90399 — Unlisted Immune Globulin
Cite this view
HANK Price Transparency. (n.d.). UNLISTED IMMUNE GLOBULIN (CPT 90399) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/90399?code_type=CPT
“UNLISTED IMMUNE GLOBULIN (CPT 90399) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/90399?code_type=CPT. Accessed .
“UNLISTED IMMUNE GLOBULIN (CPT 90399) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/90399?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $155–$522 (25th–75th percentile) across 520 hospitals · 285 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 90399 — 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 |
|---|---|---|---|---|---|---|---|
| ASCENSION ST VINCENT CARMEL Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | IN MEDICAID MGD CARE 20140101 (ST. MARY) | 1753_IN MEDICAID MGD CARE 20140101 (ST. MARY) | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | — | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | — | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | — | — | — | 2026-01-01 | MRF ↗ |
| METROHEALTH SYSTEM OutpatientFacility | Cigna | All Commercial Plans | $0.47 | — | — | 2026-04-01 | MRF ↗ |
| KOOTENAI HEALTH OutpatientFacility | Regence Blue Shield of Idaho | All Commercial Plans | $0.61 | — | — | 2026-03-27 | MRF ↗ |
| SAINT THOMAS RIVER PARK HOSPITAL Outpatient | COMMUNITY PLAN | 1351_RPTN MEDICAID REPLACEMENT UNITED HEALTH CARE COMMUNITY PLAN 20191001 | $7.57 | — | — | 2026-01-01 | MRF ↗ |
| ROANE MEDICAL CENTER Outpatient | United Healthcare | Tenncare | $9.17 | — | — | 2024-12-10 | MRF ↗ |
| LECONTE MEDICAL CENTER Outpatient | United Healthcare | Tenncare | $9.17 | — | — | 2024-12-10 | MRF ↗ |
| FORT LOUDOUN MEDICAL CENTER Outpatient | United Healthcare | Tenncare | $9.17 | — | — | 2024-12-10 | MRF ↗ |
| LECONTE MEDICAL CENTER Outpatient | United Healthcare | Tenncare | $9.17 | — | — | 2024-12-10 | MRF ↗ |
| CLAIBORNE MEDICAL CENTER OutpatientFacility | United Healthcare | Tenncare | $9.17 | — | — | 2025-12-23 | MRF ↗ |
| ROANE MEDICAL CENTER Outpatient | United Healthcare | Tenncare | $9.17 | — | — | 2024-12-10 | MRF ↗ |
| LECONTE MEDICAL CENTER OutpatientFacility | United Healthcare | Tenncare | $9.17 | — | — | 2025-12-23 | MRF ↗ |
| METHODIST MEDICAL CENTER OF OAK RIDGE OutpatientFacility | United Healthcare | Tenncare | $9.17 | — | — | 2025-12-23 | MRF ↗ |
| PARKWEST MEDICAL CENTER OutpatientFacility | United Healthcare | Tenncare | $9.17 | — | — | 2025-12-23 | MRF ↗ |
| FORT LOUDOUN MEDICAL CENTER OutpatientFacility | United Healthcare | Tenncare | $9.17 | — | — | 2025-12-23 | MRF ↗ |
| ROANE MEDICAL CENTER OutpatientFacility | United Healthcare | Tenncare | $9.17 | — | — | 2025-12-23 | MRF ↗ |
| FORT LOUDOUN MEDICAL CENTER Outpatient | United Healthcare | Tenncare | $9.17 | — | — | 2024-12-10 | MRF ↗ |
| FORT SANDERS REGIONAL MEDICAL CENTER OutpatientFacility | United Healthcare | Tenncare | $9.17 | — | — | 2025-12-23 | MRF ↗ |
| MORRISTOWN HAMBLEN HOSPITAL ASSOCIATION OutpatientFacility | United Healthcare | Tenncare | $9.17 | — | — | 2025-12-23 | MRF ↗ |
| CLAIBORNE MEDICAL CENTER OutpatientFacility | United Healthcare | Tenncare | $9.17 | — | — | 2025-12-23 | MRF ↗ |
| ST JUDE CHILDRENS RESEARCH HOSPITAL OutpatientFacility | UnitedHealthcare of TN Community Plan | MANAGED MEDICAID | $9.54 | — | — | 2025-07-01 | MRF ↗ |
| CUMBERLAND MEDICAL CENTER OutpatientFacility | United Healthcare | Tenncare | $11.00 | — | — | 2025-12-23 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | CAPITAL BLUE CROSS | CHIP | $13.57 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CAPITAL BLUE CROSS | CHIP | $13.58 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CAPITAL BLUE CROSS | CHIP | $13.58 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | CAPITAL BLUE CROSS | CHIP | $13.58 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | CAPITAL BLUE CROSS | CHIP | $14.29 | — | — | 2025-08-01 | MRF ↗ |
| ERLANGER MEDICAL CENTER OutpatientFacility | UHC | UHC COMMUNITY-CHILDREN | $14.38 | — | — | 2026-01-25 | MRF ↗ |
| ERLANGER MEDICAL CENTER OutpatientFacility | UHC | UHC COMMUNITY-CHILDREN | $14.38 | — | — | 2026-01-25 | MRF ↗ |
| ERLANGER BLEDSOE HOSPITAL OutpatientFacility | UHC | UHC COMMUNITY-CHILDREN | $14.38 | — | — | 2026-01-25 | MRF ↗ |
| ERLANGER MEDICAL CENTER OutpatientFacility | UHC | UHC COMMUNITY-ADULT | $17.41 | — | — | 2026-01-25 | MRF ↗ |
| ERLANGER MEDICAL CENTER OutpatientFacility | UHC | UHC COMMUNITY-ADULT | $17.41 | — | — | 2026-01-25 | MRF ↗ |
| ERLANGER BLEDSOE HOSPITAL OutpatientFacility | UHC | UHC COMMUNITY-ADULT | $17.41 | — | — | 2026-01-25 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Capital Blue Cross | F8103_Capital Blue Cross | $19.38 | — | — | 2026-04-01 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Amerihealth | F8102_Amerihealth | $19.38 | — | — | 2026-04-01 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Capital Blue Cross | F8103_Capital Blue Cross | $19.38 | — | — | 2026-04-01 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Amerihealth | F8102_Amerihealth | $19.38 | — | — | 2026-04-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | CAPITAL BLUE CROSS | ALL PRODUCTS | $19.38 | — | — | 2025-08-01 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $21.13 | — | — | 2026-05-06 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Hmo | $22.18 | — | — | 2026-05-06 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CAPITAL BLUE CROSS | ALL PRODUCTS | $23.01 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | CAPITAL BLUE CROSS | ALL PRODUCTS | $23.01 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CAPITAL BLUE CROSS | ALL PRODUCTS | $23.01 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | CAPITAL BLUE CROSS | ALL PRODUCTS | $24.23 | — | — | 2025-08-01 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | UHC | HARD CHIP | $30.53 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Excellus BCBS | Medicaid | $30.53 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Correctional Facility | Medicaid | $30.53 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | CDPHP | HARP | $30.53 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Excellus Healthy | Medicaid | $30.53 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Fidelis | MMC HARP CHP EPP 3_4 MLTC | $30.53 | — | — | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | Fidelis | MMC HARP CHP EPP 3_4 MLTC | $30.53 | — | — | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | UHC | HARD CHIP | $30.53 | — | — | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | Fidelis | MMC HARP CHP EPP 3_4 MLTC | $30.53 | — | — | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | CDPHP | Medicaid | $30.53 | — | — | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | Albany Correctional Facility | Medicaid | $30.53 | — | — | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | Albany Correctional Facility | Medicaid | $30.53 | — | — | 2025-01-01 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.