80500 — Lab Pathology Consultation
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Lab pathology consultation (CPT 80500) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/80500?code_type=CPT
MLA (9th ed.)
“Lab pathology consultation (CPT 80500) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/80500?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“Lab pathology consultation (CPT 80500) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/80500?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $28–$109 (25th–75th percentile) across 824 hospitals · 900 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 80500 — 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
$28
$59 typical
$109
The middle 50% of negotiated facility rates for this procedure, measured across 824 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $59 |
| Likely subtotal | $59 |
Facility charge (no separate professional fee)
$59
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 $28–$109.
- 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 |
|---|---|---|---|---|---|---|---|
| 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 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 ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Blue Medicare Partner Health Plan | Medicare | $0.30 | $5.00 | $3.00 | 2026-08-01 | 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 ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AETNA | AETNA WORKERS COMP | $0.95 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AETNA | AETNA WORKERS COMP | $0.95 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | AETNA | AETNA US HEALTHCARE HMO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | AETNA | AETNA ACO NETWORK | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | AETNA | AETNA ACO NETWORK | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | AETNA | AETNA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA SOUTH SAN ANTONIO ISD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | AETNA | AETNA US HEALTHCARE | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | AETNA | AETNA NON GATEKEEPER (PPO) | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AETNA | AETNA US HEALTHCARE PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AETNA | AETNA US HEALTHCARE HMO/POS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | AETNA | AETNA COMMERCIAL NEW BUSINESS DISCOUNT | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | AETNA | AETNA US HEALTHCARE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AETNA | AETNA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | AETNA | AETNA US HEALTHCARE PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA COMMERCIAL | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | AETNA | AETNA US HEALTHCARE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA COMMERCIAL NEW BUSINESS DISCOUNT | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | AETNA | AETNA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AETNA | AETNA US HEALTHCARE HMO/POS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA SPP | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | AETNA | AETNA COMMERCIAL | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA QPIC | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | AETNA | AETNA COMMERCIAL NEW BUSINESS DISCOUNT | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | AETNA | AETNA GATEKEEPER (HMO/POS/EPO) | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AETNA | AETNA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AETNA | AETNA US HEALTHCARE PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | AETNA | AETNA US HEALTHCARE OF CALIFORNIA | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Carolina Complete Health | Managed Medicaid | $1.38 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Non Contracted Commercial | Non Contracted Commercial | $1.42 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | United Healthcare | Compass | $1.75 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Troy | Medicare Advantage | $1.87 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | New Hanover | Medicare Advantage | $1.87 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Humana Choicecare | Medicare Advantage | $1.87 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Optum Veterans Affairs Community Care Network | Optum Veterans Affairs Community Care Network | $1.87 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | First Carolina Care | Medicare Advantage | $1.87 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Liberty Advantage | Medicare Advantage | $1.87 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Wellcare | Managed Medicaid | $1.87 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Wellcare | Medicare Advantage | $1.87 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Humana | Medicare Advantage | $1.87 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Longevity | Medicare Advantage | $1.87 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Healthy Blue | Managed Medicaid | $1.87 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | United Healthcare | Managed Medicaid | $1.87 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Aetna | Medicare Advantage | $1.87 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Aetna Qualified Health Plan | Commercial | $1.90 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Ambetter Of Nc Individual Market | Commercial | $1.99 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY HOKE HOSPITAL Outpatient | Aetna Nc State Health Plan | Commercial | $2.40 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Aetna Nc State Health Plan | Commercial | $2.40 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Aetna Nc State Health Plan | Commercial | $2.40 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | UnitedHealthcare | Community & State | $2.43 | $101.00 | — | 2026-08-17 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | UnitedHealthcare | Community & State | $2.44 | $101.35 | — | 2026-08-17 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $2.44 | — | — | 2026-01-01 | MRF ↗ |
| CAPE FEAR VALLEY HOKE HOSPITAL Outpatient | United Healthcare | Compass | $2.45 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | United Healthcare | Compass | $2.45 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Medcost | Commercial | $2.55 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | Wellpoint | Medicaid Managed Care | $2.68 | $101.00 | — | 2026-08-17 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | Wellpoint | Medicaid Managed Care | $2.69 | $101.35 | — | 2026-08-17 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Cigna | Commercial | $2.70 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY HOKE HOSPITAL Outpatient | Aetna New Business | Commerical | $2.80 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Blue Cross Blue Shield Of Nc | Commercial | $2.84 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6790_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ASIN 20230101 | $2.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $2.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $2.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $2.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $2.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $2.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $2.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $2.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $2.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $2.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $2.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $2.86 | — | — | 2026-01-01 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | Wellpoint | Medicaid Managed Care | $2.87 | $101.00 | — | 2026-08-17 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Aetna New Business | Commerical | $2.90 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Aetna New Business | Commerical | $2.90 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Aetna | Commercial | $2.90 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Aetna | Commercial | $2.90 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY HOKE HOSPITAL Outpatient | Aetna | Commercial | $2.90 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Medcost | Commercial | $3.00 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Cigna | Commercial | $3.00 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY HOKE HOSPITAL Outpatient | Cigna | Commercial | $3.00 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY HOKE HOSPITAL Outpatient | Medcost | Commercial | $3.00 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY HOKE HOSPITAL Outpatient | Blue Cross Blue Shield Of Nc | Commercial | $3.13 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Upmc | All Commercial Plans | $3.17 | — | — | 2026-04-01 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | UnitedHealthcare | Community & State | $3.19 | $101.00 | — | 2026-08-17 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Nc | Commercial | $3.20 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $3.24 | $24.00 | $18.00 | 2026-01-16 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Multiplan | Commercial | $3.60 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Humana | Commercial | $3.75 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY HOKE HOSPITAL Outpatient | Humana | Commercial | $3.75 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Humana Choicecare | Commercial | $3.75 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Humana Choicecare | Commercial | $3.75 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY HOKE HOSPITAL Outpatient | Humana Choicecare | Commercial | $3.75 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Humana | Commercial | $3.75 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $3.94 | $26.25 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $3.94 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $3.94 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | BlueMedicare HMO | $3.94 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $3.94 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | BLUE CROSS | Medicare PPO | $3.94 | $26.25 | — | 2025-07-30 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | HUMANA | HUMANA EXCHANGE HMOX | $3.94 | — | — | 2026-09-01 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $3.94 | $26.25 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $3.94 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $3.94 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $3.94 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE | $3.94 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AMERIHEALTH CARITAS | NEXT EXCHANGE-Ped | $3.94 | $26.25 | — | 2025-07-30 | MRF ↗ |
| CAPE FEAR VALLEY HOKE HOSPITAL Outpatient | Multiplan | Commercial | $4.10 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Multiplan | Commercial | $4.10 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | MOLINA | EXCHANGE | $4.20 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | MOLINA | EXCHANGE | $4.20 | $26.25 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | MOLINA | EXCHANGE | $4.20 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | MOLINA | EXCHANGE | $4.20 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | MOLINA | EXCHANGE | $4.20 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | MyBlue | $4.23 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | AVMED | Medicare | $4.44 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | AVMED | Medicare | $4.44 | $26.25 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | AVMED | Medicare | $4.44 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AVMED | Medicare | $4.44 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | AVMED | Medicare | $4.44 | $26.25 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | CIGNA | EXCHANGE | $4.46 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | CIGNA | EXCHANGE | $4.46 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | CIGNA | EXCHANGE | $4.46 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | CIGNA | EXCHANGE | $4.46 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | BLUE SELECT | $4.46 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | CIGNA | EXCHANGE | $4.46 | $26.25 | — | 2025-07-30 | MRF ↗ |
| NEBRASKA ORTHOPAEDIC HOSPITAL OutpatientFacility | AMERIGROUP | MEDICAID | $4.65 | — | — | 2025-12-27 | MRF ↗ |
| NEBRASKA ORTHOPAEDIC HOSPITAL OutpatientFacility | AMERIGROUP | MEDICAID | $4.65 | — | — | 2025-12-27 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Aetna Better Health | Healthy Kids | $4.73 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | Simply Blue | $4.93 | $26.25 | — | 2025-07-30 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Cigna | All Commercial Plans | $4.95 | — | — | 2026-04-01 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $4.98 | $24.00 | $18.00 | 2026-01-16 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | BLUE CROSS | HMO | $5.10 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | Solis Health Plan | Medicare | $5.25 | $26.25 | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | Solis Health Plan | Medicare | $5.25 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Solis Health Plan | Medicare | $5.25 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | BlueMedicare HMO | $5.25 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Solis Health Plan | Medicare | $5.25 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | Medicare PPO | $5.25 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Solis Health Plan | Medicare | $5.25 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | BlueMedicare HMO | $5.25 | $26.25 | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | BLUE CROSS | Medicare PPO | $5.25 | $26.25 | — | 2025-07-30 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Amerihealth Administrators | Amerihealth Administrators | $5.33 | $71.10 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Pcsh Ibc | Pcsh Ibc | $5.33 | $71.10 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Ibc - Local | Ibc - Local | $5.33 | $71.10 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL | Regence Blue Shield | — | $5.33 | $71.10 | — | 2026-07-30 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Capital Blue Cross | Capital Blue Cross | $5.33 | $71.10 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Keystone Direct Pos | Keystone Direct Pos | $5.33 | $71.10 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Regence Blue Shield | Regence Blue Shield | $5.33 | $71.10 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Bcbs Federal | Bcbs Federal | $5.33 | $71.10 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Independence Federal | Independence Federal | $5.33 | $71.10 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL | Capital Blue Cross | — | $5.33 | $71.10 | — | 2026-07-30 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Ibc Medicare Advantage | Ibc Medicare Advantage | $5.33 | $71.10 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Horizon Of New Jersey | Horizon Of New Jersey | $5.33 | $71.10 | — | 2026-05-08 | 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.