | — | — | 2026-01-28 | MRF ↗ |
| UNITYPOINT HEALTH - MERITER OutpatientFacility | United Healthcare | Managed Medicaid | $80.12 | — | — | 2026-01-28 | MRF ↗ |
| UNITYPOINT HEALTH - MERITER OutpatientFacility | United Healthcare | Managed Medicaid | $80.12 | — | — | 2026-01-28 | MRF ↗ |
| UNITYPOINT HEALTH - MERITER OutpatientFacility | Dean Health Plan | Managed Medicaid | $80.12 | — | — | 2026-01-28 | MRF ↗ |
| UNITYPOINT HEALTH - MERITER OutpatientFacility | Dean Health Plan | Managed Medicaid | $80.12 | — | — | 2026-01-28 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | United Healthcare Insurance Company | WI MEDICAID UHC COMMUNITY PLAN | $80.44 | — | — | 2026-03-23 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | My Choice Wisconsin | WI MEDICAID MYCHOICE WI-CARE WI | $80.44 | — | — | 2026-03-23 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | Chorus Community Health Plan | WI MEDICAID CHORUS COMMUNITY HEALTH PLANS (CCHP) | $82.05 | — | — | 2026-03-23 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY OutpatientFacility | ICare | WI Medicaid I Care - CFV | $82.19 | — | — | 2026-03-24 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | Managed Health Services | WI MEDICAID MANAGED HEALTH SERVICES & NETWORK HEALTH | $87.68 | — | — | 2026-03-23 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | My Choice Wisconsin | WI MEDICAID MY CHOICE | $90.10 | — | — | 2026-03-23 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | Molina Healthcare of Wisconsin | WI MEDICAID MOLINA HEALTHCARE | $90.10 | — | — | 2026-03-23 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | Anthem Blue Cross Blue Shield | WI MEDICAID ANTHEM | $92.51 | — | — | 2026-03-23 | MRF ↗ |
| GENEVA GENERAL HOSPITAL OutpatientFacility | MVP Health Care | Managed Medicaid | $96.86 | — | — | 2025-08-07 | MRF ↗ |
| EAST LIVERPOOL CITY HOSPITAL Outpatient | Traditional Medicaid | Traditional Medicaid | $100.41 | — | — | 2024-12-19 | MRF ↗ |
| EAST LIVERPOOL CITY HOSPITAL Outpatient | Buckeye Community Health Plan | Buckeye Community Health Plan Medicaid | $100.41 | — | — | 2024-12-19 | MRF ↗ |
| EAST LIVERPOOL CITY HOSPITAL Outpatient | Molina | Molina Medicaid | $100.41 | — | — | 2024-12-19 | MRF ↗ |
| EAST LIVERPOOL CITY HOSPITAL Outpatient | Non-Contracted Medicaid | Non-Contracted Medicaid | $100.41 | — | — | 2024-12-19 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | ICare | WI MEDICAID I CARE | $100.55 | — | — | 2026-03-23 | MRF ↗ |
| EAST LIVERPOOL CITY HOSPITAL Outpatient | Care Source | Care source Medicaid | $102.42 | — | — | 2024-12-19 | MRF ↗ |
| EAST LIVERPOOL CITY HOSPITAL Outpatient | Paramount | Paramount Medicaid | $103.42 | — | — | 2024-12-19 | MRF ↗ |
| EAST LIVERPOOL CITY HOSPITAL Outpatient | Anthem Blue Cross | Anthem BCBS Medicaid | $103.42 | — | — | 2024-12-19 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Illinois | Managed Medicaid | $103.66 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Meridian Health IL | Managed Medicaid | $103.66 | — | — | 2026-02-13 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | Wellcare (IL) Medicaid | Managed Medicaid | $103.66 | — | — | 2026-02-11 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Aetna Better Health IL | Managed Medicaid | $103.66 | — | — | 2026-02-13 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | MeridianHealth (IL) | Managed Medicaid | $103.66 | — | — | 2026-02-11 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Illinois | Managed Medicaid | $103.66 | — | — | 2026-02-11 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Molina IL | Managed Medicaid | $103.66 | — | — | 2026-02-13 | MRF ↗ |
| EAST LIVERPOOL CITY HOSPITAL Outpatient | Choice Care Humana | Choice Care Humana Medicaid | $104.43 | — | — | 2024-12-19 | MRF ↗ |
| EAST LIVERPOOL CITY HOSPITAL Outpatient | UHC | UHC Medicaid | $105.43 | — | — | 2024-12-19 | MRF ↗ |
| EAST LIVERPOOL CITY HOSPITAL Outpatient | Amerihealth Caritas | Amerihealth Caritas Medicaid | $105.43 | — | — | 2024-12-19 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $105.47 | — | — | 2026-01-01 | MRF ↗ |
| GENEVA GENERAL HOSPITAL OutpatientFacility | Aetna | Managed Medicaid | $107.62 | — | — | 2025-08-07 | MRF ↗ |
| GENEVA GENERAL HOSPITAL OutpatientFacility | Excellus Blue Choice Options | Managed Medicaid | $107.62 | — | — | 2025-08-07 | MRF ↗ |
| GENEVA GENERAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $107.62 | — | — | 2025-08-07 | MRF ↗ |
| SOLDIERS AND SAILORS MEMORIAL HOSPITAL OF YATES OutpatientFacility | United Healthcare | Managed Medicaid | $107.62 | — | — | 2025-08-07 | MRF ↗ |
| SOLDIERS AND SAILORS MEMORIAL HOSPITAL OF YATES OutpatientFacility | Fidelis | Managed Medicaid | $107.62 | — | — | 2025-08-07 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | Coordinated Care Apple Health | COORDINATED CARE BH | — | $127.52 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | CHPW Apple Health | CHP-BEHAVIORAL HEALTH ONLY | — | $123.95 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | Coordinated Care Apple Health | COORDINATED CARE AH | — | $127.52 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | Molina Apple Health | MOLINA AH | — | $114.26 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | CHPW Apple Health | CHP WASHINGTON HEALTH | — | $123.95 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | Molina Apple Health | MOLINA AH BLIND_DISABLED | — | $114.26 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | CHPW Apple Health | CHP AH | — | $123.95 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | Coordinated Care Apple Health | OPTICARE MANAGED VISION | — | $127.52 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | Coordinated Care Apple Health | COORDINATED CARE-BEHAVIORAL HEALTH ONLY | — | $127.52 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | UHC Apple Health | UNITED HEALTH CARE AH | — | $117.32 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | UHC Apple Health | NORTHWEST PHYSICIAN NETWORK | — | $117.32 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | Molina Apple Health | MOLINA BEHAVIORAL HEALTH ONLY | — | $114.26 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | UHC Apple Health | UNITED HEALTHCARE BEHAVIORAL HEALTH ONLY | — | $117.32 | — | 2024-07-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $117.88 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $117.88 | — | — | 2026-01-01 | MRF ↗ |
| SOLDIERS AND SAILORS MEMORIAL HOSPITAL OF YATES OutpatientFacility | Fidelis | Medicare Advantage | $118.38 | — | — | 2025-08-07 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD [2201], OUT AREA BLUE CROSS BLUE SHIELD, UNIVERA, EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID [1706] | BLUE CHOICE OPTION MEDICAID [170601],EXCELLUS CHILD HEALTH PLUS [220108], EXCELLUS ESS Q 1 2 [220109],EXCELLUS HLTHY NY [220110], EXCELLUS ESSENTIAL PA 3 AND 4 [170604] | $119.59 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) [1720] | AMERIGROUP (BSWNY ALTERNATE) [172001] | $119.59 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | FIDELIS MEDICAID [1708] | FIDELIS MEDICAID [170801], FIDELIS CHILD HEALTH PLUS [515502] | $119.59 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID [1716] | UNITED HEALTHCARE MEDICAID [171601] | $119.59 | — | — | 2026-04-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | BLUE CHOICE OPTION MEDICAID 170601 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | EXCELLUS ESSENTIAL 3-4 170604, EXCELLUS ESSENTIAL 1-2 200-250 2201, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS HLTHY NY 220110 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | MOLINA HEALTHCARE 1723 | MOLINA MEDICAID 172301, MOLINA CHILD HEALTH PLUS 518901 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL 3-4 171602, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNIVERA HEALTHCARE 1706 | UNIVERA MEDICAID 170607, UNIVERA ESSENTIAL 3-4 170605, UNIVERA ESSENTIAL 1-2 200-250 2201, UNIVERA CHILD HEALTH PLUS 220118, UNIVERA HLTHY NY 220112 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL 3-4 171602, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | MOLINA HEALTHCARE 1723 | MOLINA MEDICAID 172301, MOLINA CHILD HEALTH PLUS 518901 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | BLUE CHOICE OPTION MEDICAID 170601 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | EXCELLUS ESSENTIAL 3-4 170604, EXCELLUS ESSENTIAL 1-2 200-250 2201, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS HLTHY NY 220110 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL 3-4 171602, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNIVERA HEALTHCARE 1706 | UNIVERA MEDICAID 170607, UNIVERA ESSENTIAL 3-4 170605, UNIVERA ESSENTIAL 1-2 200-250 2201, UNIVERA CHILD HEALTH PLUS 220118, UNIVERA HLTHY NY 220112 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 5143 | HIGHMARK BCBS ESSENTIAL 1-2 200-250 5143 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | EXCELLUS ESSENTIAL 3-4 170604, EXCELLUS ESSENTIAL 1-2 200-250 2201, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS HLTHY NY 220110 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL 3-4 171602, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL 3-4 171602, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | BLUE CHOICE OPTION MEDICAID 170601 | $124.08 | — | — | 2026-01-01 | MRF ↗ |
| CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES OutpatientFacility | Colorado Access | Managed Medicaid | $128.09 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES OutpatientFacility | Denver Health | Managed Medicaid | $128.09 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES OutpatientFacility | Rocky Mountain Health Plan | Managed Medicaid | $128.09 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES OutpatientFacility | Colorado Access | Managed Medicaid | $128.09 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES OutpatientFacility | Denver Health | Managed Medicaid | $128.09 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES OutpatientFacility | Rocky Mountain Health Plan | Managed Medicaid | $128.09 | — | — | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Colorado Access | Managed Medicaid | $128.09 | — | — | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Denver Health | Managed Medicaid | $128.09 | — | — | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Kaiser | Managed Medicaid | $128.09 | — | — | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Naphcare | Managed Medicaid | $128.09 | — | — | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Rocky Mountain Health Plan | Managed Medicaid | $128.09 | — | — | 2024-12-02 | MRF ↗ |
| GENEVA GENERAL HOSPITAL OutpatientFacility | Fidelis | Managed Medicaid | $129.14 | — | — | 2025-08-07 | MRF ↗ |
| MIDWESTERN REGION MED CENTER, INC Outpatient | County Care | Medicaid All Plans | $130.45 | — | — | 2026-03-27 | MRF ↗ |
| MIDWESTERN REGION MED CENTER, INC Outpatient | Meridian | Medicaid All Plans | $130.45 | — | — | 2026-03-27 | MRF ↗ |
| CENTURA HEALTH-ST ANTHONY NORTH HEALTH CAMPUS OutpatientFacility | Colorado Access | Managed Medicaid | $131.48 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-ST ANTHONY NORTH HEALTH CAMPUS OutpatientFacility | Kaiser | Managed Medicaid | $131.48 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-ST ANTHONY NORTH HEALTH CAMPUS OutpatientFacility | Rocky Mountain Health Plan | Managed Medicaid | $131.48 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-ST ANTHONY NORTH HEALTH CAMPUS OutpatientFacility | Denver Health | Managed Medicaid | $131.48 | — | — | 2024-12-02 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Meridian Health Plan | Managed Medicaid | $135.76 | — | — | 2025-11-12 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Meridian Health Plan | Managed Medicaid | $135.76 | — | — | 2025-11-12 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Molina Healthcare of Illinois | Managed Medicaid | $135.76 | — | — | 2025-11-12 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Aetna Better Health (Illinicare) | Managed Medicaid | $135.76 | — | — | 2025-11-12 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Molina Healthcare of Illinois | Managed Medicaid | $135.76 | — | — | 2025-11-12 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Blue Cross Blue Shield of Illinois | Managed Medicaid | $135.76 | — | — | 2025-11-12 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Aetna Better Health (Illinicare) | Managed Medicaid | $135.76 | — | — | 2025-11-12 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Blue Cross Blue Shield of Illinois | Managed Medicaid | $135.76 | — | — | 2025-11-12 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | MOLINA HEALTHCARE 1723 | MOLINA MEDICAID 172301, MOLINA CHILD HEALTH PLUS 518901 | $136.49 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $136.49 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | MOLINA HEALTHCARE 1723 | MOLINA MEDICAID 172301, MOLINA CHILD HEALTH PLUS 518901 | $136.49 | — | — | 2026-01-01 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | HEALTHFIRST | MEDICAID; MEDICAID HARP; CHILD HEALTH PLUS | $136.61 | — | $143.80 | 2026-02-14 | MRF ↗ |
| ST MARY-CORWIN HOSPITAL OutpatientFacility | Denver Health | Managed Medicaid | $137.43 | — | — | 2024-12-02 | MRF ↗ |
| ST MARY-CORWIN HOSPITAL OutpatientFacility | Colorado Access | Managed Medicaid | $137.43 | — | — | 2024-12-02 | MRF ↗ |
| ST MARY-CORWIN HOSPITAL OutpatientFacility | Naphcare | Managed Medicaid | $137.43 | — | — | 2024-12-02 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | UNITED HEALTHCARE [5158] | UNITED HEALTHCARE ESSENTIAL PQ 1 AND 2 [515812] | $137.53 | — | — | 2026-04-01 | MRF ↗ |
| CENTURA HEALTH-ST ANTHONY HOSPITAL OutpatientFacility | Rocky Mountain Health Plan | Managed Medicaid | $138.21 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-ST ANTHONY HOSPITAL OutpatientFacility | Colorado Access | Managed Medicaid | $138.21 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-ST ANTHONY HOSPITAL OutpatientFacility | Kaiser | Managed Medicaid | $138.21 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-ST ANTHONY HOSPITAL OutpatientFacility | Denver Health | Managed Medicaid | $138.21 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-ST ANTHONY HOSPITAL OutpatientFacility | Naphcare | Managed Medicaid | $138.21 | — | — | 2024-12-02 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID [1706] | BLUE CHOICE OPTION MEDICAID [170601] | $138.89 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | FIDELIS [5155],FIDELIS [1708] | FIDELIS MEDICAID [170801], FIDELIS CHILD HEALTH PLUS [515502] | $138.89 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID [1716] | UNITED HEALTHCARE MEDICAID [171601] | $138.89 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD [2201], OUT AREA BLUE CROSS BLUE SHIELD, UNIVERA, EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID [1706] | EXCELLUS CHILD HEALTH PLUS [220108], EXCELLUS ESS Q 1 2 [220109],EXCELLUS HLTHY NY [220110], EXCELLUS ESSENTIAL PA 3 AND 4 [170604] | $138.89 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) [1720] | AMERIGROUP (BSWNY ALTERNATE) [172001] | $138.89 | — | — | 2026-04-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $142.69 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $142.69 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $142.69 | — | — | 2026-01-01 | MRF ↗ |
| LONGMONT UNITED HOSPITAL OutpatientFacility | Colorado Access | Managed Medicaid | $143.32 | — | — | 2024-12-02 | MRF ↗ |
| LONGMONT UNITED HOSPITAL OutpatientFacility | Denver Health | Managed Medicaid | $143.32 | — | — | 2024-12-02 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | MVP MEDICAID [1712] | MVP OPTION MEDICAID [171201], MVP CHILD HEALTH PLUS [290004] | $143.51 | — | — | 2026-04-01 | MRF ↗ |
| BROOKDALE HOSPITAL MEDICAL CENTER Outpatient | AMIDA CARE | MEDICAID | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| BROOKDALE HOSPITAL MEDICAL CENTER Outpatient | CARELON BEHAVIORAL HEALTH, INC. AND CARELON BEHAVIORAL HEALTH STRATEGIES, LLC | MEDICAID | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | METROPLUS HEALTH PLAN, INC. - OBHS | MEDICAID | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Interfaith Medical Center Outpatient | CARELON BEHAVIORAL HEALTH, INC. AND CARELON BEHAVIORAL HEALTH STRATEGIES, LLC | MEDICAID | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | MOLINA HEALTHCARE | Medicaid, HARP, CHP | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| BROOKDALE HOSPITAL MEDICAL CENTER Outpatient | CARELON BEHAVIORAL HEALTH, INC. AND CARELON BEHAVIORAL HEALTH STRATEGIES, LLC | HARP; QHP | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| BROOKDALE HOSPITAL MEDICAL CENTER Outpatient | CENTERS PLAN FOR HEALTHY LIVING, LLC- OBHS | MEDICAID ADVANTAGE PLUS | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Interfaith Medical Center Outpatient | METROPLUS HEALTH PLAN, INC. - OBHS | MEDICAID | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Interfaith Medical Center Outpatient | EMBLEMHEALTH PLAN, INC -OBHS | CHILD HEALTH PLUS (HMO MEDICAID) | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Interfaith Medical Center Outpatient | METROPLUS HEALTH PLAN, INC. - OBHS | CHILD HEALTH PLUS | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | METROPLUS HEALTH PLAN, INC. - OBHS | HARP (HMO MEDICAID) | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Interfaith Medical Center Outpatient | ELDERPLAN, INC. - OBHS | MEDICAID ADVANTAGE PLUS | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | CENTERS PLAN FOR HEALTHY LIVING, LLC- OBHS | MEDICAID ADVANTAGE PLUS | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Interfaith Medical Center Outpatient | METROPLUS HEALTH PLAN, INC. - OBHS | HIV SPECIAL NEEDS PLAN | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Interfaith Medical Center Outpatient | CENTERS PLAN FOR HEALTHY LIVING, LLC- OBHS | MEDICAID ADVANTAGE PLUS | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| BROOKDALE HOSPITAL MEDICAL CENTER Outpatient | ELDERPLAN, INC. - OBHS | MEDICAID ADVANTAGE PLUS | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Interfaith Medical Center Outpatient | METROPLUS HEALTH PLAN, INC. - OBHS | HARP (HMO MEDICAID) | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | ELDERPLAN, INC. - OBHS | MEDICAID ADVANTAGE PLUS | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | EMBLEMHEALTH PLAN, INC -OBHS | CHILD HEALTH PLUS (HMO MEDICAID) | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | EMBLEMHEALTH PLAN, INC -OBHS | HARP (HMO MEDICAID) | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | EMBLEMHEALTH PLAN, INC -OBHS | HIP MEDICAID ENHANCED CARE PRIME (HMO MEDICAID) | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | EMPIRE BLUECROSS BLUESHIELD- HEALTHPLUS | MEDICAID;HARP CHP | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Interfaith Medical Center Outpatient | FIDELIS CARE | MEDICAID, CHP, HARP, MLTC -FIDELIS CARE AT HOME | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | METROPLUS HEALTH PLAN, INC. - OBHS | CHILD HEALTH PLUS | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| BROOKDALE HOSPITAL MEDICAL CENTER Outpatient | MOLINA HEALTHCARE | MEDICAID, HARP, CHP | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Interfaith Medical Center Outpatient | AMIDA CARE | MEDICAID | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | PARTNERS HEALTH PLAN, INC. | MEDICAID | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Interfaith Medical Center Outpatient | Medicaid | Medicaid | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | UNITED HEALTH CARE- - -OBHS | HARP; MEDICAID MANAGED CARE; CHP | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | Medicaid | Medicaid | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | NAPHCARE | MEDICAID | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | METROPLUS HEALTH PLAN, INC. - OBHS | HIV SPECIAL NEEDS PLAN | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Interfaith Medical Center Outpatient | EMBLEMHEALTH PLAN, INC -OBHS | HIP MEDICAID ENHANCED CARE PRIME (HMO MEDICAID) | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| BROOKDALE HOSPITAL MEDICAL CENTER Outpatient | Medicaid | Medicaid | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| BROOKDALE HOSPITAL MEDICAL CENTER Outpatient | EMBLEMHEALTH PLAN, INC -OBHS | HIP MEDICAID ENHANCED CARE PRIME (HMO MEDICAID) | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Interfaith Medical Center Outpatient | EMPIRE BLUECROSS BLUESHIELD- HEALTHPLUS | MEDICAID;HARP CHP | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Interfaith Medical Center Outpatient | HEALTHFIRST (PHSP) | MEDICAID; MEDICAID HARP | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Interfaith Medical Center Outpatient | HEALTHFIRST | QHP | $143.80 | — | $143.80 | 2026-02-14 | MRF ↗ |
| Kingsbrook Jewish Medical Center Outpatient | AMIDA CARE | MEDICARE ADVANTAGE | $143.80 | — | $143.80 | 2026-02-14 | 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.