81223 — Cftr Gene Full Sequence
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). CFTR GENE FULL SEQUENCE (HCPCS 81223) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/81223?code_type=HCPCS
MLA (9th ed.)
“CFTR GENE FULL SEQUENCE (HCPCS 81223) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/81223?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“CFTR GENE FULL SEQUENCE (HCPCS 81223) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/81223?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $499–$1,074 (25th–75th percentile) across 2,269 hospitals · 5,571 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 81223 — 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
$499
$752 typical
$1,074
The middle 50% of negotiated facility rates for this procedure, measured across 2,269 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $752 |
| Likely subtotal | $752 |
Facility charge (no separate professional fee)
$752
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 $499–$1,074.
- 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 |
|---|---|---|---|---|---|---|---|
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Managed Medicaid_Aliessa and QHP | — | $1,792.00 | — | 2025-05-02 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | EmblemHealth | CBP | — | $8,142.00 | $6,920.70 | 2025-01-01 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Fidelis | Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP | — | $1,792.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Health Benefit Exchange | — | $1,792.00 | — | 2025-05-02 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | VNA Homecare Options | Medicaid | — | $8,142.00 | $6,920.70 | 2025-01-01 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Excellus BCBS | Managed Medicaid _CHP_SP | — | $1,792.00 | — | 2025-05-02 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | EmblemHealth | CBP | — | $2,495.00 | $2,120.75 | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | VNA Homecare Options | Medicaid | — | $2,495.00 | $2,120.75 | 2025-01-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | HMO, Non-City of LA, Vivity | — | $950.00 | $617.50 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | HMO, City of LA, Vivity | — | $950.00 | $617.50 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | HMO | — | $950.00 | $617.50 | 2025-11-26 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | $1,325.00 | $993.75 | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | $1,325.00 | $993.75 | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $0.29 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $0.29 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | $1,325.00 | $993.75 | 2026-09-01 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Amerigroup | Star Kids KM | $0.36 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Amerigroup | Star KM | $0.36 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Amerigroup | Chip KM | $0.36 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Amerigroup | Star Plus KM | $0.36 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Community First | Med Adv MM | $0.36 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.49 | — | — | 2026-09-01 | MRF ↗ |
| Texas Health Specialty Hospital Fort Worth InpatientFacility | Fort Worth Firefighters | Commercial | $0.54 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| Texas Health Specialty Hospital Fort Worth InpatientFacility | City of Fort Worth | Commercial | $0.54 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH InpatientFacility | Blue Cross Blue Shield | Exchange | $0.54 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $0.60 | — | — | 2026-09-01 | MRF ↗ |
| James Cancer Hospital & Solove Research Institute Outpatient | Cigna | Cigna - Transplant | $0.62 | $1,347.00 | — | 2026-07-01 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH OutpatientFacility | Fort Worth Firefighters | Commercial | $0.63 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH InpatientFacility | City of Fort Worth | Commercial | $0.67 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH OutpatientFacility | Cigna | OAP/HMO | $0.79 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH OutpatientFacility | Quick Trip | Commercial | $0.86 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH InpatientFacility | Fort Worth Firefighters | Commercial | $0.87 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH InpatientFacility | Quick Trip | Commercial | $0.90 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH OutpatientFacility | PHCS | PPO | $0.99 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | CIGNA | CIGNA COMMERCIAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | BLUE CROSS/BLUE SHIELD | BLUE COMMUNITY NM HMO NETWORK EXCHANGE | $1.00 | $3,618.00 | $2,713.50 | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | $980.00 | $735.00 | 2026-09-02 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $950.00 | $617.50 | 2025-11-26 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | MOLINA | MOLINA HEALTHCARE OF FLORIDA | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | $980.00 | $735.00 | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | CIGNA | CIGNA HMO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | Health Net of California, Inc. | HMO | — | $1,360.97 | $1,116.00 | 2025-11-26 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH OutpatientFacility | Aetna | ASA | $1.00 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE COMMUNITY NM HMO NETWORK EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | United Healthcare | POS | — | $1,360.97 | $1,116.00 | 2025-11-26 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | CIGNA | CIGNA COMMERCIAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | CIGNA | CIGNA HMO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH OutpatientFacility | Cigna | PPO | $1.00 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS STATE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NM BLUE ADVANTAGE | $1.00 | $3,618.00 | $2,713.50 | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | CIGNA | CIGNA/PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | UNITED | EXCHANGE | $1.00 | $1,497.00 | $499.00 | 2026-09-05 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH OutpatientFacility | Aetna | Coventry | $1.00 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | $980.00 | $735.00 | 2026-09-02 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $1.00 | $1,325.00 | $993.75 | 2026-09-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | SCAN Health Plan | Medicare Advantage | — | $950.00 | $617.50 | 2025-11-26 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA OutpatientFacility | CIGNA | CIGNA PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | United Healthcare | HMO | — | $1,360.97 | $1,116.00 | 2025-11-26 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | $3,618.00 | $2,713.50 | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | $980.00 | $735.00 | 2026-09-02 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | HMO | — | $1,360.97 | $1,116.00 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $1,360.97 | $1,116.00 | 2025-11-26 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO HMO | $1.00 | — | — | 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 ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | Covered | — | $1,360.97 | $1,116.00 | 2025-11-26 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO HMO | $1.00 | $3,618.00 | $2,713.50 | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | $980.00 | $735.00 | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | $3,618.00 | $2,713.50 | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | MOLINA | MOLINA HEALTHCARE OF FLORIDA | $1.00 | $1,325.00 | $993.75 | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Texas Health Specialty Hospital Fort Worth InpatientFacility | Quick Trip | Commercial | $1.02 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH InpatientFacility | PHCS | PPO | $1.07 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH OutpatientFacility | Healthsmart | Commercial | $1.07 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH InpatientFacility | Blue Cross Blue Shield | HMO | $1.08 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH InpatientFacility | Blue Cross Blue Shield | PPO | $1.19 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| Texas Health Specialty Hospital Fort Worth InpatientFacility | Healthsmart | Commercial | $1.20 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| Texas Health Specialty Hospital Fort Worth InpatientFacility | PHCS | PPO | $1.20 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH InpatientFacility | Healthsmart | Commercial | $1.20 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH InpatientFacility | Multiplan | Commercial | $1.24 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| Texas Health Specialty Hospital Fort Worth InpatientFacility | Multiplan | Commercial | $1.24 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| Texas Health Specialty Hospital Fort Worth InpatientFacility | Galaxy | Commercial | $1.26 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| Texas Health Specialty Hospital Fort Worth InpatientFacility | USA | MCO | $1.26 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH InpatientFacility | USA | MCO | $1.26 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH InpatientFacility | Galaxy | Commercial | $1.26 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH InpatientFacility | Blue Cross Blue Shield | Traditional | $1.31 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Community First Health Plan | HMO | $1.32 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| Texas Health Specialty Hospital Fort Worth InpatientFacility | Cigna | Indemnity | $1.35 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST FORT WORTH InpatientFacility | Cigna | Indemnity | $1.35 | $1.43 | $0.86 | 2026-04-21 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Healthcare Highways | PPO | $1.35 | $3.00 | $0.99 | 2026-01-13 | 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 ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Humana | Choicecare | $1.50 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Christian Brothers Services | PPO | $1.65 | $3.00 | $0.99 | 2026-01-13 | 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 | Wellcare | 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 | Healthy Blue | Managed Medicaid | $1.87 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Phcs | PPO | $1.95 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Healthsmart | Accel PPO | $1.95 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | First Health | PPO | $1.95 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Multiplan | PPO | $1.95 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Five Point Credit Union | PPO | $2.10 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Medicus Internatiaonal | PPO | $2.25 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Health Management Network | PPO | $2.40 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Beech Street | PPO | $2.40 | $3.00 | $0.99 | 2026-01-13 | 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 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 ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | HealthSmart | PPO | $2.40 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | Provider Select | PPO | $2.40 | $3.00 | $0.99 | 2026-01-13 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | United Healthcare | Compass | $2.45 | $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 | 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 ↗ |
| 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 ↗ |
| CHRISTUS SANTA ROSA MEDICAL CENTER OutpatientFacility | National Choicecare | PPO | $2.85 | $3.00 | $0.99 | 2026-01-13 | 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 ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Aetna | Commercial | $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 MEDICAL CENTER Outpatient | Aetna New Business | Commerical | $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 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 MEDICAL CENTER 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 ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Nc | Commercial | $3.20 | $5.00 | $3.00 | 2026-08-01 | MRF ↗ |
| VISTA MEDICAL CENTER EAST Outpatient | Medicaid | Medicaid | $3.54 | $58.92 | $58.92 | 2025-03-31 | 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 | 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 Choicecare | 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 ↗ |
| 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 ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | HealthNet of California, Inc. | HMO | — | $950.00 | $617.50 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Kaiser Foundation Hospitals | Medicare Advantage | — | $950.00 | $617.50 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Kaiser Foundation Hospitals | HMO | — | $950.00 | $617.50 | 2025-11-26 | MRF ↗ |
| CHILDREN'S HOSPITALS & CLINICS OF MN Outpatient | Medica | Medica Pmap | $4.68 | $22.00 | $22.00 | 2026-07-18 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | Kaiser Foundation Hospitals | HMO | — | $950.00 | $617.50 | 2025-11-26 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | Florida Health Care Plan | All Products | $5.00 | $635.00 | $349.25 | 2026-03-31 | MRF ↗ |
| NORTH SHORE MEDICAL CENTER Outpatient | Aetna Better Health Medicaid Hmo | Aetna Better Health Medicaid Hmo | $5.72 | $190.75 | $190.75 | 2026-07-15 | MRF ↗ |
| Florida Medical Center Outpatient | Aetna Better Health Medicaid Hmo | Aetna Better Health Medicaid Hmo | $5.72 | $190.75 | $190.75 | 2026-07-15 | MRF ↗ |
| CHILDREN'S HOSPITAL OF PHILADELPHIA Outpatient | Horizon NJ Health | All plan types | $5.88 | $58.76 | $58.76 | 2025-12-31 | MRF ↗ |
| VISTA MEDICAL CENTER EAST Outpatient | Blue Cross Blue Shield | Traditional | $6.30 | $58.92 | $58.92 | 2025-03-31 | MRF ↗ |
| CHILDREN'S HOSPITALS & CLINICS OF MN Inpatient | Medica | Medica Pmap | $7.44 | $22.00 | $22.00 | 2026-07-18 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | AETNA HEALTH OF CALIFORNIA INC. | PPO | — | $950.00 | $617.50 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | AETNA HEALTH OF CALIFORNIA INC. | HMO | — | $950.00 | $617.50 | 2025-11-26 | MRF ↗ |
| VISTA MEDICAL CENTER EAST Outpatient | Cigna | Commercial | $8.31 | $58.92 | $58.92 | 2025-03-31 | MRF ↗ |
| CHILDREN'S HOSPITAL OF PHILADELPHIA Outpatient | Horizon NJ Health | All plan types | $8.89 | $88.89 | $88.89 | 2025-12-31 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | PPO | — | $950.00 | $617.50 | 2025-11-26 | MRF ↗ |
| CHILDREN'S HOSPITAL OF PHILADELPHIA Outpatient | Keystone First Medicaid | All plan types | $9.70 | $58.76 | $58.76 | 2025-12-31 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | CareMore Health Plan | Medicare Advantage | — | $950.00 | $617.50 | 2025-11-26 | MRF ↗ |
| CHILDREN'S HOSPITAL OF PHILADELPHIA Outpatient | UHC Community Plans PA | All plan types | $9.75 | $58.76 | $58.76 | 2025-12-31 | MRF ↗ |
| KENMORE MERCY HOSPITAL BothFacility | HOSPICE [550001] | ERIE [55000101] | $10.00 | $838.00 | $838.00 | 2026-04-01 | MRF ↗ |
| KENMORE MERCY HOSPITAL BothFacility | HOSPICE [550001] | NIAGARA [55000102] | $10.00 | $838.00 | $838.00 | 2026-04-01 | MRF ↗ |
| MERCY HOSPITAL OF BUFFALO BothFacility | HOSPICE [550001] | NIAGARA [55000102] | $10.00 | $838.00 | $838.00 | 2026-04-01 | MRF ↗ |
| MERCY HOSPITAL OF BUFFALO BothFacility | HOSPICE [550001] | ERIE [55000101] | $10.00 | $838.00 | $838.00 | 2026-04-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Alignment Health Plan | Medicare Advantage | — | $950.00 | $617.50 | 2025-11-26 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Primecare Medical Group Of Chino Valley | Primecare Medical Group Of Chino Valley Hmo/Pos | $10.55 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Inpatient | Office Of Refugee Resettlement-Point Comfort | Point Comfort Underwriters Inc | $10.55 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Presbyterian Intercommunity Hospital | Presbyterian Health Physicians/Presbyterian Intercommunity Hosp | $10.55 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Cigna Healthcare Of California | Cigna Healthcare Of California Hmo/Pos In Net | $10.76 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Cigna Healthcare Of California | Cigna Epo/Ppo | $10.76 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| SAINT ANNE'S HOSPITAL Outpatient | United Health Medicaid | United Health Medicaid | $11.00 | $1,059.91 | $1,059.91 | 2026-07-17 | MRF ↗ |
| CHILDREN'S HOSPITAL OF PHILADELPHIA Outpatient | Health Partners | All plan types | $11.08 | $58.76 | $58.76 | 2025-12-31 | MRF ↗ |
| CHILDREN'S HOSPITALS & CLINICS OF MN Inpatient | Ucare | Ucare | $11.09 | $22.00 | $22.00 | 2026-07-18 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | St Joseph Heritage Healthcare | St Joseph Heritage Healthcare Hmo/Pos In Net Sjhap / Sjhmg | $12.42 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| CHILDREN'S HOSPITALS & CLINICS OF MN Outpatient | Medica Other Commercial | Medica Other Commercial | $12.61 | $22.00 | $22.00 | 2026-07-18 | MRF ↗ |
| CHILDREN'S HOSPITALS & CLINICS OF MN Outpatient | Medica | Medica Choice | $12.74 | $22.00 | $22.00 | 2026-07-18 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | La Salle Medical Associates | La Salle Medical Associates Hmo/Pos In Net | $12.89 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Greater Newport Physicians | Greater Newport Physicians Hmo/Pos In Net | $12.89 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Alpha Care Medical Group | Alpha Care Ipa-Hmo | $12.89 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Bristol Park Medical Group Hmo/Pos In Net | Bristol Park Medical Group Hmo/Pos In Net | $12.89 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Redlands Community Hospital | Redlands Community Hospital-Acute Care Agreement | $12.89 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| SAINT PETER'S UNIVERSITY HOSPITAL Both | Managed Care Other | BRIGHTON HEALTH | $13.00 | $1,050.00 | $1,037.00 | 2025-11-19 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Monarch Health Plan | Monarch Health Plan | $13.48 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| CHILDREN'S HOSPITALS & CLINICS OF MN Inpatient | America'S Ppo | Americas Ppo | $13.64 | $22.00 | $22.00 | 2026-07-18 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Blue Shield Of California Uc Care Ppo | Blue Shield Of California Uc Care Ppo | $13.88 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| CHILDREN'S HOSPITAL OF PHILADELPHIA Outpatient | Aetna Better Health | All plan types | $13.88 | $58.76 | $58.76 | 2025-12-31 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Epic Management | Epic Management In Network Hmo | $14.06 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Family Choice (Fountain Valley Reg Hosp) | Family Choice (Fountain Valley Reg Hosp) Medi-Cal/Caloptima | $14.06 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Arta Health Network | Arta Health Network Hmo/Pos In Net | $14.06 | $23.44 | $23.44 | 2026-07-15 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Magellan Health Services | Magellan Health Services Ppo | $14.06 | $23.44 | $23.44 | 2026-07-15 | 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.