80502 — Lab Pathology Consultation
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Lab pathology consultation (CPT 80502) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/80502?code_type=CPT
MLA (9th ed.)
“Lab pathology consultation (CPT 80502) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/80502?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“Lab pathology consultation (CPT 80502) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/80502?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $48–$194 (25th–75th percentile) across 734 hospitals · 560 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 80502 — 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
$48
$94 typical
$194
The middle 50% of negotiated facility rates for this procedure, measured across 734 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $94 |
| Likely subtotal | $94 |
Facility charge (no separate professional fee)
$94
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 $48–$194.
- 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 ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S 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 ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AETNA | AETNA WORKERS COMP | $0.95 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AETNA | AETNA WORKERS COMP | $0.95 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | AETNA | AETNA COMMERCIAL NEW BUSINESS DISCOUNT | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AETNA | AETNA US HEALTHCARE PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA SOUTH SAN ANTONIO ISD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA QPIC | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AETNA | AETNA US HEALTHCARE HMO/POS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER 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 ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | AETNA | AETNA COMMERCIAL NEW BUSINESS DISCOUNT | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | AETNA | AETNA ACO NETWORK | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | AETNA | AETNA US HEALTHCARE HMO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | AETNA | AETNA US HEALTHCARE OF CALIFORNIA | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA SPP | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER 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 ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AETNA | AETNA US HEALTHCARE HMO/POS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | AETNA | AETNA US HEALTHCARE | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | AETNA | AETNA COMMERCIAL | $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 EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | AETNA | AETNA US HEALTHCARE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS 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 ↗ |
| 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 US HEALTHCARE PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AETNA | AETNA COMMERCIAL NEW BUSINESS DISCOUNT | $1.00 | — | — | 2026-09-01 | 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 | United Healthcare | Managed Medicaid | $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 | Healthy Blue | Managed Medicaid | $1.87 | $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 | Aetna | Medicare Advantage | $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 | Humana | Medicare Advantage | $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 Choicecare | 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 | Longevity | 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 | 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 ↗ |
| BETSY JOHNSON REGIONAL 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 ↗ |
| 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 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 ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Cigna | Commercial | $2.70 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Upmc | All Commercial Plans | $2.74 | — | — | 2026-04-01 | 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 ↗ |
| 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 ↗ |
| CAPE FEAR VALLEY HOKE 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 ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Aetna | Commercial | $2.90 | $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 | Cigna | Commercial | $3.00 | $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 | Blue Cross Blue Shield Of Nc | Commercial | $3.13 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Nc | Commercial | $3.20 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL | Capital Blue Cross | — | $3.32 | $44.29 | — | 2026-07-30 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL | Bcbs | — | $3.32 | $44.29 | — | 2026-07-30 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL | Horizon Blue Cross | — | $3.32 | $44.29 | — | 2026-07-30 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL | Amerihealth Administrators | — | $3.32 | $44.29 | — | 2026-07-30 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Horizon Of New Jersey | Horizon Of New Jersey | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Empire Plan | Empire Plan | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL | Anthem Ppo | — | $3.32 | $44.29 | — | 2026-07-30 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL | Highmark Blue Cross | — | $3.32 | $44.29 | — | 2026-07-30 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL | Bcbs Federal | — | $3.32 | $44.29 | — | 2026-07-30 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Regence Blue Shield | Regence Blue Shield | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Pcsh Ibc | Pcsh Ibc | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Ibc 2021 | Ibc 2021 | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Bcbs | Bcbs | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Ibc - Local | Ibc - Local | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Horizon Blue Cross | Horizon Blue Cross | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Carefirst Administrators | Carefirst Administrators | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Amerihealth New Jersey Hmo | Amerihealth New Jersey Hmo | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Amerihealth Administrators | Amerihealth Administrators | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Ibc Local | Ibc Local | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Ibc Medicare Advantage | Ibc Medicare Advantage | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Independence Bc | Independence Bc | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL | Highmark | — | $3.32 | $44.29 | — | 2026-07-30 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Keystone Direct Pos | Keystone Direct Pos | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Keystone Healthplan East | Keystone Healthplan East | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Keystone Hmo | Keystone Hmo | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Ibc | Ibc | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Personal Choice | Personal Choice | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Independence Administrators | Independence Administrators | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL | Carefirst Administrators | — | $3.32 | $44.29 | — | 2026-07-30 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Bcbs Federal | Bcbs Federal | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Anthem Ppo | Anthem Ppo | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Capital Blue Cross | Capital Blue Cross | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL | Regence Blue Shield | — | $3.32 | $44.29 | — | 2026-07-30 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL | Ibc Medicare Advantage | — | $3.32 | $44.29 | — | 2026-07-30 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL | Amerihealth New Jersey Hmo | — | $3.32 | $44.29 | — | 2026-07-30 | MRF ↗ |
| PHYSICIANS CARE SURGICAL HOSPITAL Outpatient | Independence Federal | Independence Federal | $3.32 | $44.29 | — | 2026-05-08 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Multiplan | Commercial | $3.60 | $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 ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Humana | 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 ↗ |
| CAPE FEAR VALLEY HOKE HOSPITAL Outpatient | Humana | Commercial | $3.75 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | HUMANA | HUMANA EXCHANGE HMOX | $3.94 | — | — | 2026-09-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Multiplan | Commercial | $4.10 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY HOKE HOSPITAL Outpatient | Multiplan | Commercial | $4.10 | $5.00 | $3.00 | 2026-08-01 | 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 ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | UNITED HEALTHCARE | UNITED HEALTHCARE HMO & PPO | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | HUMANA | HUMANA GOLD INTEGRATED PLUS (MMAI) | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | BLUE CROSS | BCBS ILLINOIS PPO | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | BLUE CROSS | BLUE CROSS COMMUNITY (MMAI) | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | BLUE CROSS | BCBS ILLINOIS TRADITIONAL | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | BLUE CROSS | BCBS ILLINOIS BLUE CHOICE | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | AETNA | AETNA COVENTRY | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | AETNA | AETNA COMMERCIAL | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | HEALTH SMART | HEALTH SMART | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | MOLINA | MOLINA DUAL OPTIONS (MMAI) | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | CIGNA | CIGNA HMO & PPO PLANS | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | HUMANA | HUMANA COMMERCIAL HMO, PPO, POS, EPO | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | HUMANA | HUMANA MEDICARE ADVANTAGE | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | HEALTH ALLIANCE | HEALTH ALLIANCE MEDICARE ADVANTAGE | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | HEALTH ALLIANCE | HEALTH ALLIANCE HMO & PPO | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | ZELIS | ZELIS | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | SIHO | SIHO MEDICARE ADVANTAGE | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | HEALTH LINK | HEALTH LINK ALL PPO | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | SIHO | SIHO COMMERCIAL PPO | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | UNITED HEALTHCARE | UNITED HEALTHCARE VA COMMUNITY CARE NETWORK | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | BLUE CROSS | BCBS ILLINOIS MEDICARE ADVANTAGE | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | MULTIPLAN | MULTIPLAN | — | $13.20 | $5.71 | 2025-02-07 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Cigna | All Commercial Plans | $4.95 | — | — | 2026-04-01 | MRF ↗ |
| LAVACA MEDICAL CENTER OutpatientFacility | Unitedhealthcare | All Commercial Plans | $5.06 | — | — | 2026-04-01 | MRF ↗ |
| PARIS COMMUNITY HOSPITAL Outpatient | Medicare | HMO | $5.41 | $13.20 | $9.90 | 2026-03-10 | MRF ↗ |
| ASCENSION SAINT THOMAS THREE RIVERS Outpatient | COMMUNITY PLAN | 2494_RHTN MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY PLAN 20191001 | $5.52 | — | — | 2026-01-01 | MRF ↗ |
| DEKALB COMMUNITY HOSPITAL Outpatient | COMMUNITY PLAN | 2495_SDTN MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY PLAN 20191001 | $5.52 | — | — | 2026-01-01 | MRF ↗ |
| SAINT THOMAS RIVER PARK HOSPITAL Outpatient | COMMUNITY PLAN | 1351_RPTN MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY PLAN 20191001 | $5.52 | — | — | 2026-01-01 | MRF ↗ |
| Ascension Saint Thomas Hickman Outpatient | COMMUNITY PLAN | 2496_THTN MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY PLAN 20191001 | $5.52 | — | — | 2026-01-01 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | Jefferson Health Plan Medicaid | JNE001_JNE002_JNE003 Caid MCO CHIP | $6.14 | — | — | 2026-09-15 | MRF ↗ |
| JEFFERSON ABINGTON HOSPITAL OutpatientFacility | JAB Health Partners | JAB001 Medicaid | $6.14 | — | — | 2026-03-18 | MRF ↗ |
| THOMAS JEFFERSON UNIVERSITY HOSPITAL OutpatientFacility | Health Partners Medicaid | JCC001 JCC002 Caid MCO | $6.14 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON LANSDALE HOSPITAL OutpatientFacility | Jefferson Health Plan Medicaid | JAB002 Caid MCO CHIP | $6.14 | — | — | 2026-09-15 | MRF ↗ |
| Jefferson Methodist Hospital OutpatientFacility | Health Partners Medicaid | JCC001 JCC002 Caid MCO | $6.14 | — | — | 2026-03-18 | MRF ↗ |
| MEMORIAL HOSPITAL OF GARDENA OutpatientFacility | America's Health Network | HMO | $6.32 | $31.58 | $31.58 | 2026-02-04 | MRF ↗ |
| EAST LOS ANGELES DOCTORS HOSPITAL OutpatientFacility | America's Health Network | HMO | $6.32 | $31.58 | $31.58 | 2026-02-04 | MRF ↗ |
| COAST PLAZA HOSPITAL OutpatientFacility | America's Health Network | HMO | $6.32 | $31.58 | $31.58 | 2026-02-04 | MRF ↗ |
| HARLINGEN MEDICAL CENTER Outpatient | Non-Contracted Medicaid | Non-Contracted Managed Medicaid 95 Percent | $6.68 | $139.50 | $179.00 | 2024-12-19 | MRF ↗ |
| HARLINGEN MEDICAL CENTER Outpatient | Non-Contracted Medicaid | Non-Contracted Managed Medicaid 95 Percent | $6.68 | $139.50 | $179.00 | 2024-12-19 | MRF ↗ |
| HARLINGEN MEDICAL CENTER Outpatient | Traditional Medicaid | Traditional Medicaid | $7.03 | $139.50 | $179.00 | 2024-12-19 | MRF ↗ |
| HARLINGEN MEDICAL CENTER Outpatient | Traditional Medicaid | Traditional Medicaid | $7.03 | $139.50 | $179.00 | 2024-12-19 | MRF ↗ |
| Baylor Scott & White Continuing Care Hospital OutpatientFacility | United Healthcare | Commercial | $8.00 | $133.69 | $80.21 | 2026-02-21 | MRF ↗ |
| MYMICHIGAN MEDICAL CENTER GLADWIN OutpatientFacility | TriCare Humana | Military | $8.12 | $28.00 | $16.80 | 2026-05-11 | MRF ↗ |
| MYMICHIGAN MEDICAL CENTER GLADWIN OutpatientFacility | UHC-Optum | VACCN | $8.12 | $28.00 | $16.80 | 2026-05-11 | MRF ↗ |
| MYMICHIGAN MEDICAL CENTER GLADWIN OutpatientFacility | HAP | Medicare Advantage | $8.12 | $28.00 | $16.80 | 2026-05-11 | MRF ↗ |
| MYMICHIGAN MEDICAL CENTER GLADWIN OutpatientFacility | HAP | Medicare PPO | $8.12 | $28.00 | $16.80 | 2026-05-11 | MRF ↗ |
| MYMICHIGAN MEDICAL CENTER GLADWIN OutpatientFacility | BCN | Medicare Advantage | $8.12 | $28.00 | $16.80 | 2026-05-11 | MRF ↗ |
| MYMICHIGAN MEDICAL CENTER GLADWIN OutpatientFacility | VitalCore | MDOC | $8.12 | $28.00 | $16.80 | 2026-05-11 | MRF ↗ |
| MYMICHIGAN MEDICAL CENTER GLADWIN OutpatientFacility | BCBS | Medicare Advantage | $8.12 | $28.00 | $16.80 | 2026-05-11 | MRF ↗ |
| MYMICHIGAN MEDICAL CENTER GLADWIN OutpatientFacility | PACE | Central MI/Great Lakes/Northeast MI | $8.12 | $28.00 | $16.80 | 2026-05-11 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $8.23 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $8.23 | — | — | 2026-01-01 | 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.