81243 — Fmr1 Gen Aly Detc Abnl Allel
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). FMR1 GEN ALY DETC ABNL ALLEL (CPT 81243) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/81243?code_type=CPT
MLA (9th ed.)
“FMR1 GEN ALY DETC ABNL ALLEL (CPT 81243) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/81243?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“FMR1 GEN ALY DETC ABNL ALLEL (CPT 81243) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/81243?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $58–$289 (25th–75th percentile) across 2,318 hospitals · 7,740 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 81243 — 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
$58
$111 typical
$289
The middle 50% of negotiated facility rates for this procedure, measured across 2,318 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $111 |
| Likely subtotal | $111 |
Facility charge (no separate professional fee)
$111
- 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 HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | None | — | — | $454.77 | $227.38 | 2024-12-15 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | VNA Homecare Options | Medicaid | — | $602.00 | $511.70 | 2025-01-01 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Managed Medicaid_Aliessa and QHP | — | $483.00 | — | 2025-05-02 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | VNA Homecare Options | Medicaid | — | $760.00 | $646.00 | 2025-01-01 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Fidelis | Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP | — | $483.00 | — | 2025-05-02 | MRF ↗ |
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | None | — | — | $454.77 | $227.38 | 2024-12-15 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Health Benefit Exchange | — | $483.00 | — | 2025-05-02 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | EmblemHealth | CBP | — | $602.00 | $511.70 | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | EmblemHealth | CBP | — | $760.00 | $646.00 | 2025-01-01 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Excellus BCBS | Managed Medicaid _CHP_SP | — | $483.00 | — | 2025-05-02 | MRF ↗ |
| WAYNE COUNTY HOSPITAL Outpatient | AETNA PPO-ALL OTHER PLANS | AETNA PPO-ALL OTHER PLANS | $0.03 | $629.00 | $629.00 | 2026-03-03 | MRF ↗ |
| WAYNE COUNTY HOSPITAL Outpatient | AETNA HMO | AETNA HMO | $0.03 | $629.00 | $629.00 | 2026-03-03 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | HMO | — | $228.00 | $148.20 | 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 | — | $228.00 | $148.20 | 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 | — | $228.00 | $148.20 | 2025-11-26 | MRF ↗ |
| FAIRBANKS MEMORIAL HOSPITAL Outpatient | BANNER CHOICE - ALL PLANS | BANNER CHOICE - ALL PLANS | $0.32 | $1.17 | $1.11 | 2026-02-17 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | Freedom Health | MGMCR | $0.50 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| FAIRBANKS MEMORIAL HOSPITAL Outpatient | BLUE CROSS OF WA/AK - ALL PLANS | BLUE CROSS OF WA/AK - ALL PLANS | $0.67 | $1.17 | $1.11 | 2026-02-17 | MRF ↗ |
| FAIRBANKS MEMORIAL HOSPITAL Outpatient | MODA HEALTH PLAN - ALL PLANS | MODA HEALTH PLAN - ALL PLANS | $0.67 | $1.17 | $1.11 | 2026-02-17 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | AvMed | HIX | $0.70 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $0.84 | $227.60 | $216.22 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.84 | $227.60 | $216.22 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.84 | $227.60 | $216.22 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $0.86 | $227.60 | $216.22 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $0.91 | $227.60 | $216.22 | 2026-02-20 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $0.99 | $1,177.13 | $706.28 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $0.99 | $1,177.13 | $706.28 | 2025-08-11 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | HMO | — | $290.99 | $238.61 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $290.99 | $238.61 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $290.99 | $238.61 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $290.99 | $238.61 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | SCAN Health Plan | Medicare Advantage | — | $228.00 | $148.20 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $228.00 | $148.20 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $290.99 | $238.61 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $290.99 | $238.61 | 2025-11-26 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | Molina | MCR | $1.02 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.09 | $227.60 | $216.22 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.09 | $227.60 | $216.22 | 2026-02-20 | MRF ↗ |
| FAIRBANKS MEMORIAL HOSPITAL Outpatient | UHC - ALL PLANS | UHC - ALL PLANS | $1.11 | $1.17 | $1.11 | 2026-02-17 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $1.12 | $227.60 | $216.22 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.12 | $227.60 | $216.22 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.12 | $227.60 | $216.22 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.12 | $227.60 | $216.22 | 2026-02-20 | MRF ↗ |
| FAIRBANKS MEMORIAL HOSPITAL Outpatient | AETNA/ETHIX - ALL PLANS | AETNA/ETHIX - ALL PLANS | $1.12 | $1.17 | $1.11 | 2026-02-17 | MRF ↗ |
| FAIRBANKS MEMORIAL HOSPITAL Outpatient | MULTIPLAN - ALL PLANS | MULTIPLAN - ALL PLANS | $1.13 | $1.17 | $1.11 | 2026-02-17 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.14 | $227.60 | $216.22 | 2026-02-20 | MRF ↗ |
| FAIRBANKS MEMORIAL HOSPITAL Outpatient | FIRST CHOICE (CIGNA) - ALL PLANS | FIRST CHOICE (CIGNA) - ALL PLANS | $1.15 | $1.17 | $1.11 | 2026-02-17 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.18 | $227.60 | $216.22 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $1.23 | $227.60 | $216.22 | 2026-02-20 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | AvMed | Select | $1.34 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | AvMed | FullyInsured | $1.34 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | AvMed | Focus | $1.34 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | AvMed | Engage | $1.34 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | AvMed | Flex | $1.34 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | AvMed | Empower | $1.34 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | AvMed | ASOEO | $1.51 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | Office of Sheiff Highland Co | GVT | $1.88 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | Humana | HMO | $1.99 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | Humana | PPO | $2.15 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | United | GlobalBenefitPlanAppendix | $2.42 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | United PPO | OptionsPPO | $2.53 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | AvMed | JacksonFirstNetworkOON | $2.69 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $2.98 | — | — | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $4.10 | $402.00 | $261.30 | 2026-03-14 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | HealthNet of California, Inc. | HMO | — | $228.00 | $148.20 | 2025-11-26 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | Prime Health | PPO | $4.30 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Kaiser Foundation Hospitals | Medicare Advantage | — | $228.00 | $148.20 | 2025-11-26 | MRF ↗ |
| HCA FLORIDA HIGHLANDS HOSPITAL Outpatient | Prime Health | PPO | $4.57 | $5.38 | $5.38 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA PASADENA HOSPITAL A PART OF HCA FLORID Outpatient | Access 2 Healthcare Physicians Freedom Optimum Group Members | MGMCR | $4.59 | $97.59 | $97.59 | 2026-03-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | Kaiser Foundation Hospitals | HMO | — | $228.00 | $148.20 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Kaiser Foundation Hospitals | HMO | — | $228.00 | $148.20 | 2025-11-26 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Both | CIGNA HMO NEW BUSINESS | 1594_CIGNA HMO NEW BUSINESS 20250701 | $4.80 | $24.00 | $8.88 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S SOUTHSIDE Both | CIGNA NEW BUSINESS | 1465_CIGNA NEW BUSINESS 20250701 | $4.80 | $24.00 | $8.88 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S ST JOHNS COUNTY Both | CIGNA HMO NEW BUSINESS | 1700_CIGNA HMO NEW BUSINESS 20250701 | $4.80 | $24.00 | $8.88 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S CLAY COUNTY Both | CIGNA HMO NEW BUSINESS | 1698_CIGNA HMO NEW BUSINESS 20250701 | $4.80 | $24.00 | $8.88 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Both | CIGNA HMO NEW BUSINESS | 1594_CIGNA HMO NEW BUSINESS 20250701 | $4.80 | $24.00 | $8.88 | 2026-01-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | BLUE CROSS MEDICAID [1612] | CDH ILLINOIS MEDICAID | $4.83 | $70.00 | $49.00 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | COUNTYCARE IL COOK CO [1607] | CDH ILLINOIS MEDICAID | $4.83 | $70.00 | $49.00 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | HEALTH ALLIANCE MEDICAID [1310] | CDH ILLINOIS MEDICAID | $4.83 | $70.00 | $49.00 | 2026-04-01 | MRF ↗ |
| FLAGLER HOSPITAL OutpatientFacility | Florida Health Care Plan | All Products | $5.00 | $201.00 | $110.55 | 2026-03-31 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | Alliance Coal | Commercial | $5.25 | $21.00 | $11.13 | 2026-02-11 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | Aetna Medicare | Medicare Advantage | $5.25 | $21.00 | $11.13 | 2026-02-11 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Fidelis | Medicare Advantage | $5.70 | $285.00 | $185.25 | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Fidelis | Medicare Advantage | $5.70 | $285.00 | $185.25 | 2025-01-01 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Cigna HealthCare of California, Inc. (CHC) and Cigna Health and Life Insurance Company (CHLIC) | HMO | — | $95.00 | $61.75 | 2025-11-26 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Illinois Dual Eligibility | Medicare Advantage | $6.72 | $21.00 | $11.13 | 2026-02-11 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | United Healthcare Medicare | Medicare Advantage | $6.72 | $21.00 | $11.13 | 2026-02-11 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | Meridiancomplete (IL) | Dual Medicare/Medicaid | $6.72 | $21.00 | $11.13 | 2026-02-11 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | Caresource Just for Me | Commercial | $6.72 | $21.00 | $11.13 | 2026-02-11 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | Wellcare (IL) Medicare | Medicare Advantage | $6.72 | $21.00 | $11.13 | 2026-02-11 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | Meridiancare (IL) | Medicare Advantage | $6.72 | $21.00 | $11.13 | 2026-02-11 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | Anthem Medicare | Medicare Advantage | $6.72 | $21.00 | $11.13 | 2026-02-11 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | VA CCN | Medicare Advantage | $6.72 | $21.00 | $11.13 | 2026-02-11 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | MHS Ambetter | Commercial | $6.72 | $21.00 | $11.13 | 2026-02-11 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | Wellcare (IL) Medicare MMAI | Dual Medicare/Medicaid | $6.72 | $21.00 | $11.13 | 2026-02-11 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | MyTruAdvantage | Medicare Advantage | $6.72 | $21.00 | $11.13 | 2026-02-11 | MRF ↗ |
| SAVANNAH HEALTH SERVICES LLC DBA MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER Outpatient | Peach State | MGMCD | $6.78 | $355.00 | $355.00 | 2024-10-01 | MRF ↗ |
| SAVANNAH HEALTH SERVICES LLC DBA MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER Outpatient | Humana | COMM | — | $355.00 | $355.00 | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Peach State | MGMCD | $6.78 | — | — | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Humana | COMM | — | — | — | 2024-10-01 | MRF ↗ |
| HCA FLORIDA PASADENA HOSPITAL A PART OF HCA FLORID Outpatient | Access 2 Healthcare Physicians Optimum | MGMCR | $7.03 | $97.59 | $97.59 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA PASADENA HOSPITAL A PART OF HCA FLORID Outpatient | Access 2 Healthcare Physicians Freedom Health | MGMCR | $7.03 | $97.59 | $97.59 | 2026-03-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | COUNTYCARE IL COOK CO [1607] | CDH ILLINOIS MEDICAID | $7.11 | $103.00 | $72.10 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | BLUE CROSS MEDICAID [1612] | CDH ILLINOIS MEDICAID | $7.11 | $103.00 | $72.10 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | HEALTH ALLIANCE MEDICAID [1310] | CDH ILLINOIS MEDICAID | $7.11 | $103.00 | $72.10 | 2026-04-01 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | California PhysiciansÆ Service, dba Blue Shield of California | Medi-Cal | — | $95.00 | $61.75 | 2025-11-26 | MRF ↗ |
| HCA FLORIDA PASADENA HOSPITAL A PART OF HCA FLORID Outpatient | Freedom Health Care | MGMGR | $7.61 | $97.59 | $97.59 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA PASADENA HOSPITAL A PART OF HCA FLORID Outpatient | Optimum Healthcare | PFFS | $7.61 | $97.59 | $97.59 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA PASADENA HOSPITAL A PART OF HCA FLORID Outpatient | Optimum Healthcare | MCRHMO | $7.61 | $97.59 | $97.59 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA PASADENA HOSPITAL A PART OF HCA FLORID Outpatient | Optimum Healthcare | MCRPPO | $7.61 | $97.59 | $97.59 | 2026-03-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | CDH BCBS BLUECHOICE SELECT | $7.77 | $70.00 | $49.00 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | CDH BCBS BLUECHOICE OPTIONS | $7.77 | $70.00 | $49.00 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | ALTERNATE BLUE CROSS [1402] | CDH BCBS BLUECHOICE SELECT | $7.77 | $70.00 | $49.00 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | ALTERNATE BLUE CROSS [1402] | CDH BCBS BLUECHOICE OPTIONS | $7.77 | $70.00 | $49.00 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | ALTERNATE BLUE CROSS [1402] | CDH BCBS BLUECHOICE PREFERRED | $7.77 | $70.00 | $49.00 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | CDH BCBS BLUECHOICE PREFERRED | $7.77 | $70.00 | $49.00 | 2026-04-01 | MRF ↗ |
| HCA FLORIDA PASADENA HOSPITAL A PART OF HCA FLORID Outpatient | Suncoast Neighborly Care | MedicarePACE | $7.81 | $97.59 | $97.59 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA PASADENA HOSPITAL A PART OF HCA FLORID Outpatient | AvMed | HIX | $7.81 | $97.59 | $97.59 | 2026-03-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | AETNA HEALTH OF CALIFORNIA INC. | PPO | — | $228.00 | $148.20 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | AETNA HEALTH OF CALIFORNIA INC. | HMO | — | $228.00 | $148.20 | 2025-11-26 | MRF ↗ |
| Baylor Scott & White Continuing Care Hospital OutpatientFacility | United Healthcare | Commercial | $8.00 | $1,115.43 | $669.26 | 2026-02-21 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | GLOBAL EXCEL [1712] | CDH MEDICARE | — | $70.00 | $49.00 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | ALTERNATE BLUE CROSS MEDICARE ADV [2304] | CDH MEDICARE | — | $70.00 | $49.00 | 2026-04-01 | MRF ↗ |
| ST JOSEPH'S BEHAVIORAL HEALTH CENTER Outpatient | DHR | Medicaid|All Plans | $8.36 | $83.60 | $47.74 | 2026-02-28 | MRF ↗ |
| NOVANT HEALTH HUNTERSVILLE MEDICAL CENTER OutpatientFacility | NC Department of Public Safety | Medicaid eligible Offenders | $8.52 | $69.00 | $34.50 | 2026-03-30 | MRF ↗ |
| NOVANT HEALTH HUNTERSVILLE MEDICAL CENTER OutpatientFacility | Carolina Complete | Medicaid | $8.52 | $69.00 | $34.50 | 2026-03-30 | MRF ↗ |
| SUNRISE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna | MCR | $8.56 | — | — | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Aetna | MCR | $8.56 | — | — | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Aetna | MCR | $8.56 | — | — | 2026-03-01 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | UNIVERSAL IPA MCR ADV OP/PROFEE ONLY-ALL OTHER PLA | UNIVERSAL IPA MCR ADV OP/PROFEE ONLY-ALL OTHER PLA | $8.67 | $45.63 | $12.32 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | TRICARE BLUE SHIELD | TRICARE BLUE SHIELD | $8.67 | $45.63 | $12.32 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | HEALTHNET MCARE | HEALTHNET MCARE | $8.67 | $45.63 | $12.32 | 2026-01-31 | MRF ↗ |
| NOVANT HEALTH HUNTERSVILLE MEDICAL CENTER OutpatientFacility | AmeriHealth | Medicaid | $8.69 | $69.00 | $34.50 | 2026-03-30 | MRF ↗ |
| NOVANT HEALTH HUNTERSVILLE MEDICAL CENTER OutpatientFacility | United Healthcare | Medicaid | $8.69 | $69.00 | $34.50 | 2026-03-30 | MRF ↗ |
| NOVANT HEALTH HUNTERSVILLE MEDICAL CENTER OutpatientFacility | Wellcare | Medicaid | $8.69 | $69.00 | $34.50 | 2026-03-30 | MRF ↗ |
| NOVANT HEALTH HUNTERSVILLE MEDICAL CENTER OutpatientFacility | Blue Cross NC | Healthy Blue Medicaid | $8.69 | $69.00 | $34.50 | 2026-03-30 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Both | CIGNA HMO | 1592_CIGNA HMO 20250701 | $8.88 | $24.00 | $8.88 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Both | CIGNA PPO | 1593_CIGNA PPO 20250701 | $8.88 | $24.00 | $8.88 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Both | CIGNA PPO | 1593_CIGNA PPO 20250701 | $8.88 | $24.00 | $8.88 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S SOUTHSIDE Both | CIGNA HMO | 1463_CIGNA HMO 20250701 | $8.88 | $24.00 | $8.88 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S SOUTHSIDE Both | CIGNA PPO | 1464_CIGNA PPO 20250701 | $8.88 | $24.00 | $8.88 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S RIVERSIDE Both | CIGNA HMO | 1592_CIGNA HMO 20250701 | $8.88 | $24.00 | $8.88 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S ST JOHNS COUNTY Both | CIGNA HMO | 1696_CIGNA HMO 20250701 | $8.88 | $24.00 | $8.88 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S CLAY COUNTY Both | CIGNA PPO | 1695_CIGNA PPO 20250701 | $8.88 | $24.00 | $8.88 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S ST JOHNS COUNTY Both | CIGNA PPO | 1697_CIGNA PPO 20250701 | $8.88 | $24.00 | $8.88 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT'S CLAY COUNTY Both | CIGNA HMO | 1694_CIGNA HMO 20250701 | $8.88 | $24.00 | $8.88 | 2026-01-01 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | HEALTH NET | HEALTH NET | $8.92 | $30.30 | $22.73 | 2026-04-27 | MRF ↗ |
| NOVANT HEALTH MATTHEWS MEDICAL CENTER OutpatientFacility | Carolina Complete | Medicaid | $8.97 | $69.00 | $34.50 | 2026-03-30 | MRF ↗ |
| NOVANT HEALTH MATTHEWS MEDICAL CENTER OutpatientFacility | NC Department of Public Safety | Medicaid eligible Offenders | $8.97 | $69.00 | $34.50 | 2026-03-30 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER- COLLEGE STATI OutpatientFacility | United Healthcare | Commercial | $9.00 | $1,115.43 | $669.26 | 2026-02-20 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER -TAYLOR OutpatientFacility | United Healthcare | Commercial | $9.00 | $1,001.45 | $600.87 | 2026-02-24 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - MARBLE FALLS OutpatientFacility | United Healthcare | Commercial | $9.00 | $1,115.43 | $669.26 | 2026-02-20 | MRF ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | United Healthcare | Commercial | $9.00 | $1,115.43 | $669.26 | 2026-02-21 | MRF ↗ |
| ADVENTIST HEALTH HOWARD MEMORIAL Outpatient | BLUE SHIELD MCARE | BLUE SHIELD MCARE | $9.13 | $45.63 | $13.69 | 2026-01-25 | MRF ↗ |
| ADVENTIST HEALTH HOWARD MEMORIAL Outpatient | TRICARE BLUE SHIELD - ALL PLANS | TRICARE BLUE SHIELD - ALL PLANS | $9.13 | $45.63 | $13.69 | 2026-01-25 | MRF ↗ |
| NOVANT HEALTH MATTHEWS MEDICAL CENTER OutpatientFacility | Blue Cross NC | Healthy Blue Medicaid | $9.15 | $69.00 | $34.50 | 2026-03-30 | MRF ↗ |
| NOVANT HEALTH MATTHEWS MEDICAL CENTER OutpatientFacility | Wellcare | Medicaid | $9.15 | $69.00 | $34.50 | 2026-03-30 | MRF ↗ |
| NOVANT HEALTH MATTHEWS MEDICAL CENTER OutpatientFacility | United Healthcare | Medicaid | $9.15 | $69.00 | $34.50 | 2026-03-30 | MRF ↗ |
| NOVANT HEALTH MATTHEWS MEDICAL CENTER OutpatientFacility | AmeriHealth | Medicaid | $9.15 | $69.00 | $34.50 | 2026-03-30 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | PPO | — | $228.00 | $148.20 | 2025-11-26 | MRF ↗ |
| WOODLAND MEMORIAL HOSPITAL Inpatient | WCMG | Commercial|All Plans | $9.20 | $83.60 | $22.91 | 2026-02-28 | MRF ↗ |
| MERCY HOSPITAL OF FOLSOM Inpatient | WCMG | Commercial|All Plans | $9.20 | $83.60 | $32.53 | 2026-02-28 | MRF ↗ |
| MERCY SAN JUAN MEDICAL CENTER Inpatient | WCMG | Commercial|All Plans | $9.20 | $83.60 | $22.91 | 2026-02-28 | MRF ↗ |
| WOODLAND MEMORIAL HOSPITAL Inpatient | WCMG | Commercial|All Plans | $9.20 | $83.60 | $22.91 | 2026-02-28 | MRF ↗ |
| ADVENTIST HEALTH HOWARD MEMORIAL Outpatient | BC MEDICARE | BC MEDICARE | $9.22 | $45.63 | $13.69 | 2026-01-25 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | MY TRUE ADVANTAGE - ALL PLANS | MY TRUE ADVANTAGE - ALL PLANS | $9.39 | $30.30 | $22.73 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | CARESOURCE MCR ADV | CARESOURCE MCR ADV | $9.39 | $30.30 | $22.73 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | UHC MCR ADV | UHC MCR ADV | $9.39 | $30.30 | $22.73 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | AETNA MCR ADV | AETNA MCR ADV | $9.49 | $30.30 | $22.73 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | HUMANA MCR ADV | HUMANA MCR ADV | $9.49 | $30.30 | $22.73 | 2026-04-27 | MRF ↗ |
| ADVENTIST HEALTH CLEARLAKE Outpatient | TRICARE BLUE SHIELD- ALL PLANS | TRICARE BLUE SHIELD- ALL PLANS | $9.58 | $45.63 | $16.43 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH CLEARLAKE Outpatient | KAISER MCR ADV | KAISER MCR ADV | $9.58 | $45.63 | $16.43 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH CLEARLAKE Outpatient | BLUE SHIELD MCR ADV | BLUE SHIELD MCR ADV | $9.58 | $45.63 | $16.43 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH CLEARLAKE Outpatient | TRICARE BLUE SHIELD- ALL PLANS | TRICARE BLUE SHIELD- ALL PLANS | $9.58 | $45.63 | $16.43 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH CLEARLAKE Outpatient | KAISER MCR ADV | KAISER MCR ADV | $9.58 | $45.63 | $16.43 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH CLEARLAKE Outpatient | BLUE SHIELD MCR ADV | BLUE SHIELD MCR ADV | $9.58 | $45.63 | $16.43 | 2026-01-24 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | ANTHEM MCR ADV | ANTHEM MCR ADV | $9.67 | $30.30 | $22.73 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | VIANT BEECH ST MCR ADV | VIANT BEECH ST MCR ADV | $9.67 | $30.30 | $22.73 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | TODAY'S OPTION MCR ADV-ALL PLANS | TODAY'S OPTION MCR ADV-ALL PLANS | $9.67 | $30.30 | $22.73 | 2026-04-27 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC UHC HARMONY HMO [164026] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | UC AFF BLUE SHIELD SR/SDSM [164037] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | UC AFF MC HUMANA GENERIC PAYOR [164027] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC UHC ALLIANCE HMO [164020] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC HEALTHNET HMO [164004] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC BRAND NEW DAY HMO [164030] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC BLUE SHIELD GENERIC PAYOR [164016] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC UHC VEBA HMO [164033] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC HUMANA GENERIC PAYOR [164014] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | UC AFF ANTHEM/XIMED HMO [164022] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | UC AFF ANTHEM/SDSM HMO [164024] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC HUMANA HMO [164013] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC ANTHEM BLUE CROSS GENERIC PAYOR [164009] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC CIGNA HMO [164003] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC CIGNA GENERIC PAYOR [164007] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC HNET BLUE&GOLD ACO [164017] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC BRAND NEW DAY GENERIC PAYOR [164031] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC HEALTHNET GENERIC PAYOR [164010] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC AETNA GENERIC PAYOR [164008] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC UNITED HEALTHCARE GENERIC PAYOR [164011] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MC UNITED HEALTHCARE HMO [164005] | UC MANAGED CARE | $9.69 | $80.75 | $44.41 | 2026-04-01 | 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.