72255 — Myelography Thoracic Spine
Cite this view
HANK Price Transparency. (n.d.). MYELOGRAPHY THORACIC SPINE (CPT 72255) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/72255?code_type=CPT
“MYELOGRAPHY THORACIC SPINE (CPT 72255) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/72255?code_type=CPT. Accessed .
“MYELOGRAPHY THORACIC SPINE (CPT 72255) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/72255?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $432–$1,362 (25th–75th percentile) across 1,950 hospitals · 5,613 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 72255 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
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 radiologist-read fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
The middle 50% of negotiated facility rates for this procedure, measured across 1,950 hospitals. The radiologist-read 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. | $811 |
| Radiologist read Estimate national typical Medicare $42 × 1.8 commercial. | $76 |
| Likely subtotal | $887 |
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Radiologist read (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: Urban Institute — commercial-to-Medicare physician price ratios by specialty (Berenson/Ginsburg et al.); radiology ~1.8x. National, approximate; within-specialty/metro variation is a known limitation.
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 |
|---|---|---|---|---|---|---|---|
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | None | — | — | $8,307.79 | $4,153.90 | 2024-12-15 | MRF ↗ |
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | None | — | — | $8,307.79 | $4,153.90 | 2024-12-15 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $1,450.00 | $1,189.00 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | HMO | — | $1,450.00 | $1,189.00 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $1,450.00 | $1,189.00 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $1,450.00 | $1,189.00 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | HMO | — | $1,450.00 | $1,189.00 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $1,450.00 | $1,189.00 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $1,450.00 | $1,189.00 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | Covered | — | $1,450.00 | $1,189.00 | 2025-11-26 | MRF ↗ |
| COMANCHE COUNTY MEDICAL CENTER Outpatient | MPI - ALL PLANS | MPI - ALL PLANS | $1.42 | $141.12 | $91.73 | 2026-05-07 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Healthplan Medicaid | Wv Medicaid | $1.64 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Wellpoint | Wv Medicaid | $1.72 | — | — | 2026-05-06 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP SELECT [10026309] | $1.84 | $1,444.00 | $1,010.80 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP HMO OUT IPA [10026302] | $1.84 | $1,444.00 | $1,010.80 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | IRON CLAD INSURANCE [10026304] | $1.84 | $1,444.00 | $1,010.80 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP POS/EPO [10026306] | $1.84 | $1,444.00 | $1,010.80 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP GIC NAVIGATOR POS [10026312] | $1.84 | $1,444.00 | $1,010.80 | 2025-01-01 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $2.44 | $659.00 | $626.05 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $2.44 | $659.00 | $626.05 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $2.44 | $659.00 | $626.05 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $2.50 | $659.00 | $626.05 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $2.57 | $659.00 | $626.05 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $2.64 | $659.00 | $626.05 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $3.16 | $659.00 | $626.05 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $3.16 | $659.00 | $626.05 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $3.23 | $659.00 | $626.05 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $3.23 | $659.00 | $626.05 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $3.31 | $676.00 | $642.20 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $3.31 | $676.00 | $642.20 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $3.36 | $659.00 | $626.05 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $3.38 | $676.00 | $642.20 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $3.52 | $676.00 | $642.20 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $3.65 | $676.00 | $642.20 | 2026-02-20 | MRF ↗ |
| ROANE MEDICAL CENTER Outpatient | Ambetter | Exchange | $4.81 | — | — | 2024-12-10 | MRF ↗ |
| FORT LOUDOUN MEDICAL CENTER Outpatient | Ambetter | Exchange | $4.81 | — | — | 2024-12-10 | MRF ↗ |
| LECONTE MEDICAL CENTER Outpatient | Ambetter | Exchange | $4.81 | — | — | 2024-12-10 | MRF ↗ |
| ROANE MEDICAL CENTER Outpatient | Ambetter | Exchange | $4.81 | — | — | 2024-12-10 | MRF ↗ |
| FORT LOUDOUN MEDICAL CENTER Outpatient | Ambetter | Exchange | $4.81 | — | — | 2024-12-10 | MRF ↗ |
| LECONTE MEDICAL CENTER Outpatient | Ambetter | Exchange | $4.81 | — | — | 2024-12-10 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | HMO | — | $5,133.59 | $3,336.83 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | HMO, Non-City of LA, Vivity | — | $5,133.59 | $3,336.83 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | HMO, City of LA, Vivity | — | $5,133.59 | $3,336.83 | 2025-11-26 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $5.70 | $3,164.00 | $813.28 | 2024-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $7.77 | — | — | 2025-12-31 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | POS | — | $1,450.00 | $1,189.00 | 2025-11-26 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $12.50 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $12.58 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $12.58 | — | — | 2026-03-18 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $12.96 | $96.00 | $72.00 | 2026-01-16 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | California PhysiciansÆ Service, dba Blue Shield of California | Medi-Cal | — | $5,133.59 | $3,336.83 | 2025-11-26 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $14.33 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $14.41 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $14.41 | — | — | 2026-03-18 | MRF ↗ |
| METHODIST HOSPITALS OF MEMPHIS Both | CIGNA [100009] | HB Cigna PPO - LeBonheur | $14.97 | $2,468.00 | $542.96 | 2026-03-19 | MRF ↗ |
| RUSSELLVILLE HOSPITAL Both | HMO | ONE CALL CARE HMO OP | $15.00 | $1,595.00 | $414.70 | 2025-10-30 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $15.60 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $15.69 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $15.69 | — | — | 2026-03-18 | MRF ↗ |
| SAVANNAH HEALTH SERVICES LLC DBA MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER Outpatient | BCBS | Pathway | $15.90 | — | — | 2024-10-01 | MRF ↗ |
| SAVANNAH HEALTH SERVICES LLC DBA MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER Outpatient | BCBS | HIX | $15.90 | — | — | 2024-10-01 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $16.54 | — | — | 2026-04-14 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $18.53 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $18.53 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $18.53 | $524.00 | $314.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $18.53 | $524.00 | $314.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $18.53 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $18.53 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $18.53 | $524.00 | $314.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $18.53 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $18.53 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $18.53 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $18.53 | — | — | 2026-01-01 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $19.92 | $96.00 | $72.00 | 2026-01-16 | MRF ↗ |
| ST JOE MERCY HOSPITAL SYSTEM LIVONIA OutpatientFacility | VACCN United | Veterans Affairs | $20.50 | $1,174.00 | $763.10 | 2025-01-01 | MRF ↗ |
| ST JOE MERCY HOSPITAL SYSTEM LIVONIA OutpatientFacility | VACCN United | Veterans Affairs | $20.50 | $1,174.00 | $763.10 | 2025-01-01 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $20.79 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $20.79 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $20.79 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $20.79 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $20.79 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $20.79 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $20.79 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $20.79 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $20.79 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $20.79 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $20.79 | — | — | 2026-04-14 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $21.06 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $21.06 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $21.06 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $21.06 | — | — | 2026-04-01 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $21.06 | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $21.06 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $21.06 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $21.06 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $21.06 | — | — | 2026-04-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | $524.00 | $314.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | $524.00 | $314.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | $524.00 | $314.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | $524.00 | $314.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $21.40 | — | — | 2026-01-01 | MRF ↗ |
| METRO NASHVILLE GENERAL HOSPITAL Both | UNITEDHEALTHCARE | MEDICARE ADVANTAGE SNP | $22.04 | $1,684.00 | $1,010.40 | 2024-07-01 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Geisinger | Geisinger Medicaid HC | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Geisinger | Geisinger CHIP | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Geisinger | Geisinger CHIP | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Geisinger | Geisinger Medicaid HC | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | United Healthcare | United Healthcare Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| CANONSBURG GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | United Healthcare | United Healthcare Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Geisinger | Geisinger Medicaid HC | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Geisinger | Geisinger CHIP | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $22.84 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $22.84 | — | — | 2026-04-14 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.