68100 — Biopsy Of Eyelid Lining
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). BIOPSY OF EYELID LINING (HCPCS 68100) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/68100?code_type=HCPCS
MLA (9th ed.)
“BIOPSY OF EYELID LINING (HCPCS 68100) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/68100?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“BIOPSY OF EYELID LINING (HCPCS 68100) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/68100?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $648–$3,184 (25th–75th percentile) across 1,798 hospitals · 2,837 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 68100 — 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 the surgeon's fee are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$648
$2,297 typical
$3,184
The middle 50% of negotiated facility rates for this procedure, measured across 1,798 hospitals. The the surgeon's fee 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. | $2,297 |
| Surgeon (professional fee) Estimate national typical Medicare $81 × 1.22 commercial. | $99 |
| Likely subtotal | $2,396 |
Surgical episode (typical)
~$2,396
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge
- Complications, revisions, or readmissions
- Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)
The biggest swing: which insurer's rate applies — negotiated prices here run $648–$3,184.
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 |
|---|---|---|---|---|---|---|---|
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | HEALTHSMART | HEALTHSMART WORKERS COMP | $0.17 | — | — | 2026-05-20 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $0.20 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | HEALTHSMART | HEALTHSMART WORKERS COMP | $0.22 | — | — | 2026-09-02 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.49 | — | — | 2026-09-01 | MRF ↗ |
| James Cancer Hospital & Solove Research Institute Outpatient | Cigna | Cigna - Transplant | $0.62 | $3,515.00 | — | 2026-07-01 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| CHI Memorial Hospital - Hixson Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| NORTHRIDGE HOSPITAL MEDICAL CENTER Outpatient | Alliant Health | Commercial|All Plans | $0.65 | — | — | 2026-02-28 | MRF ↗ |
| SHELBY BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NON OPTIONS PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR PLUS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE - OPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| CITIZENS BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| SHELBY BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PRINCETON BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Medicaid | Medicaid | $1.00 | $9,539.00 | $4,769.50 | 2026-07-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PRINCETON BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanPPO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Medicaid | Medicaid | $1.00 | $6,359.00 | $3,179.50 | 2026-07-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE CHARTER | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE SHIELD PROMISE MEDICARE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA HMO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID NON UHRIP | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | CARE1ST MEDICARE ADVANTAGE | CARE1ST MEDICARE ADVANTAGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE COMMERCIAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID STAR | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM NON UHRIP | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR KIDS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE - MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE COMMERCIAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR KIDS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID STAR PLUS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | HUMANA | HUMANA MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NON OPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE - OPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | CARE1ST MEDICARE ADVANTAGE | CARE1ST MEDICARE ADVANTAGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW BUSINESS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE CHARTER | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW BUSINESS | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID STAR PLUS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| CITIZENS BAPTIST MEDICAL CENTER Outpatient | Cigna | CignaHealthPlanHMO | $1.00 | — | — | 2024-12-11 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE SHIELD PROMISE MEDICARE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE SHIELD - MANTECA SURGERY CENTER MEDICARE ADVANTAGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | SCOTT AND WHITE HEALTH PLAN | SCOTT AND WHITE HEALTH PLAN MEDICAID STAR KIDS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA HMO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.06 | — | — | 2026-09-02 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $1.07 | $9,539.00 | $4,769.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $1.07 | $6,359.00 | $3,179.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $1.10 | $6,359.00 | $3,179.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $1.10 | $9,539.00 | $4,769.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $1.18 | $6,359.00 | $3,179.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $1.18 | $9,539.00 | $4,769.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Jefferson Health Plan | Jefferson Health Plan - Managed Medicaid | $1.20 | $6,359.00 | $3,179.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Jefferson Health Plan | Jefferson Health Plan - Managed Medicaid | $1.20 | $9,539.00 | $4,769.50 | 2026-07-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.30 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA WORKERS COMPENSATION | $1.30 | — | — | 2026-09-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - Managed Medicaid | $1.47 | $6,359.00 | $3,179.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - Managed Medicaid | $1.47 | $9,539.00 | $4,769.50 | 2026-07-01 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $1.80 | $487.00 | $462.65 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.80 | $487.00 | $462.65 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.80 | $487.00 | $462.65 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.85 | $487.00 | $462.65 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.90 | $487.00 | $462.65 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $1.95 | $487.00 | $462.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $2.39 | $487.00 | $462.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $2.39 | $487.00 | $462.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $2.44 | $487.00 | $462.65 | 2026-02-20 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - CHIP - Managed Medicare | $2.50 | $9,539.00 | $4,769.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - CHIP - Managed Medicare | $2.50 | $6,359.00 | $3,179.50 | 2026-07-01 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $2.53 | $487.00 | $462.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $2.63 | $487.00 | $462.65 | 2026-02-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $2.72 | $335.00 | $63.65 | 2026-05-20 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | KANCARE CONTRACTED [320213] | HB SPRG AETNA BETTER HEALTH (KANCARE) | $3.75 | $15.00 | $9.75 | 2026-06-04 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | KANCARE [20213] | HB SPRG AETNA BETTER HEALTH (KANCARE) | $3.75 | $15.00 | $9.75 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | KANCARE [20213] | HB CTHG KANCARE UHC MEDICAID | $3.75 | $15.00 | $9.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | KANCARE CONTRACTED [320213] | HB SPRG AETNA BETTER HEALTH (KANCARE) | $3.75 | $15.00 | $9.75 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | KANCARE [20213] | HB CTHG KANCARE UHC MEDICAID | $3.75 | $15.00 | $9.75 | 2026-06-04 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | KANCARE CONTRACTED [320213] | HB CTHG KANCARE UHC MEDICAID | $3.75 | $15.00 | $9.75 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | KANCARE [20213] | HB JOPL AETNA BETTER HEALTH (KANCARE) | $3.75 | $15.00 | $9.75 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | KANCARE [20213] | HB SPRG AETNA BETTER HEALTH (KANCARE) | $3.75 | $15.00 | $9.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | KANCARE CONTRACTED [320213] | HB CTHG KANCARE UHC MEDICAID | $3.75 | $15.00 | $9.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | KANCARE CONTRACTED [320213] | HB JOPL AETNA BETTER HEALTH (KANCARE) | $3.75 | $15.00 | $9.75 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | SUNFLOWER HEALTH PLAN CONTRACTED [320369] | HB JOPL AMBETTER EXCHANGE MO | $4.20 | $15.00 | $9.75 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | HOME STATE HEALTH PLAN CONTRACTED [320187] | HB JOPL AMBETTER EXCHANGE MO | $4.20 | $15.00 | $9.75 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | AMBETTER CONTRACTED [320452] | HB JOPL AMBETTER EXCHANGE MO | $4.20 | $15.00 | $9.75 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | NOVASYS CONTRACTED [320285] | HB JOPL AMBETTER EXCHANGE MO | $4.20 | $15.00 | $9.75 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | KANCARE CONTRACTED [320213] | HB CTHG KANCARE UHC MEDICAID | $4.50 | $18.00 | $11.70 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | KANCARE CONTRACTED [320213] | HB CTHG KANCARE UHC MEDICAID | $4.50 | $18.00 | $11.70 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | KANCARE CONTRACTED [320213] | HB SPRG AETNA BETTER HEALTH (KANCARE) | $4.50 | $18.00 | $11.70 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | KANCARE [20213] | HB CTHG KANCARE UHC MEDICAID | $4.50 | $18.00 | $11.70 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | KANCARE [20213] | HB CTHG KANCARE UHC MEDICAID | $4.50 | $18.00 | $11.70 | 2026-06-04 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | KANCARE [20213] | HB SPRG AETNA BETTER HEALTH (KANCARE) | $4.50 | $18.00 | $11.70 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | KANCARE CONTRACTED [320213] | HB JOPL AETNA BETTER HEALTH (KANCARE) | $4.50 | $18.00 | $11.70 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | KANCARE [20213] | HB JOPL AETNA BETTER HEALTH (KANCARE) | $4.50 | $18.00 | $11.70 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | HUMANA CONTRACTED [320193] | HB JOPL HUMANA COMMERCIAL | $4.50 | $15.00 | $9.75 | 2026-06-09 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | KANCARE CONTRACTED [320213] | HB SPRG AETNA BETTER HEALTH (KANCARE) | $4.50 | $18.00 | $11.70 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | KANCARE [20213] | HB SPRG AETNA BETTER HEALTH (KANCARE) | $4.50 | $18.00 | $11.70 | 2026-03-12 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $4.88 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $4.88 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $4.88 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $4.88 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $4.88 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $4.88 | — | — | 2026-09-02 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | MEDICAID [20240] | HB SPRG/JOPL ARK MEDICAID | $5.00 | $15.00 | $9.75 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | HOME STATE HEALTH PLAN CONTRACTED [320187] | HB JOPL AMBETTER EXCHANGE MO | $5.04 | $18.00 | $11.70 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | AMBETTER CONTRACTED [320452] | HB JOPL AMBETTER EXCHANGE MO | $5.04 | $18.00 | $11.70 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | SUNFLOWER HEALTH PLAN CONTRACTED [320369] | HB JOPL AMBETTER EXCHANGE MO | $5.04 | $18.00 | $11.70 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | NOVASYS CONTRACTED [320285] | HB JOPL AMBETTER EXCHANGE MO | $5.04 | $18.00 | $11.70 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | HUMANA CONTRACTED [320193] | HB JOPL HUMANA COMMERCIAL | $5.40 | $18.00 | $11.70 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | MEDICA CONTRACTED [320239] | HB JOPL/SEKS MEDICA EXCHANGE | $5.46 | $15.00 | $9.75 | 2026-06-09 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $5.63 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $5.63 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $5.63 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $5.63 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $5.63 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $5.63 | — | — | 2026-09-02 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | MEDICA CONTRACTED [320239] | HB SPRG LEBN MEDICA EXCHANGE | $5.93 | $15.00 | $9.75 | 2026-06-04 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | MEDICA [20239] | HB SPRG LEBN MEDICA EXCHANGE | $5.93 | $15.00 | $9.75 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | MEDICA [20239] | HB SPRG LEBN MEDICA EXCHANGE | $5.93 | $15.00 | $9.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | MEDICA CONTRACTED [320239] | HB SPRG LEBN MEDICA EXCHANGE | $5.93 | $15.00 | $9.75 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | HEALTH SYSTEMS INC CONTRACTED [320174] | HB SPRG HEALTH SYSTEMS | $6.00 | $15.00 | $9.75 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | UNITED HEALTHCARE CONTRACTED [320396] | HB JOPL UHC ALL PAYER | $6.00 | $15.00 | $9.75 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | OPTUM HEALTH BEHAVIORAL SOLUTIONS [520250] | HB JOPL UHC ALL PAYER | $6.00 | $15.00 | $9.75 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | UNITED MEDICAL RESOURCES CONTRACTED [320454] | HB JOPL UHC ALL PAYER | $6.00 | $15.00 | $9.75 | 2026-06-09 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | BENEFIT MANAGEMENT CONTRACTED [320052] | HB SPRG DEC OZARK COMMUNITY HOSPITAL | $6.00 | $15.00 | $9.75 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | UNITED HEALTHCARE CONTRACTED [320396] | HB JOPL UHC INDIVIDUAL EXCHANGE | $6.00 | $15.00 | $9.75 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | INSURANCE SYSTEM INC CONTRACTED [320465] | HB SPRG HEALTH SYSTEMS | $6.00 | $15.00 | $9.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | BENEFIT MANAGEMENT CONTRACTED [320052] | HB SPRG DEC OZARK COMMUNITY HOSPITAL | $6.00 | $15.00 | $9.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | HEALTH SYSTEMS INC CONTRACTED [320174] | HB SPRG HEALTH SYSTEMS | $6.00 | $15.00 | $9.75 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | INSURANCE SYSTEM INC CONTRACTED [320465] | HB SPRG HEALTH SYSTEMS | $6.00 | $15.00 | $9.75 | 2026-06-04 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | HOME STATE HEALTH PLAN CONTRACTED [320187] | HB SPRG AMBETTER EXCHANGE MO | $6.11 | $15.00 | $9.75 | 2026-06-04 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | AMBETTER CONTRACTED [320452] | HB SPRG AMBETTER EXCHANGE MO | $6.11 | $15.00 | $9.75 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | HOME STATE HEALTH PLAN CONTRACTED [320187] | HB SPRG AMBETTER EXCHANGE MO | $6.11 | $15.00 | $9.75 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | NOVASYS CONTRACTED [320285] | HB SPRG AMBETTER EXCHANGE MO | $6.11 | $15.00 | $9.75 | 2026-06-04 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | NOVASYS CONTRACTED [320285] | HB SPRG AMBETTER EXCHANGE MO | $6.11 | $15.00 | $9.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | SUNFLOWER HEALTH PLAN CONTRACTED [320369] | HB SPRG AMBETTER EXCHANGE MO | $6.11 | $15.00 | $9.75 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SPRINGFIELD OutpatientFacility | AMBETTER CONTRACTED [320452] | HB SPRG AMBETTER EXCHANGE MO | $6.11 | $15.00 | $9.75 | 2026-03-12 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | SUNFLOWER HEALTH PLAN CONTRACTED [320369] | HB SPRG AMBETTER EXCHANGE MO | $6.11 | $15.00 | $9.75 | 2026-06-04 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $6.20 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $6.20 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $6.20 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $6.20 | — | — | 2026-05-20 | 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.