64421 — Njx Aa&/strd Ntrcost Nrv Ea
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). NJX AA&/STRD NTRCOST NRV EA (CPT 64421) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/64421?code_type=CPT
MLA (9th ed.)
“NJX AA&/STRD NTRCOST NRV EA (CPT 64421) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/64421?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“NJX AA&/STRD NTRCOST NRV EA (CPT 64421) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/64421?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $762–$1,833 (25th–75th percentile) across 2,370 hospitals · 7,837 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 64421 — 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 figures are estimates from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$762
$1,133 typical
$1,833
The middle 50% of negotiated facility rates for this procedure, measured across 2,370 hospitals. Surgeon & 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. | $1,133 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $22 × 1.22 commercial. | $26 |
| Likely subtotal | $1,160 |
Surgical episode (typical)
~$1,160
Your recovery plan — adjust to what your surgeon told you
After surgery, 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)
~$4,945
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Surgeon (professional fee) (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.99 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $0.99 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.99 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $6,874.78 | $4,468.61 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | SCAN Health Plan | Medicare Advantage | — | $6,874.78 | $4,468.61 | 2025-11-26 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.01 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.04 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $1.07 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.28 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.28 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.31 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.31 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $1.31 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.31 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.33 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.36 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.39 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $1.44 | $267.00 | $253.65 | 2026-02-20 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $1.46 | $3,212.00 | $3,212.00 | 2026-02-13 | MRF ↗ |
| HANCOCK COUNTY HEALTH SYSTEM Outpatient | WELLMARK HMO-ALL OTHER PLANS | WELLMARK HMO-ALL OTHER PLANS | $3.28 | $566.00 | $424.50 | 2026-03-26 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $4.28 | $2,379.00 | $935.63 | 2024-12-31 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | BCBS - MN | Medicaid|All Plans | $6.90 | $23.00 | $13.34 | 2026-02-28 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | MEDICA MEDICAID [16023] | MEDICA ACCESSABILITY [1602301] | $6.96 | $29.00 | — | 2026-01-01 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | MEDICA MEDICAID [16023] | MEDICA CHOICE CARE [1602302] | $6.96 | $29.00 | — | 2026-01-01 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | UNIVERSAL IPA MCAL OP/PROFEE ONLY | UNIVERSAL IPA MCAL OP/PROFEE ONLY | $7.00 | $83.00 | $22.41 | 2026-01-31 | MRF ↗ |
| CATALINA ISLAND MEDICAL CENTER Outpatient | LA CARE MEDI-CAL-ALL OTHER PLANS | LA CARE MEDI-CAL-ALL OTHER PLANS | $7.00 | $65.00 | $45.50 | 2026-03-17 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | HEALTHNET MEDI-CAL | HEALTHNET MEDI-CAL | $7.00 | $83.00 | $15.77 | 2026-01-31 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | AETNA [1003] | AETNA MEDI-CAL | $7.00 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| WASHINGTON HOSPITAL Outpatient | KAISER MEDI-CAL | KAISER MEDI-CAL | $7.00 | $337.00 | $219.05 | 2026-02-10 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | MEDI-CAL | MEDI-CAL | $7.00 | $83.00 | $15.77 | 2026-01-31 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MEDI-CAL [2001] | MEDI-CAL | $7.00 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | CCIPA MEDI-CAL - ALL PLANS | CCIPA MEDI-CAL - ALL PLANS | $7.00 | $83.00 | $15.77 | 2026-01-31 | MRF ↗ |
| WASHINGTON HOSPITAL Outpatient | KAISER MEDI-CAL | KAISER MEDI-CAL | $7.00 | $337.00 | $219.05 | 2026-02-10 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BRAND NEW DAY [1089] | MEDI-CAL | $7.00 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE CROSS [1013] | BLUE CROSS MEDI-CAL UNLISTED IPA [10130011] | $7.00 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | COMMUNITY ELDERCARE [1027] | MEDI-CAL | $7.00 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CAREMORE [2028] | MEDI-CAL | $7.00 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE SHIELD PROMISE [1017] | BLUE SHIELD PROMISE (FKA CARE1ST HEALTHPLAN MEDI-CAL) | $7.00 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | VANTAGE [1092] | PROSPECT VANTAGE MEDICAL GROUP MEDI-CAL | $7.00 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $7.00 | $83.00 | $15.77 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | MEDI-CAL | MEDI-CAL | $7.00 | $83.00 | $22.41 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TULARE Outpatient | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | UPN-UNITED PHYSCN NTWRK MCAL PROFEE ONLY | $7.00 | $83.00 | $15.77 | 2026-01-31 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MEDI-CAL [1048] | MEDI-CAL | $7.00 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| CATALINA ISLAND MEDICAL CENTER Outpatient | MEDI-CAL | MEDI-CAL | $7.00 | $65.00 | $45.50 | 2026-03-17 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE CROSS [1013] | MEDI-CAL | $7.00 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | XIMED [2016] | MEDI-CAL | $7.00 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Health Partners | Medicare|All Plans | $7.59 | $23.00 | $13.34 | 2026-02-28 | MRF ↗ |
| RIDGEVIEW MEDICAL CENTER Both | MEDICA MEDICARE [16024] | MEDICA DUAL SOLUTION [1602402] | $7.59 | $29.00 | — | 2026-01-01 | MRF ↗ |
| HELEN NEWBERRY JOY HOSPITAL Outpatient | MI WC - ALL PLANS | MI WC - ALL PLANS | $7.67 | $21.30 | $13.42 | 2026-01-27 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Medica | Medicare|All Plans | $7.97 | $23.00 | $13.34 | 2026-02-28 | MRF ↗ |
| CATALINA ISLAND MEDICAL CENTER Outpatient | MOLINA MEDICAID-ALL OTHER PLANS | MOLINA MEDICAID-ALL OTHER PLANS | $8.05 | $65.00 | $45.50 | 2026-03-17 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | BCBS - MN | Medicare|All Plans | $8.28 | $23.00 | $13.34 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Humana | Medicare|All Plans | $8.28 | $23.00 | $13.34 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Health Partners | Medicaid|All Plans | $8.51 | $23.00 | $13.34 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Medica | Medicaid|All Plans | $8.51 | $23.00 | $13.34 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Ucare | Medicare|All Plans | $8.70 | $23.00 | $13.34 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MOLINA [1055] | MOLINA MEDI-CAL [10550002] | $8.82 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MOLINA [1055] | MOLINA MEDI-CAL COMMUNITY CARE [10550015] | $8.82 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MOLINA [1055] | MOLINA MEDI-CAL | $8.82 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MOLINA [1240] | MOLINA MEDI-CAL [12400001] | $8.82 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE MOLINA [1240] | MOLINA MEDI-CAL | $8.82 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $8.94 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $8.94 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $8.94 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $8.94 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $8.94 | — | — | 2026-04-16 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC LCD | ALL PRODUCTS | $8.94 | $1,918.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC LCD | ALL PRODUCTS | $8.94 | $1,918.00 | — | 2026-01-01 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $8.94 | — | — | 2026-04-16 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | COMMUNITY HEALTH GROUP [1022] | COMMUNITY HEALTH GROUP (MEDI-CAL) | $9.03 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Ucare | Medicaid|All Plans | $9.37 | $23.00 | $13.34 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | HEALTH NET [1039] | HEALTH NET MEDI-CAL | $9.45 | $8,646.91 | $4,755.80 | 2026-04-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | LA Care Health | Medi-cal | $10.04 | — | — | 2026-03-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | Molina | MCD | $10.04 | — | — | 2026-03-01 | MRF ↗ |
| Northern Montana Hospital Outpatient | Healthy Kids Medicaid | Medicaid | $10.71 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | Healthy Kids Medicaid | Medicaid | $10.71 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | Montana Medicaid | Medicaid | $10.71 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | Montana Medicaid | Medicaid | $10.71 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| CHASE COUNTY COMMUNITY HOSPITAL Outpatient | Midlands Choice | Medicare Advantage | $11.00 | $31.00 | $31.00 | 2025-12-02 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Brand New Day | MCD | $11.04 | — | — | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Gold Coast Health Plan | MCD | $11.04 | — | — | 2026-03-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | Brand New Day | MCD | $11.04 | — | — | 2026-03-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | UNITED HEALTHCARE [158] | NLFH UHC HMO/PPO | $11.36 | $6,480.49 | $4,536.34 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | UNITED HEALTHCARE [158] | NLFH UHC CORE | $11.36 | $6,480.49 | $4,536.34 | 2026-04-01 | MRF ↗ |
| Northern Montana Hospital Outpatient | TriWest | PPO | $12.00 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | Humana Medicare Advantage | Medicare | $12.00 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | United Medicare Advantage | Medicare | $12.00 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | United Medicare Advantage | Medicare | $12.00 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | TriWest | PPO | $12.00 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | Humana Medicare Advantage | Medicare | $12.00 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Blue Cross Complete | MEDICAID | $12.27 | $947.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | McLaren | MEDICAID | $12.27 | $947.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | HAP CareSource | MEDICAID | $12.27 | $947.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $12.27 | $947.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Priority Health | MEDICAID | $12.27 | $947.00 | — | 2025-06-28 | MRF ↗ |
| Northern Montana Hospital Outpatient | Aetna Medicare Advantage | Medicare | $12.40 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Outpatient | Aetna Medicare Advantage | Medicare | $12.40 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| METRO NASHVILLE GENERAL HOSPITAL Both | UNITEDHEALTHCARE | MEDICARE ADVANTAGE SNP | $12.56 | $1,938.00 | $1,162.80 | 2024-07-01 | MRF ↗ |
| METRO NASHVILLE GENERAL HOSPITAL Both | UNITEDHEALTHCARE | MEDICARE ADVANTAGE SNP | $12.56 | $1,938.00 | $1,162.80 | 2024-07-01 | MRF ↗ |
| METRO NASHVILLE GENERAL HOSPITAL Both | UNITEDHEALTHCARE | MEDICARE ADVANTAGE SNP | $12.56 | $1,938.00 | $1,162.80 | 2024-07-01 | MRF ↗ |
| METRO NASHVILLE GENERAL HOSPITAL Both | UNITEDHEALTHCARE | MEDICARE ADVANTAGE SNP | $12.56 | $1,938.00 | $1,162.80 | 2024-07-01 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED BEHAVORIAL HEALTH [120] | UNITED BEHAVORIAL HEALTH [12001] | — | $242.88 | $242.88 | 2024-12-30 | MRF ↗ |
| UNITY HOSPITAL Inpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN [10104] | $12.62 | $242.88 | $242.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK MEDICARE [11402] | — | $242.88 | $242.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN [10104] | $12.62 | $242.88 | $242.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | GENERIC MEDICARE HMO [125] | GENERIC MEDICARE HMO [12505] | — | $242.88 | $242.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE [10301] | — | $242.88 | $242.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | GENERIC CARRIER [107] | COMMERCIAL [10701] | — | $242.88 | $242.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | MULTIPLAN [141] | MULTIPLAN [14101] | — | $242.88 | $242.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK [11401] | — | $242.88 | $242.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | EMBLEM GHI [113] | EMBLEM GHI [11301] | — | $242.88 | $242.88 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK ESSENTIALS [11404] | — | $242.88 | $242.88 | 2024-12-30 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | BCBS - MN | Commercial|Federal Plans | $12.88 | $23.00 | $13.34 | 2026-02-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Aetna Better Health | MEDICAID | $12.88 | $947.00 | — | 2025-06-28 | MRF ↗ |
| GROVE HILL MEMORIAL HOSPITAL BothFacility | Aetna | All Other Plans | $12.99 | $17.33 | $10.40 | 2026-05-05 | MRF ↗ |
| GROVE HILL MEMORIAL HOSPITAL BothFacility | Cigna | All Plans | $12.99 | $17.33 | $10.40 | 2026-05-05 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | BCBS - MN | Commercial|All Other Plans | $13.11 | $23.00 | $13.34 | 2026-02-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | HAP Caresource Medicaid | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | HAP | HAP Caresource Medicaid | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | HAP Caresource Medicaid | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Aetna Better Health | MEDICAID | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | HAP | HAP Caresource Medicaid | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | McLaren | MEDICAID | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Priority Health | MEDICAID | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Aetna Better Health | MEDICAID | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Aetna Better Health | MEDICAID | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | McLaren | MEDICAID | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Priority Health | MEDICAID | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Priority Health | MEDICAID | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | McLaren | MEDICAID | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna Better Health | MEDICAID | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Blue Cross Complete | MEDICAID | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | McLaren | MEDICAID | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Priority Health | MEDICAID | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Blue Cross Complete | MEDICAID | $13.13 | $482.00 | — | 2025-06-28 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | ALOHACARE | ABD - ADULT | $13.20 | $45.00 | $27.00 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | ALOHACARE | NON-ABD - PEDIATRIC | $13.20 | $45.00 | $27.00 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | ALOHACARE | NON-ABD - ADULT | $13.20 | $45.00 | $27.00 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | ALOHACARE | ABD - PEDIATRIC | $13.20 | $45.00 | $27.00 | 2026-02-12 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $13.22 | — | — | 2026-03-18 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | PGT | Medicare|All Plans | $13.25 | $104.00 | $18.20 | 2026-02-28 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $13.30 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $13.30 | — | — | 2026-03-18 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | OHANA | QUEST - NON-ABD | $13.41 | $45.00 | $27.00 | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL OutpatientFacility | OHANA | NON-ABD | $13.41 | $45.00 | $27.00 | 2026-02-12 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AETNA | Medicare|All Plans | $13.52 | $104.00 | $18.20 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | BCBS | Medicare|All Plans | $13.52 | $104.00 | $18.20 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | UNITED | Medicare|All Plans | $13.80 | $104.00 | $18.20 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | Health Partners | Commercial|All Plans | $13.80 | $23.00 | $13.34 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AMERIVANTAGE | Medicare|All Plans | $13.93 | $104.00 | $18.20 | 2026-02-28 | MRF ↗ |
| LINCOLN HOSPITAL Outpatient | AMBETTER MCAID - ALL PLANS | AMBETTER MCAID - ALL PLANS | $14.02 | $417.69 | $375.92 | 2026-03-09 | MRF ↗ |
| LINCOLN HOSPITAL Outpatient | MOLINA HLTHY OPTIONS | MOLINA HLTHY OPTIONS | $14.02 | $417.69 | $375.92 | 2026-03-09 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Blue Cross Complete | MEDICAID | $14.31 | $482.00 | — | 2025-06-28 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan – Hmo | $14.38 | — | — | 2026-03-01 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan | $14.38 | — | — | 2026-03-01 | MRF ↗ |
| Northern Montana Hospital Inpatient | Healthy Kids Medicaid | Medicaid | $14.44 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Inpatient | Montana Medicaid | Medicaid | $14.44 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Inpatient | Montana Medicaid | Medicaid | $14.44 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| Northern Montana Hospital Inpatient | Healthy Kids Medicaid | Medicaid | $14.44 | $40.00 | $28.00 | 2026-04-02 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | SCANHealth | Medicare|All Plans | $14.47 | $104.00 | $18.20 | 2026-02-28 | MRF ↗ |
| Riverside Community Hospital Outpatient | Inland Empire Health Plan | MGMCD | $14.56 | — | — | 2026-03-01 | MRF ↗ |
| LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC Outpatient | UHC | Medicaid HMO | $14.61 | $31.75 | $19.05 | 2025-01-01 | MRF ↗ |
| LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC Outpatient | Wellcare | Medicaid HMO | $14.61 | $31.75 | $19.05 | 2025-01-01 | MRF ↗ |
| LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC Outpatient | Humana | Medicare HMO/Gold Plus Medicare HMO | $14.61 | $31.75 | $19.05 | 2025-01-01 | MRF ↗ |
| LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC Outpatient | Wellcare | Medicare HMO | $14.61 | $31.75 | $19.05 | 2025-01-01 | MRF ↗ |
| LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC Outpatient | The Funds - UMWA | Medicare HMO | $14.61 | $31.75 | $19.05 | 2025-01-01 | MRF ↗ |
| LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC Outpatient | Humana | Caresource KY | $14.61 | $31.75 | $19.05 | 2025-01-01 | MRF ↗ |
| LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC Outpatient | Gateway | Medicare HMO | $14.61 | $31.75 | $19.05 | 2025-01-01 | MRF ↗ |
| LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC Outpatient | Aetna | Medicare HMO | $14.61 | $31.75 | $19.05 | 2025-01-01 | MRF ↗ |
| LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC Outpatient | Passport | Medicaid HMO | $14.61 | $31.75 | $19.05 | 2025-01-01 | MRF ↗ |
| LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC Outpatient | Aetna | Medicaid HMO | $14.61 | $31.75 | $19.05 | 2025-01-01 | MRF ↗ |
| LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC Outpatient | Cigna | Medicare HMO | $14.61 | $31.75 | $19.05 | 2025-01-01 | MRF ↗ |
| LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC Outpatient | Anthem | Medicaid HMO | $14.61 | $31.75 | $19.05 | 2025-01-01 | MRF ↗ |
| LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC Outpatient | UHC | Medicare HMO | $14.61 | $31.75 | $19.05 | 2025-01-01 | MRF ↗ |
| LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC Outpatient | Anthem | Medicare Advantage / Mediblue Access / Medicare Select | $14.61 | $31.75 | $19.05 | 2025-01-01 | MRF ↗ |
| LINCOLN HOSPITAL Outpatient | AMERIGROUP MCAID - ALL PLANS | AMERIGROUP MCAID - ALL PLANS | $14.86 | $492.82 | $443.54 | 2026-03-09 | MRF ↗ |
| METRO NASHVILLE GENERAL HOSPITAL Both | CORIZON | INMATE SERVICES | $14.94 | $1,938.00 | $1,162.80 | 2024-07-01 | MRF ↗ |
| METRO NASHVILLE GENERAL HOSPITAL Both | CORIZON | INMATE SERVICES | $14.94 | $1,938.00 | $1,162.80 | 2024-07-01 | MRF ↗ |
| METRO NASHVILLE GENERAL HOSPITAL Both | CORIZON | INMATE SERVICES | $14.94 | $1,938.00 | $1,162.80 | 2024-07-01 | MRF ↗ |
| METRO NASHVILLE GENERAL HOSPITAL Both | CORIZON | INMATE SERVICES | $14.94 | $1,938.00 | $1,162.80 | 2024-07-01 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $15.15 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $15.25 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $15.25 | — | — | 2026-03-18 | MRF ↗ |
| LAKEWOOD HEALTH SYSTEM Outpatient | UCARE MSHO/SPECIAL NEEDS | UCARE MSHO/SPECIAL NEEDS | $15.36 | $1,215.00 | $753.30 | 2026-04-22 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Aetna Better Health Ky | Managed Care Medicaid Plan | $15.38 | $1,449.00 | $738.99 | 2026-05-09 | MRF ↗ |
| MCLAREN GREATER LANSING Outpatient | Medicaid - United | Medicaid - United | $15.55 | $672.00 | $336.00 | 2025-12-31 | MRF ↗ |
| HURLEY MEDICAL CENTER Both | UNITED HEALTH CARE COMMUNITY PLAN MEDICAID [9004] | UNITED HEALTH CARE MEDICAID [900401] | $15.55 | $182.00 | $182.00 | 2026-03-23 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Traditional Medicaid HMO/PPO | Traditional Medicaid HMO/PPO | $15.55 | $672.00 | $336.00 | 2025-12-31 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Traditional Medicaid HMO/PPO | Traditional Medicaid HMO/PPO | $15.55 | $672.00 | $336.00 | 2025-12-31 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - United | Medicaid - United | $15.55 | $672.00 | $336.00 | 2025-12-31 | MRF ↗ |
| MCLAREN PORT HURON Outpatient | Medicaid - United | Medicaid - United | $15.55 | $672.00 | $336.00 | 2025-12-31 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - United | Medicaid - United | $15.55 | $672.00 | $336.00 | 2025-12-31 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - United | Medicaid - United | $15.55 | $672.00 | $336.00 | 2025-12-31 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - United | Medicaid - United | $15.55 | $672.00 | $336.00 | 2025-12-31 | MRF ↗ |
| MCLAREN GREATER LANSING Outpatient | Traditional Medicaid HMO/PPO | Traditional Medicaid HMO/PPO | $15.55 | $672.00 | $336.00 | 2025-12-31 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Traditional Medicaid HMO/PPO | Traditional Medicaid HMO/PPO | $15.55 | $672.00 | $336.00 | 2025-12-31 | 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.