86 — Pacemaker And Other Cardiovascular Device Insertion And Replacement
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PACEMAKER AND OTHER CARDIOVASCULAR DEVICE INSERTION AND REPLACEMENT (EAPG 86) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/86?code_type=EAPG
MLA (9th ed.)
“PACEMAKER AND OTHER CARDIOVASCULAR DEVICE INSERTION AND REPLACEMENT (EAPG 86) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/86?code_type=EAPG. Accessed .
Chicago (notes-bibliography)
“PACEMAKER AND OTHER CARDIOVASCULAR DEVICE INSERTION AND REPLACEMENT (EAPG 86) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/86?code_type=EAPG.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $5,776–$13,607 (25th–75th percentile) across 86 hospitals · 93 payers.
“Negotiated” is the hospital’s negotiated facility rate for this EAPG 86 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
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 |
|---|---|---|---|---|---|---|---|
| ST MARY'S REGIONAL MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Ok | Qhp | $379.02 | — | — | 2026-07-15 | MRF ↗ |
| ST MARY'S REGIONAL MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Ok | Advantage | $379.02 | — | — | 2026-07-15 | MRF ↗ |
| ST MARY'S REGIONAL MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Ok | Ppo | $484.36 | — | — | 2026-07-15 | MRF ↗ |
| ST MARY'S REGIONAL MEDICAL CENTER Outpatient | Blue Choice | Managed Care | $550.18 | — | — | 2026-07-15 | MRF ↗ |
| SAUK PRAIRIE HOSPITAL OutpatientFacility | Humana | Managed Medicaid | $1,511.88 | — | — | 2026-01-29 | MRF ↗ |
| SAUK PRAIRIE HOSPITAL OutpatientFacility | Quartz | Managed Medicaid | $1,511.88 | — | — | 2026-01-29 | MRF ↗ |
| SAUK PRAIRIE HOSPITAL OutpatientFacility | Dean Health Plan | Managed Medicaid | $1,511.88 | — | — | 2026-01-29 | MRF ↗ |
| SAUK PRAIRIE HOSPITAL OutpatientFacility | GHC | Managed Medicaid | $1,511.88 | — | — | 2026-01-29 | MRF ↗ |
| SAUK PRAIRIE HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $1,511.88 | — | — | 2026-01-29 | MRF ↗ |
| SAUK PRAIRIE HOSPITAL OutpatientFacility | Anthem BCBS | Managed Medicaid | $1,511.88 | — | — | 2026-01-29 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY OutpatientFacility | My Choice Wisconsin | WI MEDICAID MYCHOICE WI-CARE WI | $3,310.77 | — | — | 2026-03-24 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY OutpatientFacility | Chorus Community Health Plan | WI MEDICAID CHORUS COMMUNITY HEALTH PLANS (CCHP) | $3,376.98 | — | — | 2026-03-24 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY OutpatientFacility | Managed Health Services | WI MEDICAID MANAGED HEALTH SERVICES & NETWORK HEALTH | $3,608.74 | — | — | 2026-03-24 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY OutpatientFacility | Molina Healthcare of Wisconsin | WI MEDICAID MOLINA HEALTHCARE | $3,608.74 | — | — | 2026-03-24 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY OutpatientFacility | My Choice Wisconsin | WI MEDICAID TRILOGY | $3,708.06 | — | — | 2026-03-24 | MRF ↗ |
| UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY Outpatient | Community Care Medicaid | Mco Community Care Family Care | $3,729.47 | — | — | 2026-07-15 | MRF ↗ |
| UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY Outpatient | Chorus Community Health Plan Medicaid | Mco Chorus Community Health Plan | $3,729.47 | — | — | 2026-07-15 | MRF ↗ |
| UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY Outpatient | Aetna Better Health Medicaid | Mco Aetna Better Health Il | $3,729.47 | — | — | 2026-07-15 | MRF ↗ |
| UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY Outpatient | Managed Health Services Medicaid | Mco Managed Health/Network Health Plans | $3,729.47 | — | — | 2026-07-15 | MRF ↗ |
| UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY Outpatient | Anthem Medicaid | Mco Anthem | $3,729.47 | — | — | 2026-07-15 | MRF ↗ |
| UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY Outpatient | United Healthcare Medicaid | Mco United Healthcare | $3,729.47 | — | — | 2026-07-15 | MRF ↗ |
| UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY Outpatient | Molina Healthcare Of Il Medicaid | Mco Molina Il | $3,729.47 | — | — | 2026-07-15 | MRF ↗ |
| UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY Outpatient | Icare Medicaid | Mco Icare | $3,729.47 | — | — | 2026-07-15 | MRF ↗ |
| UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY Outpatient | Ghc Eau Claire Medicaid | Mco Ghc Eau Claire | $3,729.47 | — | — | 2026-07-15 | MRF ↗ |
| UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY Outpatient | Mercy Care Medicaid | Mco Mercycare | $3,729.47 | — | — | 2026-07-15 | MRF ↗ |
| UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY Outpatient | Molina Healthcare Of Wi Medicaid | Mco Molina Healthcare Of Wi | $3,729.47 | — | — | 2026-07-15 | MRF ↗ |
| UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY Outpatient | My Choice Medicaid | Mco Hmo My Choice | $3,729.47 | — | — | 2026-07-15 | MRF ↗ |
| UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY Outpatient | Dean Health Plan Medicaid | Mco Deancare | $3,729.47 | — | — | 2026-07-15 | MRF ↗ |
| UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY Outpatient | Meridian Medicaid | Mco Meridian Health Plan Il | $3,729.47 | — | — | 2026-07-15 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY OutpatientFacility | Anthem Blue Cross Blue Shield | WI MEDICAID ANTHEM | $3,807.38 | — | — | 2026-03-24 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | United Healthcare Insurance Company | WI MEDICAID UHC COMMUNITY PLAN | $4,050.32 | — | — | 2026-03-23 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | My Choice Wisconsin | WI MEDICAID MYCHOICE WI-CARE WI | $4,050.32 | — | — | 2026-03-23 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | Chorus Community Health Plan | WI MEDICAID CHORUS COMMUNITY HEALTH PLANS (CCHP) | $4,131.33 | — | — | 2026-03-23 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN FOX VALLEY OutpatientFacility | ICare | WI Medicaid I Care - CFV | $4,138.46 | — | — | 2026-03-24 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | Managed Health Services | WI MEDICAID MANAGED HEALTH SERVICES & NETWORK HEALTH | $4,414.85 | — | — | 2026-03-23 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | My Choice Wisconsin | WI MEDICAID MY CHOICE | $4,536.36 | — | — | 2026-03-23 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | Molina Healthcare of Wisconsin | WI MEDICAID MOLINA HEALTHCARE | $4,536.36 | — | — | 2026-03-23 | MRF ↗ |
| STURDY MEMORIAL HOSPITAL Outpatient | Mass Health | Medicaid | $4,560.93 | — | — | 2026-07-15 | MRF ↗ |
| STURDY MEMORIAL HOSPITAL Outpatient | Boston Medical Center /Wellsense- | Non-Metals (Baco) | $4,560.93 | — | — | 2026-07-15 | MRF ↗ |
| MILFORD REGIONAL MEDICAL CENTER Outpatient | Tufts Health Together | Medicaid | $4,593.20 | — | — | 2026-07-15 | MRF ↗ |
| MILFORD REGIONAL MEDICAL CENTER Outpatient | Masshealth | — | $4,593.20 | — | — | 2026-07-15 | MRF ↗ |
| MILFORD REGIONAL MEDICAL CENTER Outpatient | Fallon 365 / Wellforce | Medicaid | $4,593.20 | — | — | 2026-07-15 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | Anthem Blue Cross Blue Shield | WI MEDICAID ANTHEM | $4,657.87 | — | — | 2026-03-23 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Hne | Medicaid | $4,731.30 | — | — | 2026-07-15 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Bmc | Healthnet Plan | $4,731.30 | — | — | 2026-07-15 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $4,909.77 | — | — | 2026-01-01 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Mvp | Essential Plan 1,2,5,6 | $4,921.32 | — | — | 2026-07-15 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Cdphp | Essential Plan 1 & 2 | $4,921.32 | — | — | 2026-07-15 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Cdphp | Essential Plan 3 & 4 | $4,921.32 | — | — | 2026-07-15 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Mvp | Medicaid | $4,921.32 | — | — | 2026-07-15 | MRF ↗ |
| SOUTHWESTERN VERMONT MEDICAL CENTER Outpatient | Uhc | Medicaid | $4,921.32 | — | — | 2026-07-15 | MRF ↗ |
| CHILDRENS HOSPITAL OF WISCONSIN OutpatientFacility | ICare | WI MEDICAID I CARE | $5,062.90 | — | — | 2026-03-23 | MRF ↗ |
| GENEVA GENERAL HOSPITAL OutpatientFacility | MVP Health Care | Managed Medicaid | $5,071.74 | — | — | 2025-08-07 | MRF ↗ |
| LAKEWOOD RANCH MEDICAL CENTER Outpatient | United Healthcare | Medicaid | $5,079.00 | — | — | 2026-07-15 | MRF ↗ |
| MANATEE MEMORIAL HOSPITAL Outpatient | United Healthcare | Medicaid | $5,079.14 | — | — | 2026-07-15 | MRF ↗ |
| WELLINGTON REGIONAL MEDICAL CENTER Outpatient | Humana | Medicaid | $5,079.14 | — | — | 2026-07-15 | MRF ↗ |
| WELLINGTON REGIONAL MEDICAL CENTER Outpatient | Wellcare | Medicaid | $5,079.14 | — | — | 2026-07-15 | MRF ↗ |
| WELLINGTON REGIONAL MEDICAL CENTER Outpatient | Sunshine State Health | Medicaid | $5,079.14 | — | — | 2026-07-15 | MRF ↗ |
| WELLINGTON REGIONAL MEDICAL CENTER Outpatient | Clear Health Alliance | Medicaid | $5,079.14 | — | — | 2026-07-15 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Aetna Better Health IL | Managed Medicaid | $5,167.38 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Meridian Health IL | Managed Medicaid | $5,167.38 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Molina IL | Managed Medicaid | $5,167.38 | — | — | 2026-02-13 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Illinois | Managed Medicaid | $5,167.38 | — | — | 2026-02-11 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | Wellcare (IL) Medicaid | Managed Medicaid | $5,167.38 | — | — | 2026-02-11 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Illinois | Managed Medicaid | $5,167.38 | — | — | 2026-02-13 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Outpatient | Blue Cross Blue Shield | Medicaid- Aca, Fhp, Icp | $5,167.38 | — | — | 2026-09-20 | MRF ↗ |
| GIBSON GENERAL HOSPITAL OutpatientFacility | MeridianHealth (IL) | Managed Medicaid | $5,167.38 | — | — | 2026-02-11 | MRF ↗ |
| WELLINGTON REGIONAL MEDICAL CENTER Outpatient | United Healthcare | Medicaid | $5,282.30 | — | — | 2026-07-15 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Outpatient | Meridian | Medicaid | $5,322.41 | — | — | 2026-09-20 | MRF ↗ |
| LAKEWOOD RANCH MEDICAL CENTER Outpatient | Staywell | Wellcare Medicaid | $5,333.00 | — | — | 2026-07-15 | MRF ↗ |
| LAKEWOOD RANCH MEDICAL CENTER Outpatient | Humana | Medicaid | $5,333.00 | — | — | 2026-07-15 | MRF ↗ |
| MANATEE MEMORIAL HOSPITAL Outpatient | Humana | Medicaid | $5,333.10 | — | — | 2026-07-15 | MRF ↗ |
| MANATEE MEMORIAL HOSPITAL Outpatient | Staywell | Wellcare Medicaid | $5,333.10 | — | — | 2026-07-15 | MRF ↗ |
| MANATEE MEMORIAL HOSPITAL Outpatient | Vivada | Medicaid | $5,434.68 | — | — | 2026-07-15 | MRF ↗ |
| LAKEWOOD RANCH MEDICAL CENTER Outpatient | Vivada | Medicaid | $5,435.00 | — | — | 2026-07-15 | MRF ↗ |
| STURDY MEMORIAL HOSPITAL Outpatient | Boston Medical Center /Wellsense | Silver | $5,473.12 | — | — | 2026-07-15 | MRF ↗ |
| LAKEWOOD RANCH MEDICAL CENTER Outpatient | Aetna | Medicaid | $5,485.47 | — | — | 2026-07-15 | MRF ↗ |
| WELLINGTON REGIONAL MEDICAL CENTER Outpatient | Aetna | Medicaid | $5,485.47 | — | — | 2026-07-15 | MRF ↗ |
| MANATEE MEMORIAL HOSPITAL Outpatient | Aetna | Medicaid | $5,485.47 | — | — | 2026-07-15 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $5,487.39 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $5,487.39 | — | — | 2026-01-01 | MRF ↗ |
| LAKEWOOD RANCH MEDICAL CENTER Outpatient | Sunshine State Health | Medicaid | $5,587.00 | — | — | 2026-07-15 | MRF ↗ |
| MANATEE MEMORIAL HOSPITAL Outpatient | Sunshine State Health | Medicaid | $5,587.05 | — | — | 2026-07-15 | MRF ↗ |
| WELLINGTON REGIONAL MEDICAL CENTER Outpatient | Molina | Medicaid | $5,587.05 | — | — | 2026-07-15 | MRF ↗ |
| GENEVA GENERAL HOSPITAL OutpatientFacility | Excellus Blue Choice Options | Managed Medicaid | $5,635.27 | — | — | 2025-08-07 | MRF ↗ |
| GENEVA GENERAL HOSPITAL OutpatientFacility | Aetna | Managed Medicaid | $5,635.27 | — | — | 2025-08-07 | MRF ↗ |
| SOLDIERS AND SAILORS MEMORIAL HOSPITAL OF YATES OutpatientFacility | Fidelis | Managed Medicaid | $5,635.27 | — | — | 2025-08-07 | MRF ↗ |
| GENEVA GENERAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $5,635.27 | — | — | 2025-08-07 | MRF ↗ |
| SOLDIERS AND SAILORS MEMORIAL HOSPITAL OF YATES OutpatientFacility | United Healthcare | Managed Medicaid | $5,635.27 | — | — | 2025-08-07 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | MOLINA HEALTHCARE 1723 | MOLINA MEDICAID 172301, MOLINA CHILD HEALTH PLUS 518901 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL 3-4 171602, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNIVERA HEALTHCARE 1706 | UNIVERA MEDICAID 170607, UNIVERA ESSENTIAL 3-4 170605, UNIVERA ESSENTIAL 1-2 200-250 2201, UNIVERA CHILD HEALTH PLUS 220118, UNIVERA HLTHY NY 220112 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 5143 | HIGHMARK BCBS ESSENTIAL 1-2 200-250 5143 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | EXCELLUS ESSENTIAL 3-4 170604, EXCELLUS ESSENTIAL 1-2 200-250 2201, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS HLTHY NY 220110 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | EXCELLUS ESSENTIAL 3-4 170604, EXCELLUS ESSENTIAL 1-2 200-250 2201, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS HLTHY NY 220110 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | BLUE CHOICE OPTION MEDICAID 170601 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL 3-4 171602, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | BLUE CHOICE OPTION MEDICAID 170601 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL 3-4 171602, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | MOLINA HEALTHCARE 1723 | MOLINA MEDICAID 172301, MOLINA CHILD HEALTH PLUS 518901 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNIVERA HEALTHCARE 1706 | UNIVERA MEDICAID 170607, UNIVERA ESSENTIAL 3-4 170605, UNIVERA ESSENTIAL 1-2 200-250 2201, UNIVERA CHILD HEALTH PLUS 220118, UNIVERA HLTHY NY 220112 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL 3-4 171602, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL 3-4 171602, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | BLUE CHOICE OPTION MEDICAID 170601 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | EXCELLUS ESSENTIAL 3-4 170604, EXCELLUS ESSENTIAL 1-2 200-250 2201, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS HLTHY NY 220110 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $5,776.20 | — | — | 2026-01-01 | MRF ↗ |
| ELLENVILLE REGIONAL HOSPITAL OutpatientFacility | Galaxy Health | Workers Comp | $6,074.59 | — | — | 2026-05-22 | MRF ↗ |
| MANATEE MEMORIAL HOSPITAL Outpatient | Simply | Medicaid | $6,094.97 | — | — | 2026-07-15 | MRF ↗ |
| MANATEE MEMORIAL HOSPITAL Outpatient | Amerigroup | Medicaid | $6,094.97 | — | — | 2026-07-15 | MRF ↗ |
| WELLINGTON REGIONAL MEDICAL CENTER Outpatient | Prestigehealth | Medicaid | $6,094.97 | — | — | 2026-07-15 | MRF ↗ |
| LAKEWOOD RANCH MEDICAL CENTER Outpatient | Amerigroup | Medicaid | $6,095.00 | — | — | 2026-07-15 | MRF ↗ |
| LAKEWOOD RANCH MEDICAL CENTER Outpatient | Simply | Medicaid | $6,095.00 | — | — | 2026-07-15 | MRF ↗ |
| ELLENVILLE REGIONAL HOSPITAL OutpatientFacility | Hamaspik Choice | Medicaid | $6,198.72 | — | — | 2026-05-22 | MRF ↗ |
| ELLENVILLE REGIONAL HOSPITAL OutpatientFacility | EmblemHealth | Essential Plan 3/Essential Plan 4 | $6,198.72 | — | — | 2026-05-22 | MRF ↗ |
| ELLENVILLE REGIONAL HOSPITAL OutpatientFacility | United Healthcare | CHIP/Family Health Plus/Medicaid | $6,198.72 | — | — | 2026-05-22 | MRF ↗ |
| ELLENVILLE REGIONAL HOSPITAL OutpatientFacility | EmblemHealth | Medicaid | $6,198.72 | — | — | 2026-05-22 | MRF ↗ |
| SOLDIERS AND SAILORS MEMORIAL HOSPITAL OF YATES OutpatientFacility | Fidelis | Medicare Advantage | $6,198.80 | — | — | 2025-08-07 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | Molina Apple Health | MOLINA AH | $6,249.34 | $6,249.34 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | Molina Apple Health | MOLINA AH BLIND_DISABLED | $6,249.34 | $6,249.34 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | Molina Apple Health | MOLINA BEHAVIORAL HEALTH ONLY | $6,249.34 | $6,249.34 | — | 2024-07-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID [1706] | BLUE CHOICE OPTION MEDICAID [170601] | $6,307.24 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) [1720] | AMERIGROUP (BSWNY ALTERNATE) [172001] | $6,307.24 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD [2201], OUT AREA BLUE CROSS BLUE SHIELD, UNIVERA, EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID [1706] | EXCELLUS CHILD HEALTH PLUS [220108], EXCELLUS ESS Q 1 2 [220109],EXCELLUS HLTHY NY [220110], EXCELLUS ESSENTIAL PA 3 AND 4 [170604] | $6,307.24 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID [1716] | UNITED HEALTHCARE MEDICAID [171601] | $6,307.24 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | FIDELIS [5155],FIDELIS [1708] | FIDELIS MEDICAID [170801], FIDELIS CHILD HEALTH PLUS [515502] | $6,307.24 | — | — | 2026-04-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | MOLINA HEALTHCARE 1723 | MOLINA MEDICAID 172301, MOLINA CHILD HEALTH PLUS 518901 | $6,353.82 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | MOLINA HEALTHCARE 1723 | MOLINA MEDICAID 172301, MOLINA CHILD HEALTH PLUS 518901 | $6,353.82 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $6,353.82 | — | — | 2026-01-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | UHC Apple Health | UNITED HEALTH CARE AH | $6,416.73 | $6,416.73 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | UHC Apple Health | NORTHWEST PHYSICIAN NETWORK | $6,416.73 | $6,416.73 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | UHC Apple Health | UNITED HEALTHCARE BEHAVIORAL HEALTH ONLY | $6,416.73 | $6,416.73 | — | 2024-07-01 | MRF ↗ |
| MIDWESTERN REGION MED CENTER, INC Outpatient | County Care | Medicaid All Plans | $6,502.92 | — | — | 2026-03-27 | MRF ↗ |
| MIDWESTERN REGION MED CENTER, INC Outpatient | Meridian | Medicaid All Plans | $6,502.92 | — | — | 2026-03-27 | MRF ↗ |
| ELLENVILLE REGIONAL HOSPITAL OutpatientFacility | WellCare | Child Health Plus/Family Health Plus/Medicaid | $6,508.71 | — | — | 2026-05-22 | MRF ↗ |
| ELLENVILLE REGIONAL HOSPITAL OutpatientFacility | MVP Health Care of NY | Child Health Plus/Family Health Plus/HARP/Medicaid | $6,508.71 | — | — | 2026-05-22 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $6,642.63 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $6,642.63 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $6,642.63 | — | — | 2026-01-01 | MRF ↗ |
| GENEVA GENERAL HOSPITAL OutpatientFacility | Fidelis | Managed Medicaid | $6,762.32 | — | — | 2025-08-07 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Aetna Better Health (Illinicare) | Managed Medicaid | $6,767.42 | — | — | 2025-11-12 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Blue Cross Blue Shield of Illinois | Managed Medicaid | $6,767.42 | — | — | 2025-11-12 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Molina Healthcare of Illinois | Managed Medicaid | $6,767.42 | — | — | 2025-11-12 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Meridian Health Plan | Managed Medicaid | $6,767.42 | — | — | 2025-11-12 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Aetna Better Health (Illinicare) | Managed Medicaid | $6,767.42 | — | — | 2025-11-12 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Molina Healthcare of Illinois | Managed Medicaid | $6,767.42 | — | — | 2025-11-12 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Meridian Health Plan | Managed Medicaid | $6,767.42 | — | — | 2025-11-12 | MRF ↗ |
| FERRELL HOSPITAL COMMUNITY FOUNDATIONS OutpatientFacility | Blue Cross Blue Shield of Illinois | Managed Medicaid | $6,767.42 | — | — | 2025-11-12 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | CHPW Apple Health | CHP-BEHAVIORAL HEALTH ONLY | $6,779.42 | $6,779.42 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | CHPW Apple Health | CHP WASHINGTON HEALTH | $6,779.42 | $6,779.42 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | CHPW Apple Health | CHP AH | $6,779.42 | $6,779.42 | — | 2024-07-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $6,873.68 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | MVP MEDICAID 1712 | MVP OPTION MEDICAID 171201, MVP CHILD HEALTH PLUS 290004 | $6,931.44 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | MVP MEDICAID 1712 | MVP OPTION MEDICAID 171201, MVP CHILD HEALTH PLUS 290004 | $6,931.44 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | MVP MEDICAID 1712 | MVP OPTION MEDICAID 171201, MVP CHILD HEALTH PLUS 290004 | $6,931.44 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | MVP MEDICAID 1712 | MVP OPTION MEDICAID 171201, MVP CHILD HEALTH PLUS 290004 | $6,931.44 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | MVP MEDICAID 1712 | MVP OPTION MEDICAID 171201, MVP CHILD HEALTH PLUS 290004 | $6,931.44 | — | — | 2026-01-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | Coordinated Care Apple Health | COORDINATED CARE AH | $6,974.71 | $6,974.71 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | Coordinated Care Apple Health | COORDINATED CARE-BEHAVIORAL HEALTH ONLY | $6,974.71 | $6,974.71 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | Coordinated Care Apple Health | OPTICARE MANAGED VISION | $6,974.71 | $6,974.71 | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Outpatient | Coordinated Care Apple Health | COORDINATED CARE BH | $6,974.71 | $6,974.71 | — | 2024-07-01 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Rocky Mountain Health Plan | Managed Medicaid | $7,006.20 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES OutpatientFacility | Denver Health | Managed Medicaid | $7,006.20 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES OutpatientFacility | Colorado Access | Managed Medicaid | $7,006.20 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES OutpatientFacility | Rocky Mountain Health Plan | Managed Medicaid | $7,006.20 | — | — | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Kaiser | Managed Medicaid | $7,006.20 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES OutpatientFacility | Denver Health | Managed Medicaid | $7,006.20 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES OutpatientFacility | Rocky Mountain Health Plan | Managed Medicaid | $7,006.20 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES OutpatientFacility | Colorado Access | Managed Medicaid | $7,006.20 | — | — | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Naphcare | Managed Medicaid | $7,006.20 | — | — | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Colorado Access | Managed Medicaid | $7,006.20 | — | — | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Denver Health | Managed Medicaid | $7,006.20 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-ST ANTHONY NORTH HEALTH CAMPUS OutpatientFacility | Colorado Access | Managed Medicaid | $7,191.72 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-ST ANTHONY NORTH HEALTH CAMPUS OutpatientFacility | Kaiser | Managed Medicaid | $7,191.72 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-ST ANTHONY NORTH HEALTH CAMPUS OutpatientFacility | Denver Health | Managed Medicaid | $7,191.72 | — | — | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-ST ANTHONY NORTH HEALTH CAMPUS OutpatientFacility | Rocky Mountain Health Plan | Managed Medicaid | $7,191.72 | — | — | 2024-12-02 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | MOLINA HEALTHCARE 1723 | MOLINA MEDICAID 172301, MOLINA CHILD HEALTH PLUS 518901 | $7,220.25 | — | — | 2026-01-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE [5158] | UNITED HEALTHCARE ESSENTIAL PQ 1 AND 2 [515812] | $7,253.33 | — | — | 2026-04-01 | MRF ↗ |
| GRAND LAKE HEALTH SYSTEM Outpatient | Paramount Advantage Medicaid | Mco | $7,373.10 | — | — | 2026-07-15 | MRF ↗ |
| GRAND LAKE HEALTH SYSTEM Outpatient | Uhc Community Plan Medicaid | Mco | $7,373.10 | — | — | 2026-07-15 | MRF ↗ |
| GRAND LAKE HEALTH SYSTEM Outpatient | Molina Medicaid | Mco | $7,373.10 | — | — | 2026-07-15 | MRF ↗ |
| GRAND LAKE HEALTH SYSTEM Outpatient | Humana Medicaid | Mco | $7,373.10 | — | — | 2026-07-15 | MRF ↗ |
| GRAND LAKE HEALTH SYSTEM Outpatient | Amerihealth Caritas Medicaid | Mco | $7,373.10 | — | — | 2026-07-15 | MRF ↗ |
| GRAND LAKE HEALTH SYSTEM Outpatient | Buckeye Community Health Plan Medicaid | Mco | $7,373.10 | — | — | 2026-07-15 | MRF ↗ |
| GRAND LAKE HEALTH SYSTEM Outpatient | Caresource Medicaid | Mco | $7,373.10 | — | — | 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.