80159 — Clozapine
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Clozapine (HCPCS 80159) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/80159?code_type=HCPCS
MLA (9th ed.)
“Clozapine (HCPCS 80159) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/80159?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Clozapine (HCPCS 80159) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/80159?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $20–$83 (25th–75th percentile) across 3,216 hospitals · 8,867 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 80159 — 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 this costs at this hospital
The hospital facility charge for this code — an actual negotiated rate from our data. A separate professional fee isn’t separately estimable for this code (see the note below).
What hospitals actually negotiate
Measured
$20
$36 typical
$83
The middle 50% of negotiated facility rates for this procedure, measured across 3,216 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $36 |
| Likely subtotal | $36 |
Facility charge (no separate professional fee)
$36
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 $20–$83.
- Laboratory tests are priced under the Clinical Laboratory Fee Schedule (CLFS), not the PFS, so a separate professional fee is not estimable here — the figure above is the facility charge only.
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
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 | — | — | — | $81.39 | $40.70 | 2024-12-15 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | VNA Homecare Options | Medicaid | — | $79.00 | $67.15 | 2025-01-01 | MRF ↗ |
| SUNNYVIEW HOSPITAL AND REHABILITATION CENTER OutpatientFacility | VNA Homecare Options | Medicaid | — | $176.00 | $149.60 | 2025-01-01 | MRF ↗ |
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | — | — | — | $81.39 | $40.70 | 2024-12-15 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | VNA Homecare Options | Medicaid | — | $248.00 | $210.80 | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | EmblemHealth | CBP | — | $248.00 | $210.80 | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | EmblemHealth | CBP | — | $79.00 | $67.15 | 2025-01-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | HMO, City of LA, Vivity | — | $25.09 | $16.31 | 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 | — | $25.09 | $16.31 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | HMO | — | $25.09 | $16.31 | 2025-11-26 | MRF ↗ |
| BEACON BEHAVIORAL HOSPITAL - CENTRAL Inpatient | ALL PLANS | HMO/PPO/POS/Self-Pay | — | — | $60.45 | 2025-10-01 | MRF ↗ |
| BEACON BEHAVIORAL HOSPITAL- NEW ORLEANS, LLC Inpatient | ALL PLANS | HMO/PPO/POS/Self-Pay | — | $60.45 | — | 2025-06-16 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | $27.73 | $20.80 | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | $20.00 | $15.00 | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | $27.73 | $20.80 | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | $20.00 | $15.00 | 2026-09-01 | MRF ↗ |
| DECATUR MEMORIAL HOSPITAL Outpatient | Commercial Workers Compensation | Commercial Workers Compensation | $0.27 | $51.00 | $51.00 | 2026-07-15 | MRF ↗ |
| DECATUR MEMORIAL HOSPITAL Outpatient | Hfn | Hfn Workers Compensation | $0.27 | $51.00 | $51.00 | 2026-07-15 | MRF ↗ |
| PIEDMONT MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $0.29 | $391.00 | $293.25 | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $0.29 | $391.00 | $293.25 | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | $20.00 | $15.00 | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | $27.73 | $20.80 | 2026-09-01 | MRF ↗ |
| JACKSONVILLE MEMORIAL HOSPITAL Outpatient | Commercial Workers Compensation | Commercial Workers Compensation | $0.34 | $63.00 | $63.00 | 2026-11-06 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AvMed | Medicare | $0.41 | $8.25 | $5.78 | 2026-09-29 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AvMed | Medicare | $0.41 | $8.25 | $5.78 | 2026-09-29 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AvMed | Medicare | $0.41 | $8.25 | $5.78 | 2026-09-29 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AvMed | Medicare | $0.41 | $8.25 | $5.78 | 2026-05-27 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL BothFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.49 | $175.00 | $131.25 | 2026-09-01 | MRF ↗ |
| KERN VALLEY HEALTHCARE DISTRICT Outpatient | HEALTHNET MCAL | HEALTHNET MCAL | $0.53 | $6.60 | $1.19 | 2026-02-25 | MRF ↗ |
| KERN VALLEY HEALTHCARE DISTRICT Outpatient | HEALTHNET (AIM) | HEALTHNET (AIM) | $0.53 | $6.60 | $1.19 | 2026-02-25 | MRF ↗ |
| BAYSTATE MEDICAL CENTER Both | Serenity Pace | Medicare Managed Care | $0.57 | $114.00 | $114.00 | 2026-06-05 | MRF ↗ |
| PIEDMONT MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $0.60 | $391.00 | $293.25 | 2026-09-01 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | Freedom Health | MGMCR | $0.61 | $6.60 | $6.60 | 2024-10-01 | MRF ↗ |
| James Cancer Hospital & Solove Research Institute Outpatient | Cigna | Cigna - Transplant | $0.62 | $96.00 | — | 2026-07-01 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $0.62 | $80.00 | $29.60 | 2026-03-31 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $0.65 | $69.59 | $69.59 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $0.65 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $0.65 | — | — | 2026-03-18 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Serenity Pace | Medicare Managed Care | $0.67 | $133.00 | $133.00 | 2026-06-05 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $0.71 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $0.71 | $69.59 | $69.59 | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $0.71 | — | — | 2026-03-18 | MRF ↗ |
| BAYSTATE MEDICAL CENTER Both | UnitedHealthCare | All Commercial Plans | $0.72 | $114.00 | $114.00 | 2026-06-05 | MRF ↗ |
| BAYSTATE MEDICAL CENTER Both | Wellpoint | All Commercial | $0.74 | $114.00 | $114.00 | 2026-06-05 | MRF ↗ |
| BAYSTATE MEDICAL CENTER Both | Aetna | All Commercial Plans | $0.74 | $114.00 | $114.00 | 2026-06-05 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.77 | $209.00 | $198.55 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.77 | $209.00 | $198.55 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $0.77 | $209.00 | $198.55 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $0.79 | $209.00 | $198.55 | 2026-02-20 | MRF ↗ |
| BAYSTATE MEDICAL CENTER Both | Multiplan | All Commercial Plans | $0.80 | $114.00 | $114.00 | 2026-06-05 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Molina | Molina Medi-Cal | $0.82 | $13.00 | $9.75 | 2025-07-01 | MRF ↗ |
| SHARP MEMORIAL HOSPITAL Outpatient | Molina | Molina Medi-Cal | $0.82 | $13.00 | $9.75 | 2025-07-01 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $0.82 | $209.00 | $198.55 | 2026-02-20 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Interplan | Interplan | $0.82 | $13.00 | $9.75 | 2026-04-01 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $0.84 | $209.00 | $198.55 | 2026-02-20 | MRF ↗ |
| Medical Center Barbour Outpatient | Healthcare Authority Multiplan | Multiplan | $0.85 | $1.00 | $0.50 | 2026-11-06 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Wellpoint | All Commercial | $0.86 | $133.00 | $133.00 | 2026-06-05 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | AvMed | HIX | $0.86 | $6.60 | $6.60 | 2024-10-01 | MRF ↗ |
| Florida Medical Center Outpatient | Aetna Better Health Medicaid Hmo | Aetna Better Health Medicaid Hmo | $0.91 | $30.23 | $30.23 | 2026-07-15 | MRF ↗ |
| NORTH SHORE MEDICAL CENTER Outpatient | Aetna Better Health Medicaid Hmo | Aetna Better Health Medicaid Hmo | $0.91 | $30.23 | $30.23 | 2026-07-15 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Multiplan | All Commercial Plans | $0.93 | $133.00 | $133.00 | 2026-06-05 | MRF ↗ |
| BAYSTATE MEDICAL CENTER Both | BCBS | HMO Commercial | $0.94 | $114.00 | $114.00 | 2026-06-05 | MRF ↗ |
| BAYSTATE MEDICAL CENTER Both | BCBS | Indemnity Commercial | $0.95 | $114.00 | $114.00 | 2026-06-05 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | AETNA | Acop | $0.95 | $139.00 | $90.35 | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | AETNA | Acop | $0.95 | $139.00 | $90.35 | 2026-06-15 | MRF ↗ |
| BAYSTATE MEDICAL CENTER Both | BCBS | PPO Commercial | $0.95 | $114.00 | $114.00 | 2026-06-05 | MRF ↗ |
| BAYSTATE MEDICAL CENTER Both | First Health | PPO | $0.97 | $114.00 | $114.00 | 2026-06-05 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | AETNA | AETNA US HEALTHCARE | $1.00 | $178.00 | $133.50 | 2026-09-01 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | CIGNA | CIGNA PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SAN RAMON REGIONAL MEDICAL CENTER OutpatientFacility | AETNA | AETNA GATEKEEPER (HMO/POS/EPO) | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | CIGNA | CIGNA HMO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | AETNA | AETNA EXCHANGE | $1.00 | $178.00 | $133.50 | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | AETNA | AETNA COMMERCIAL NEW BUSINESS DISCOUNT | $1.00 | $178.00 | $133.50 | 2026-09-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | SCAN Health Plan | Medicare Advantage | — | $25.09 | $16.31 | 2025-11-26 | MRF ↗ |
| DESERT REGIONAL MEDICAL CENTER BothFacility | AETNA | AETNA NON GATEKEEPER (PPO) | $1.00 | $20.00 | $15.00 | 2026-09-02 | MRF ↗ |
| SAN RAMON REGIONAL MEDICAL CENTER OutpatientFacility | AETNA | AETNA NON GATEKEEPER (PPO) | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | AETNA | AETNA EXCHANGE | $1.00 | $27.73 | $20.80 | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL BothFacility | AETNA | AETNA EXCHANGE | $1.00 | $175.00 | $131.25 | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | $20.00 | $15.00 | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | $20.00 | $15.00 | 2026-05-20 | MRF ↗ |
| SAINT FRANCIS BARTLETT MEDICAL CENTER BothFacility | CIGNA | CIGNA HEALTH PLAN OF TENNESSEE-RPO | $1.00 | $171.00 | $128.25 | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL BothFacility | AETNA | AETNA COMMERCIAL | $1.00 | $175.00 | $131.25 | 2026-09-01 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | CIGNA | CIGNA HMO | $1.00 | $27.73 | $20.80 | 2026-09-02 | MRF ↗ |
| DESERT REGIONAL MEDICAL CENTER BothFacility | CIGNA | CIGNA HMO | $1.00 | $20.00 | $15.00 | 2026-09-02 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $1.00 | $20.00 | $15.00 | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | AETNA | AETNA US HEALTHCARE PPO | $1.00 | $20.00 | $15.00 | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $1.00 | $391.00 | $293.25 | 2026-09-01 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | UNITED | EXCHANGE | $1.00 | $68.08 | $20.15 | 2026-09-05 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL BothFacility | AETNA | AETNA SOUTH SAN ANTONIO ISD | $1.00 | $175.00 | $131.25 | 2026-09-01 | MRF ↗ |
| SAINT FRANCIS BARTLETT MEDICAL CENTER BothFacility | CIGNA | CIGNA HEALTH PLAN OF TENNESSEE - PPO | $1.00 | $171.00 | $128.25 | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | MOLINA | MOLINA HEALTHCARE OF FLORIDA | $1.00 | $27.73 | $20.80 | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | AETNA | AETNA US HEALTHCARE HMO/POS | $1.00 | $20.00 | $15.00 | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | $20.00 | $15.00 | 2026-05-20 | MRF ↗ |
| SAN RAMON REGIONAL MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS EXCHANGE HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | $20.00 | $15.00 | 2026-05-20 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | $20.00 | $15.00 | 2026-09-02 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | AETNA | AETNA US HEALTHCARE HMO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | $178.00 | $133.50 | 2026-09-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $25.09 | $16.31 | 2025-11-26 | MRF ↗ |
| DESERT REGIONAL MEDICAL CENTER BothFacility | CIGNA | CIGNA COMMERCIAL | $1.00 | $20.00 | $15.00 | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | AETNA | AETNA COMMERCIAL NEW BUSINESS DISCOUNT | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO HMO | $1.00 | $178.00 | $133.50 | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | $20.00 | $15.00 | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | AETNA | AETNA GATEKEEPER (HMO/POS/EPO) | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NM BLUE ADVANTAGE | $1.00 | $178.00 | $133.50 | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE COMMUNITY NM HMO NETWORK EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SAINT FRANCIS BARTLETT MEDICAL CENTER BothFacility | AETNA | AETNA HEALTH | $1.00 | $171.00 | $128.25 | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | AETNA | AETNA US HEALTHCARE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL BothFacility | AETNA | AETNA SPP | $1.00 | $175.00 | $131.25 | 2026-09-01 | MRF ↗ |
| SAINT FRANCIS BARTLETT MEDICAL CENTER BothFacility | CIGNA | CIGNA HEALTH PLAN OF TENNESSEE - HMO | $1.00 | $171.00 | $128.25 | 2026-09-01 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | CIGNA | CIGNA COMMERCIAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | AETNA | AETNA ACO NETWORK | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL BothFacility | AETNA | AETNA COMMERCIAL NEW BUSINESS DISCOUNT | $1.00 | $175.00 | $131.25 | 2026-09-01 | MRF ↗ |
| DESERT REGIONAL MEDICAL CENTER BothFacility | AETNA | AETNA GATEKEEPER (HMO/POS/EPO) | $1.00 | $20.00 | $15.00 | 2026-09-02 | MRF ↗ |
| METROWEST MEDICAL CENTER BothFacility | AETNA | AETNA US HEALTHCARE | $1.00 | $293.00 | $219.75 | 2026-06-05 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | AETNA | AETNA US HEALTHCARE PPO | $1.00 | $27.73 | $20.80 | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $1.00 | $391.00 | $293.25 | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | $20.00 | $15.00 | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | $20.00 | $15.00 | 2026-05-20 | MRF ↗ |
| PIEDMONT MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $1.00 | $391.00 | $293.25 | 2026-09-01 | MRF ↗ |
| SAN RAMON REGIONAL MEDICAL CENTER OutpatientFacility | AETNA | AETNA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | CIGNA | CIGNA/PPO | $1.00 | $27.73 | $20.80 | 2026-09-02 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | AETNA | AETNA US HEALTHCARE HMO/POS | $1.00 | $27.73 | $20.80 | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $1.00 | $27.73 | $20.80 | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | BLUE CROSS/BLUE SHIELD | BLUE COMMUNITY NM HMO NETWORK EXCHANGE | $1.00 | $178.00 | $133.50 | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER BothFacility | AETNA | AETNA COMMERCIAL | $1.00 | $391.00 | $293.25 | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | $20.00 | $15.00 | 2026-05-20 | MRF ↗ |
| SAINT FRANCIS BARTLETT MEDICAL CENTER BothFacility | AETNA | AETNA COMMERCIAL NEW BUSINESS DISCOUNT | $1.00 | $171.00 | $128.25 | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | AETNA | AETNA EXCHANGE | $1.00 | $20.00 | $15.00 | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | $20.00 | $15.00 | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | $178.00 | $133.50 | 2026-09-01 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | AETNA | AETNA US HEALTHCARE PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | AETNA | AETNA ACO NETWORK | $1.00 | $178.00 | $133.50 | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NM BLUE ADVANTAGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | AETNA | AETNA NON GATEKEEPER (PPO) | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| PIEDMONT MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS STATE | $1.00 | $391.00 | $293.25 | 2026-09-01 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | AETNA | AETNA US HEALTHCARE OF CALIFORNIA | $1.00 | $27.73 | $20.80 | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | AETNA | AETNA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DESERT REGIONAL MEDICAL CENTER BothFacility | CIGNA | CIGNA PPO | $1.00 | $20.00 | $15.00 | 2026-09-02 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | MOLINA | MOLINA HEALTHCARE OF FLORIDA | $1.00 | $20.00 | $15.00 | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO HMO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DESERT REGIONAL MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS EXCHANGE HIX | $1.00 | $20.00 | $15.00 | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | CIGNA | CIGNA COMMERCIAL | $1.00 | $27.73 | $20.80 | 2026-09-02 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL BothFacility | AETNA | AETNA QPIC | $1.00 | $175.00 | $131.25 | 2026-09-01 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | Indemnity Commercial | $1.02 | $133.00 | $133.00 | 2026-06-05 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.02 | $209.00 | $198.55 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.02 | $209.00 | $198.55 | 2026-02-20 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | HMO Commercial | $1.02 | $133.00 | $133.00 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | PPO Commercial | $1.02 | $133.00 | $133.00 | 2026-06-05 | MRF ↗ |
| BRIDGEPORT HOSPITAL Outpatient | Medicaid Managed UHC | All Plans | $1.03 | $120.90 | $61.66 | 2025-01-10 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.04 | $209.00 | $198.55 | 2026-02-20 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $1.05 | — | — | 2026-03-18 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | AETNA | Asa_Whirlpool_Peia | $1.11 | $139.00 | $90.35 | 2026-06-15 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Aetna | All Commercial Plans | $1.11 | $133.00 | $133.00 | 2026-06-05 | MRF ↗ |
| BAYSTATE MEDICAL CENTER Both | Coventry | Health Care Workers Comp | $1.12 | $114.00 | $114.00 | 2026-06-05 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $1.13 | $209.00 | $198.55 | 2026-02-20 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | First Health | PPO | $1.13 | $133.00 | $133.00 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Connecticare | All Commercial Plans | $1.14 | $133.00 | $133.00 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Connecticare | CBI Other Commercial Plan | $1.14 | $133.00 | $133.00 | 2026-06-05 | MRF ↗ |
| MCKAY-DEE HOSPITAL Inpatient | Donor Connect | Other | $1.16 | $115.83 | $86.87 | 2026-11-03 | MRF ↗ |
| KERN VALLEY HEALTHCARE DISTRICT Outpatient | UHC - ALL PLANS | UHC - ALL PLANS | $1.19 | $6.60 | $1.19 | 2026-02-25 | MRF ↗ |
| KERN VALLEY HEALTHCARE DISTRICT Outpatient | HUMANA MED ADV - ALL PLANS | HUMANA MED ADV - ALL PLANS | $1.19 | $6.60 | $1.19 | 2026-02-25 | MRF ↗ |
| KERN VALLEY HEALTHCARE DISTRICT Outpatient | HEALTHNET MED ADV | HEALTHNET MED ADV | $1.19 | $6.60 | $1.19 | 2026-02-25 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $1.24 | $8.25 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $1.24 | $8.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $1.24 | $8.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $1.24 | $8.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $1.24 | $8.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $1.24 | $8.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $1.24 | $8.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $1.24 | $8.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $1.24 | $8.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $1.24 | $8.25 | — | 2025-07-30 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | Molina | MCR | $1.25 | $6.60 | $6.60 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA LARGO HOSPITAL Outpatient | Access 2 Healthcare Physicians Freedom Optimum Group Members | MGMCR | $1.30 | $27.73 | $27.73 | 2026-03-01 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Coventry | Health Care Workers Comp | $1.30 | $133.00 | $133.00 | 2026-06-05 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | MOLINA | EXCHANGE | $1.32 | $8.25 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | MOLINA | EXCHANGE | $1.32 | $8.25 | — | 2025-07-30 | MRF ↗ |
| LAKE GRANBURY MEDICAL CENTER Outpatient | Self Pay | Self Pay | $1.32 | $22.00 | $3.96 | 2026-07-15 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | Amerihealth Caritas | QHP | $1.32 | $8.25 | $5.78 | 2026-09-29 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | MOLINA | EXCHANGE | $1.32 | $8.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Amerihealth Caritas | QHP | $1.32 | $8.25 | $5.78 | 2026-09-29 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | MOLINA | EXCHANGE | $1.32 | $8.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Amerihealth Caritas | QHP | $1.32 | $8.25 | $5.78 | 2026-05-27 | MRF ↗ |
| HCA FLORIDA NORTHSIDE HOSPITAL Outpatient | Access 2 Healthcare Physicians Freedom Optimum Group Members | MGMCR | $1.32 | $28.00 | $28.00 | 2026-03-01 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | MOLINA | EXCHANGE | $1.32 | $8.25 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | Amerihealth Caritas | QHP | $1.32 | $8.25 | $5.78 | 2026-09-29 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | MyBlue | $1.33 | $8.25 | — | 2025-07-30 | MRF ↗ |
| INTERMOUNTAIN MEDICAL CENTER Inpatient | Donor Connect | Other | $1.39 | $115.83 | $86.87 | 2026-11-02 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | CIGNA | EXCHANGE | $1.40 | $8.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AvMed | Commercial | $1.40 | $8.25 | $5.78 | 2026-05-27 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AvMed | Commercial | $1.40 | $8.25 | $5.78 | 2026-09-29 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE InpatientFacility | Aetna Better Health | Healthy Kids | $1.40 | $8.25 | $5.78 | 2026-09-29 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Community Care Plan | Commercial | $1.40 | $8.25 | $5.78 | 2026-05-27 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | CIGNA | EXCHANGE | $1.40 | $8.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | CIGNA | EXCHANGE | $1.40 | $8.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | BLUE SELECT | $1.40 | $8.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | CIGNA | EXCHANGE | $1.40 | $8.25 | — | 2025-07-30 | 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.