64624 — Dstrj Nulyt Agt Gnclr Nrv
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). DSTRJ NULYT AGT GNCLR NRV (HCPCS 64624) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/64624?code_type=HCPCS
MLA (9th ed.)
“DSTRJ NULYT AGT GNCLR NRV (HCPCS 64624) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/64624?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“DSTRJ NULYT AGT GNCLR NRV (HCPCS 64624) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/64624?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,556–$3,598 (25th–75th percentile) across 2,164 hospitals · 6,171 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 64624 — 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
$1,556
$2,319 typical
$3,598
The middle 50% of negotiated facility rates for this procedure, measured across 2,164 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. | $2,319 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $133 × 1.22 commercial. | $163 |
| Likely subtotal | $2,481 |
Surgical episode (typical)
~$2,481
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)
~$6,266
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 |
|---|---|---|---|---|---|---|---|
| MAYO CLINIC HEALTH SYSTEM - MANKATO OutpatientFacility | MEDICA [91180027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [150] | $0.43 | — | — | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - MANKATO OutpatientFacility | MEDICA [1110027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [150] | $0.43 | — | — | 2026-03-31 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM IN RED WING OutpatientFacility | MEDICA [1110027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [150] | $0.81 | — | — | 2026-03-31 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB SPRG OK MEDICAID | $0.85 | $4,756.83 | $3,091.94 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB SPRG OK MEDICAID | $0.85 | $4,756.83 | $3,091.94 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | MEDICAID [20240] | HB FTSM OK MEDICAID | $0.85 | $3,560.75 | $2,314.49 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB SPRG OK MEDICAID | $0.85 | $4,756.83 | $3,091.94 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | HUMANA MEDICAID CONTRACTED [320486] | HB SPRG OK MEDICAID | $0.85 | $4,756.83 | $3,091.94 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | MEDICAID [20240] | HB SPRG OK MEDICAID | $0.85 | $4,756.83 | $3,091.94 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | HUMANA MEDICAID CONTRACTED [320486] | HB SPRG OK MEDICAID | $0.85 | $4,756.83 | $3,091.94 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB SPRG OK MEDICAID | $0.85 | $4,756.83 | $3,091.94 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | MEDICAID [20240] | HB FTSM OK MEDICAID | $0.85 | $3,560.75 | $2,314.49 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | MEDICAID [20240] | HB SPRG OK MEDICAID | $0.85 | $4,756.83 | $3,091.94 | 2026-03-12 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $0.96 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $0.96 | — | $7,528.59 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $1.92 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.17 | $6,448.30 | $3,868.98 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.17 | $6,448.30 | $3,868.98 | 2025-08-11 | MRF ↗ |
| HANCOCK COUNTY HEALTH SYSTEM Outpatient | WELLMARK HMO-ALL OTHER PLANS | WELLMARK HMO-ALL OTHER PLANS | $3.28 | $3,350.00 | $2,512.50 | 2026-03-26 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (INDEPENDENCE) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - OR (REGENCE) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MD (CAREFIRST) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - LA | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - ID | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MO (ANTHEM) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - ME (ANTHEM) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - RI | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (ANTHEM) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL ALTERNATE | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE SHIELD - PA (HIGHMARK) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NV (ANTHEM) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - HI | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - FEDERAL | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - FL | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE SHIELD - CA | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - VT | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MI | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - KY (ANTHEM) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - TN | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - OH (ANTHEM) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BCN DOMESTIC | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - WY | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK WESTERN | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - GA (ANTHEM) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | KAISER DOMESTIC | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BCBS GENERIC | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MN | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - KS | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CARE NETWORK | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (CAREFIRST) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NC | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS DOMESTIC | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - WI (ANTHEM) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE SHIELD - WA (REGENCE) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - TX | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - AK (PREMERA) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NH (ANTHEM) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - AR | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (ANTHEM) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE SHIELD - ID (REGENCE) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MT | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | WC DOMESTIC | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - CA (ANTHEM) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE DISTINCTION TRANSPLANT | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (EXCELLUS) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - WV (HIGHMARK) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MA | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (CAPITAL) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - WA (PREMERA) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - DE (HIGHMARK) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NE | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NM | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - IN (ANTHEM) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - SC | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - ND | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MS | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - OK | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - CO (ANTHEM) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - AL | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - DC (CAREFIRST) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | PRE-EMPLOYMENT | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - UT (REGENCE) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK HMO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - AZ | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - CT (ANTHEM) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NJ (HORIZON) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - SD (WELLMARK) | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK NORTHEASTERN | WELLMARK PPO | $3.44 | — | $4,857.42 | 2026-03-31 | MRF ↗ |
| MERCY HOSPITAL OKLAHOMA CITY, INC OutpatientFacility | OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB OKLC OK MEDICAID (SOONERCARE) | $3.50 | $7,110.91 | $4,622.09 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL OKLAHOMA CITY, INC OutpatientFacility | HUMANA MEDICAID CONTRACTED [320486] | HB OKLC OK MEDICAID (SOONERCARE) | $3.50 | $7,110.91 | $4,622.09 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL OKLAHOMA CITY, INC OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB OKLC OK MEDICAID (SOONERCARE) | $3.50 | $7,110.91 | $4,622.09 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL OKLAHOMA CITY, INC OutpatientFacility | MEDICAID [20240] | HB OKLC OK MEDICAID (SOONERCARE) | $3.50 | $7,110.91 | $4,622.09 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ARDMORE, INC OutpatientFacility | MEDICAID [20240] | HB ARDM OK MEDICAID (SOONERCARE) | $3.60 | $5,441.08 | $3,536.70 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ARDMORE, INC OutpatientFacility | OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB ARDM OK MEDICAID (SOONERCARE) | $3.60 | $5,441.08 | $3,536.70 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ARDMORE, INC OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB ARDM OK MEDICAID (SOONERCARE) | $3.60 | $5,441.08 | $3,536.70 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL LEBANON OutpatientFacility | MEDICAID [20240] | HB LEBN OK MEDICAID | $3.60 | $3,715.53 | $2,415.09 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL ARDMORE, INC OutpatientFacility | HUMANA MEDICAID CONTRACTED [320486] | HB ARDM OK MEDICAID (SOONERCARE) | $3.60 | $5,441.08 | $3,536.70 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL OKLAHOMA CITY, INC OutpatientFacility | LONGEVITY HEALTH PLAN [10477] | HB OKLC MANAGED MEDICARE | $3.86 | $7,110.91 | $4,622.09 | 2026-03-12 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK HMO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CARE NETWORK | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL ALTERNATE | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - IL | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (INDEPENDENCE) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MT | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MI | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | PRE-EMPLOYMENT | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE BENEFIT ADMINISTRATORS OF MASSACHUSETTS | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - WI (ANTHEM) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - OR (REGENCE) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - AZ | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - DE (HIGHMARK) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - IN (ANTHEM) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | KAISER DOMESTIC | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE DISTINCTION TRANSPLANT | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NE | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MN | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - FEDERAL | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - CA (ANTHEM) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - CT (ANTHEM) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - CO (ANTHEM) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BCN DOMESTIC | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MS | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - FL | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - AR | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NC | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - DC (CAREFIRST) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS DOMESTIC | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (EXCELLUS) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NV (ANTHEM) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - OK | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE SHIELD - CA | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - ME (ANTHEM) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - KY (ANTHEM) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - HI | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - ID | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NM | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NJ (HORIZON) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE SHIELD - ID (REGENCE) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - LA | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - AK (PREMERA) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE SHIELD - PA (HIGHMARK) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - KS | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - PA (CAPITAL) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE SHIELD - WA (REGENCE) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - WA (PREMERA) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NH (ANTHEM) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - ND | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - WY | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MD (CAREFIRST) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - OH (ANTHEM) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK NORTHEASTERN | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - TX | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - VT | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (ANTHEM) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - TN | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BCBS GENERIC | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - SC | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - RI | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - AL | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - UT (REGENCE) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - GA (ANTHEM) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - WV (HIGHMARK) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MO (ANTHEM) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - VA (CAREFIRST) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | WC DOMESTIC | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE SHIELD - NY HIGHMARK WESTERN | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MA | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - SD (WELLMARK) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - NY (ANTHEM) | WELLMARK PPO | $4.64 | — | $6,441.24 | 2026-03-31 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $4.75 | $6,448.30 | $3,868.98 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $4.75 | $6,448.30 | $3,868.98 | 2025-08-11 | MRF ↗ |
| DELTA MEMORIAL HOSPITAL Outpatient | Summit Administration Services, Inc | Default | $5.00 | $416.29 | $333.03 | 2026-03-31 | MRF ↗ |
| DELTA MEMORIAL HOSPITAL Outpatient | Summit Administration Services, Inc | Default | $5.00 | $416.29 | $333.03 | 2026-03-31 | MRF ↗ |
| MERCY SPECIALTY HOSPITAL SOUTHEAST KANSAS OutpatientFacility | MEDICAID [20240] | HB SEKS ARK MEDICAID | $5.00 | $1,947.00 | $1,265.55 | 2026-03-18 | MRF ↗ |
| CHEYENNE COUNTY HOSPITAL Outpatient | AETNA COVENTRY - ALL OTHER PLANS | AETNA COVENTRY - ALL OTHER PLANS | $5.08 | $218.50 | — | 2026-03-02 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $5.95 | $297.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $5.95 | $297.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $5.95 | $297.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $5.95 | $297.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $5.95 | $297.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $5.95 | $297.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $5.95 | $297.50 | — | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - RI | WELLMARK PPO | $6.88 | — | $7,528.59 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE SHIELD - PA (HIGHMARK) | WELLMARK PPO | $6.88 | — | $7,528.59 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MN | WELLMARK PPO | $6.88 | — | $7,528.59 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | PRE-EMPLOYMENT | WELLMARK PPO | $6.88 | — | $7,528.59 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE SHIELD - CA | WELLMARK PPO | $6.88 | — | $7,528.59 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - IA (WELLMARK) | WELLMARK HMO | $6.88 | — | $7,528.59 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | KAISER DOMESTIC | WELLMARK PPO | $6.88 | — | $7,528.59 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BCN DOMESTIC | WELLMARK PPO | $6.88 | — | $7,528.59 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - AZ | WELLMARK PPO | $6.88 | — | $7,528.59 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - AK (PREMERA) | WELLMARK PPO | $6.88 | — | $7,528.59 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - ME (ANTHEM) | WELLMARK PPO | $6.88 | — | $7,528.59 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - MI | WELLMARK PPO | $6.88 | — | $7,528.59 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER OutpatientFacility | BLUE CROSS - FEDERAL | WELLMARK PPO | $6.88 | — | $7,528.59 | 2026-03-31 | 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.