64628 — Trml Dstrj Ios Bvn 1st 2 L/s
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). TRML DSTRJ IOS BVN 1ST 2 L/S (CPT 64628) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/64628?code_type=CPT
MLA (9th ed.)
“TRML DSTRJ IOS BVN 1ST 2 L/S (CPT 64628) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/64628?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“TRML DSTRJ IOS BVN 1ST 2 L/S (CPT 64628) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/64628?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $7,118–$16,157 (25th–75th percentile) across 1,541 hospitals · 3,052 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 64628 — 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 |
|---|---|---|---|---|---|---|---|
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $98,487.40 | $64,016.81 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | SCAN Health Plan | Medicare Advantage | — | $98,487.40 | $64,016.81 | 2025-11-26 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - MANKATO OutpatientFacility | MEDICA [1110027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [150] | $6.76 | — | — | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - MANKATO OutpatientFacility | MEDICA [91180027] | MEDICA PRIME SOLUTIONS PART B MEDICARE ADVANTAGE PLAN [150] | $6.76 | — | — | 2026-03-31 | MRF ↗ |
| UNIVERSITY OF VIRGINIA MEDICAL CENTER Outpatient | VETERANS [99909] | UVA HB VETERANS CHOICE | $8.43 | $29,736.45 | $17,841.87 | 2026-03-24 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | UHC COMMUNITY MEDICAID [2175] | HB XR UHC INDIANA PATHWAYS MEDICAID | $17.52 | $39,510.87 | $23,956.12 | 2025-12-19 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Healthy New York | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Essential Plan | $33.69 | — | — | 2026-04-14 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | MEDICAID [20240] | HB SPRG OK MEDICAID | $34.02 | $40,039.57 | $26,025.72 | 2026-03-12 | MRF ↗ |
| MERCY SPECIALTY HOSPITAL SOUTHEAST KANSAS OutpatientFacility | HUMANA MEDICAID CONTRACTED [320486] | HB SEKS OK MEDICAID | $34.02 | $42,111.99 | $27,372.79 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | HUMANA MEDICAID CONTRACTED [320486] | HB SPRG OK MEDICAID | $34.02 | $40,039.57 | $26,025.72 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB SPRG OK MEDICAID | $34.02 | $40,039.57 | $26,025.72 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | MEDICAID [20240] | HB SPRG OK MEDICAID | $34.02 | $40,039.57 | $26,025.72 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB SPRG OK MEDICAID | $34.02 | $40,039.57 | $26,025.72 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB SPRG OK MEDICAID | $34.02 | $40,039.57 | $26,025.72 | 2026-03-12 | MRF ↗ |
| MERCY SPECIALTY HOSPITAL SOUTHEAST KANSAS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB SEKS OK MEDICAID | $34.02 | $42,111.99 | $27,372.79 | 2026-03-18 | MRF ↗ |
| MERCY SPECIALTY HOSPITAL SOUTHEAST KANSAS OutpatientFacility | MEDICAID [20240] | HB SEKS OK MEDICAID | $34.02 | $42,111.99 | $27,372.79 | 2026-03-18 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | HUMANA MEDICAID CONTRACTED [320486] | HB SPRG OK MEDICAID | $34.02 | $40,039.57 | $26,025.72 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB SPRG OK MEDICAID | $34.02 | $40,039.57 | $26,025.72 | 2026-03-12 | MRF ↗ |
| MERCY SPECIALTY HOSPITAL SOUTHEAST KANSAS OutpatientFacility | OKLAHOMA COMPLETE HEALTH MEDICAID CONTRACTED [320485] | HB SEKS OK MEDICAID | $34.02 | $42,111.99 | $27,372.79 | 2026-03-18 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | $8,858.25 | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | $8,858.25 | 2024-12-08 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $36.04 | — | — | 2026-04-01 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $36.04 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $36.04 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $36.04 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $36.04 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $36.04 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $36.04 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $36.04 | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $36.04 | — | — | 2026-04-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $40.90 | — | — | 2026-04-14 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $44.82 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Medicare Managed Care Plan | $44.82 | — | — | 2026-04-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Univera | Univera Commercial | $48.12 | — | — | 2026-04-14 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | $8,858.25 | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | HMO | — | $98,487.40 | $64,016.81 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | HMO, City of LA, Vivity | — | $98,487.40 | $64,016.81 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | HMO, Non-City of LA, Vivity | — | $98,487.40 | $64,016.81 | 2025-11-26 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $55.56 | — | — | 2025-12-31 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | BCBS MEDICAID CONTRACTED [320046] | HB SPRG KANCARE HEALTHY BLUE MEDICAID | $59.96 | $40,039.57 | $26,025.72 | 2026-03-12 | MRF ↗ |
| MERCY SPECIALTY HOSPITAL SOUTHEAST KANSAS OutpatientFacility | KANCARE CONTRACTED [320213] | HB SEKS UHC KS MEDICAID | $59.96 | $42,111.99 | $27,372.79 | 2026-03-18 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | BCBS MEDICAID CONTRACTED [320046] | HB SPRG KANCARE HEALTHY BLUE MEDICAID | $59.96 | $40,039.57 | $26,025.72 | 2026-03-12 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $75.34 | $41,855.00 | $14,325.75 | 2024-12-31 | MRF ↗ |
| Harper University Hospital Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | $35,717.00 | $26,787.75 | 2025-01-31 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | HealthNet of California, Inc. | HMO | — | $98,487.40 | $64,016.81 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Kaiser Foundation Hospitals | Medicare Advantage | — | $98,487.40 | $64,016.81 | 2025-11-26 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Blue Shield | Ucd Hb Blue Shield Referred | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Blue Shield | Ucd Hb Blue Shield Ifp | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Pipe Trades | Ucd Hb Blue Shield Referred | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Ufcw | Ucd Hb Blue Shield Referred | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Blue Shield | Ucd Hb Blue Shield Calpers | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Sheet Metal Workers Union(Smw) | Ucd Hb Blue Shield Referred | $111.72 | — | — | 2026-04-01 | MRF ↗ |
| ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL OutpatientFacility | Wellpoint | NJ Family Care | $134.74 | — | — | 2026-03-04 | MRF ↗ |
| CARIBOU MEDICAL CENTER Outpatient | AETNA MCR ADV | AETNA MCR ADV | $158.00 | $1,200.00 | $840.00 | 2026-03-16 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | AIDS Healthcare Foundation and AHF Healthcare Centers | PHC California/Medi-Cal HMO | — | $98,487.40 | $64,016.81 | 2025-11-26 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER OutpatientFacility | HEALTH PLAN w/o UHRIP | CHIP | $187.73 | — | — | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER OutpatientFacility | HEALTH PLAN w/o UHRIP | STAR KIDS | $187.73 | — | — | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER OutpatientFacility | HEALTH PLAN w/o UHRIP | CHIP | $187.73 | — | — | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER PROSPER OutpatientFacility | HEALTH PLAN w/o UHRIP | STAR KIDS | $187.73 | — | — | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | HEALTH PLAN w. UHRIP | STAR | $187.73 | — | — | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | HEALTH PLAN w/o UHRIP | STAR KIDS | $187.73 | — | — | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | HEALTH PLAN w/o UHRIP | CHIP | $187.73 | — | — | 2026-01-01 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Blue Cross Complete | MEDICAID | $206.43 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Priority Health | MEDICAID | $206.43 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | HAP CareSource | MEDICAID | $206.43 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | McLaren | MEDICAID | $206.43 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $206.43 | — | — | 2025-06-28 | MRF ↗ |
| TRINITAS REGIONAL MEDICAL CENTER OutpatientFacility | Wellpoint | NJ Family Care | $209.26 | — | — | 2026-03-04 | MRF ↗ |
| MERCY SPECIALTY HOSPITAL SOUTHEAST KANSAS OutpatientFacility | HEALTH CHOICE CONTRACTED [320166] | HB SEKS HEALTHCHOICE-OSEEGIB | $212.68 | $42,111.99 | $27,372.79 | 2026-03-18 | MRF ↗ |
| NEWARK BETH ISRAEL MEDICAL CENTER OutpatientFacility | United Healthcare | Community Plan | $215.42 | — | — | 2026-03-04 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Aetna Better Health | MEDICAID | $216.75 | — | — | 2025-06-28 | MRF ↗ |
| ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL - SOMERSET OutpatientFacility | Wellpoint | NJ Family Care | $221.57 | — | — | 2026-03-04 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Horizon | Managed Medicaid | $222.21 | $41,855.00 | $14,123.76 | 2024-12-31 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Priority Health | MEDICAID | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | HAP Caresource Medicaid | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Blue Cross Complete | MEDICAID | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Priority Health | MEDICAID | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Aetna Better Health | MEDICAID | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | McLaren | MEDICAID | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Aetna Better Health | MEDICAID | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | McLaren | MEDICAID | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | HAP Caresource Medicaid | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | McLaren | MEDICAID | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Priority Health | MEDICAID | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna Better Health | MEDICAID | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | HAP | HAP Caresource Medicaid | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | McLaren | MEDICAID | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Blue Cross Complete | MEDICAID | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Priority Health | MEDICAID | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Aetna Better Health | MEDICAID | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | HAP | HAP Caresource Medicaid | $223.08 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| MILLE LACS HEALTH SYSTEM Both | VA - VETERANS ADMIN | VA - VETERANS ADMIN | $235.60 | $1,178.00 | $824.60 | 2026-03-04 | MRF ↗ |
| MILLE LACS HEALTH SYSTEM Both | MEDICARE RAILROAD | MEDICARE RAILROAD | $235.60 | $1,178.00 | $824.60 | 2026-03-04 | MRF ↗ |
| MILLE LACS HEALTH SYSTEM Both | MEDICARE | MEDICARE | $235.60 | $1,178.00 | $824.60 | 2026-03-04 | MRF ↗ |
| MILLE LACS HEALTH SYSTEM Both | MEDICA ADVANTAGE | MEDICA ADV SOLUTION | $235.60 | $1,178.00 | $824.60 | 2026-03-04 | MRF ↗ |
| MILLE LACS HEALTH SYSTEM Both | UCARE MSHO | UCARE MSHO | $235.60 | $1,178.00 | $824.60 | 2026-03-04 | MRF ↗ |
| MILLE LACS HEALTH SYSTEM Both | HUMANA INC | HUMANA INC | $235.60 | $1,178.00 | $824.60 | 2026-03-04 | MRF ↗ |
| MILLE LACS HEALTH SYSTEM Both | (WPS) MEDICARE | WPS-MEDICARE | $235.60 | $1,178.00 | $824.60 | 2026-03-04 | MRF ↗ |
| MILLE LACS HEALTH SYSTEM Both | MEDICARE REPLACEMENTS | ADVANTRA FREEDOM | $235.60 | $1,178.00 | $824.60 | 2026-03-04 | MRF ↗ |
| MILLE LACS HEALTH SYSTEM Both | SOUTH COUNTRY HEALTH PMAP | SOUTH COUNTRY HEALTH | $235.60 | $1,178.00 | $824.60 | 2026-03-04 | MRF ↗ |
| MILLE LACS HEALTH SYSTEM Both | UHC MC ADV | UHC MC ADV | $235.60 | $1,178.00 | $824.60 | 2026-03-04 | MRF ↗ |
| MILLE LACS HEALTH SYSTEM Both | MEDICARE REPLACEMENTS | MEDICARE REPLACEMENTS | $235.60 | $1,178.00 | $824.60 | 2026-03-04 | MRF ↗ |
| MILLE LACS HEALTH SYSTEM Both | MEDICA ADVANTAGE | MEDICA ADV SOLU | $235.60 | $1,178.00 | $824.60 | 2026-03-04 | MRF ↗ |
| MILLE LACS HEALTH SYSTEM Both | UCARE MEDICARE PLANS | UCARE MEDICARE PLANS | $235.60 | $1,178.00 | $824.60 | 2026-03-04 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan | $242.06 | — | — | 2026-03-01 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan – Hmo | $242.06 | — | — | 2026-03-01 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Blue Cross Complete | MEDICAID | $243.16 | $4,240.00 | — | 2025-06-28 | MRF ↗ |
| BAPTIST MEMORIAL HOSPITAL-CRITTENDEN, INC OutpatientFacility | CareSource | Medicaid | $257.50 | $19,864.00 | $2,979.60 | 2026-02-27 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Blue Cross Blue Shield Of Vt | Federal | $261.04 | $704.00 | $528.00 | 2026-05-18 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Blue Cross Blue Shield Of Vt | Default | $261.04 | $704.00 | $528.00 | 2026-05-18 | MRF ↗ |
| NORTHEASTERN VERMONT REGIONAL HOSPITAL Both | Blue Cross Blue Shield Of Vt | Ppo | $261.04 | $704.00 | $528.00 | 2026-05-18 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Traditional Medicaid HMO/PPO | Traditional Medicaid HMO/PPO | $262.84 | $808.50 | $404.30 | 2025-12-31 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Traditional Medicaid HMO/PPO | Traditional Medicaid HMO/PPO | $262.84 | $808.50 | $404.30 | 2025-12-31 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - United | Medicaid - United | $262.84 | $808.50 | $404.30 | 2025-12-31 | MRF ↗ |
| MCLAREN LAPEER REGION Outpatient | Medicaid - United | Medicaid - United | $262.84 | $808.50 | $404.30 | 2025-12-31 | MRF ↗ |
| MCLAREN CARO REGION Outpatient | Traditional Medicaid HMO/PPO | Traditional Medicaid HMO/PPO | $262.84 | $808.50 | $404.30 | 2025-12-31 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Medicaid - United | Medicaid - United | $262.84 | $808.50 | $404.30 | 2025-12-31 | MRF ↗ |
| MCLAREN LAPEER REGION Outpatient | Medicaid - United | Medicaid - United | $262.84 | $808.50 | $404.30 | 2025-12-31 | MRF ↗ |
| MCLAREN CARO REGION Outpatient | Medicaid - United | Medicaid - United | $262.84 | $808.50 | $404.30 | 2025-12-31 | MRF ↗ |
| MCLAREN CARO REGION Outpatient | Traditional Medicaid HMO/PPO | Traditional Medicaid HMO/PPO | $262.84 | $808.50 | $404.30 | 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.