90853 — Group Psychotherapy
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). GROUP PSYCHOTHERAPY (CPT 90853) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/90853?code_type=CPT
MLA (9th ed.)
“GROUP PSYCHOTHERAPY (CPT 90853) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/90853?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“GROUP PSYCHOTHERAPY (CPT 90853) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/90853?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $90–$252 (25th–75th percentile) across 2,047 hospitals · 7,597 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 90853 — 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 the whole episode might cost
Your hospital facility price plus the separately-billed professional fees a complete episode adds. The facility figure is an actual negotiated rate from our data; the surgeon and anesthesia figures are estimates from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$90
$148 typical
$252
The middle 50% of negotiated facility rates for this procedure, measured across 2,047 hospitals. Surgeon & anesthesia fees are modeled estimates added on top.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $148 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $24 × 1.22 commercial. | $30 |
| Likely subtotal | $178 |
Surgical episode (typical)
~$178
Your recovery plan — adjust to what your surgeon told you
After surgery, recovery care is billed separately. We pre-fill the typical plan; change it to your situation.
Recovery cost modeled
~$3,785
With your recovery plan (typical)
~$3,963
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Surgeon (professional fee) (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
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 HOSPITAL MANSFIELD Inpatient | None | — | — | $505.99 | $253.00 | 2024-12-15 | MRF ↗ |
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | None | — | — | $505.99 | $253.00 | 2024-12-15 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.20 | $53.00 | $50.35 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $0.21 | $53.00 | $50.35 | 2026-02-20 | MRF ↗ |
| HANCOCK COUNTY HEALTH SYSTEM Outpatient | WELLMARK HMO-ALL OTHER PLANS | WELLMARK HMO-ALL OTHER PLANS | $0.21 | $81.00 | $60.75 | 2026-03-26 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.25 | $53.00 | $50.35 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.26 | $53.00 | $50.35 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $0.29 | $53.00 | $50.35 | 2026-02-20 | MRF ↗ |
| ST BARNABAS HOSPITAL OutpatientFacility | Optum | Medicaid | $0.32 | $237.00 | — | 2026-02-27 | MRF ↗ |
| ST BARNABAS HOSPITAL OutpatientFacility | Optum | Medicaid | $0.32 | $237.00 | — | 2026-02-27 | MRF ↗ |
| WATERBURY HOSPITAL OutpatientFacility | Cigna | Commercial | $0.34 | $1.00 | $0.50 | 2026-05-13 | MRF ↗ |
| WATERBURY HOSPITAL OutpatientFacility | Aetna | Commercial | $0.38 | $1.00 | $0.50 | 2026-05-13 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Cigna | Cigna - HMO | $0.49 | $459.00 | $344.25 | 2026-04-01 | MRF ↗ |
| WATERBURY HOSPITAL OutpatientFacility | ConnectiCare | Commercial | $0.65 | $1.00 | $0.50 | 2026-05-13 | MRF ↗ |
| WATERBURY HOSPITAL OutpatientFacility | United Healthcare | Commercial | $0.70 | $1.00 | $0.50 | 2026-05-13 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Aetna | Aetna Whole Health | $1.00 | $459.00 | $344.25 | 2026-04-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | California Physicians' Service dba Blue Shield of California | Covered | — | $910.00 | $746.20 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $910.00 | $746.20 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | California Physicians' Service dba Blue Shield of California | Medicare Advantage | — | $3,482.00 | $2,855.24 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | HMO | — | $910.00 | $746.20 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | POS | — | $910.00 | $746.20 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $910.00 | $746.20 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | HMO | — | $910.00 | $746.20 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $910.00 | $746.20 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | California Physicians' Service dba Blue Shield of California | HMO | — | $910.00 | $746.20 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $910.00 | $746.20 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $3,482.00 | $2,855.24 | 2025-11-26 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | TX CHILDREN HEALTH | CHIP | $1.10 | $219.41 | $164.56 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | TX CHILDREN HEALTH | STAR | $1.10 | $219.41 | $164.56 | 2026-01-01 | MRF ↗ |
| COOK CHILDRENS MEDICAL CENTER OutpatientFacility | TX CHILDREN HEALTH | STAR KIDS | $1.10 | $219.41 | $164.56 | 2026-01-01 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $1.43 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $1.44 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $1.44 | $351.79 | $351.79 | 2026-03-18 | MRF ↗ |
| RICHMOND UNIVERSITY MEDICAL CENTER OutpatientFacility | Beacon Health | Commercial Non- HMO Emblem | $1.50 | $3.00 | $75.96 | 2025-08-06 | MRF ↗ |
| RICHMOND UNIVERSITY MEDICAL CENTER OutpatientFacility | Beacon Health | Medicare Emblem & VNS | $1.50 | $3.00 | $75.96 | 2025-08-06 | MRF ↗ |
| RICHMOND UNIVERSITY MEDICAL CENTER OutpatientFacility | Beacon Health | Commercial Non-HMO Empire | $1.50 | $3.00 | $75.96 | 2025-08-06 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $1.64 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $1.65 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $1.65 | $351.79 | $351.79 | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $1.79 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $1.80 | $351.79 | $351.79 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $1.80 | — | — | 2026-03-18 | MRF ↗ |
| RICHMOND UNIVERSITY MEDICAL CENTER OutpatientFacility | Magnacare | All Products | $1.80 | $3.00 | $75.96 | 2025-08-06 | MRF ↗ |
| RICHMOND UNIVERSITY MEDICAL CENTER OutpatientFacility | Multiplan | All Products | $1.95 | $3.00 | $75.96 | 2025-08-06 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.07 | $234.21 | $140.53 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.07 | $234.21 | $140.53 | 2025-08-11 | MRF ↗ |
| RICHMOND UNIVERSITY MEDICAL CENTER OutpatientFacility | Emblem | GHI PPO EPO HMO | $3.00 | $3.00 | $3.00 | 2025-08-06 | MRF ↗ |
| RICHMOND UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | High Performance | $3.00 | $3.00 | $3.00 | 2025-08-06 | MRF ↗ |
| RICHMOND UNIVERSITY MEDICAL CENTER OutpatientFacility | UHC | Managed Medicaid | $3.00 | $3.00 | $3.00 | 2025-08-06 | MRF ↗ |
| RICHMOND UNIVERSITY MEDICAL CENTER OutpatientFacility | UHC | Medicare Advantage | $3.00 | $3.00 | $3.00 | 2025-08-06 | MRF ↗ |
| RICHMOND UNIVERSITY MEDICAL CENTER OutpatientFacility | Emblem | HIP PPO EPO HMO | $3.00 | $3.00 | $3.00 | 2025-08-06 | MRF ↗ |
| RICHMOND UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | All Products | $3.00 | $3.00 | $3.00 | 2025-08-06 | MRF ↗ |
| RICHMOND UNIVERSITY MEDICAL CENTER OutpatientFacility | Cigna | All Products | $3.00 | $3.00 | $3.00 | 2025-08-06 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $3.40 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $3.40 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $3.40 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $3.40 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $3.40 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $3.40 | — | — | 2026-04-16 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $3.47 | $107.00 | $107.00 | 2025-10-04 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Healthnet Medical | Managed Medicaid | $3.47 | $56.50 | $39.55 | 2026-05-18 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $3.47 | $107.00 | $107.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | MEDI-CAL | MEDI-CAL | $3.47 | $107.00 | $107.00 | 2025-10-04 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Healthnet Medical | Managed Medicaid | $3.47 | $56.50 | $39.55 | 2026-05-22 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $3.47 | $107.00 | $107.00 | 2025-10-04 | MRF ↗ |
| GEISINGER SOUTH WILKES-BARRE Outpatient | Medicaid | Medicaid | $3.50 | $238.00 | $147.56 | 2026-04-01 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | Medicaid | Medicaid | $3.50 | $238.00 | $147.56 | 2025-07-01 | MRF ↗ |
| INCLINE VILLAGE COMMUNITY HOSPITAL Outpatient | BLUE CROSS MEDI-CAL - ALL PLANS | BLUE CROSS MEDI-CAL - ALL PLANS | $3.52 | $107.00 | $107.00 | 2025-09-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | BLUE CROSS MCAL | BLUE CROSS MCAL | $3.52 | $107.00 | $107.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $3.54 | $107.00 | $107.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | CA HEALTH AND WELLNESS-ALL PLANS | CA HEALTH AND WELLNESS-ALL PLANS | $3.54 | $107.00 | $107.00 | 2025-10-04 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | WITH UFC | $3.57 | $202.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | WITH UFC | $3.57 | $202.00 | — | 2026-01-01 | MRF ↗ |
| GEISINGER SOUTH WILKES-BARRE Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $3.60 | $238.00 | $147.56 | 2026-04-01 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $3.60 | $238.00 | $147.56 | 2025-07-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Kern Healthcare Systems | Commercial | $3.64 | $56.50 | $39.55 | 2026-05-18 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Kern Healthcare Systems | Commercial | $3.64 | $56.50 | $39.55 | 2026-05-22 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $3.65 | $27.00 | $20.25 | 2026-01-16 | MRF ↗ |
| COLUMBUS COMMUNITY HOSPITAL OutpatientFacility | ICARE | MEDICARE ADVANTAGE | $3.77 | $13.00 | $7.15 | 2026-04-01 | MRF ↗ |
| DINI-TOWNSEND HOSPITAL AT NNMH Outpatient | None | — | — | $78.80 | $3.94 | 2026-03-30 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MEDICAID - OUT OF STATE [1047] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | ALIGNMENT HEALTH PLAN [2020] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER Outpatient | HCLA | Medicaid|Preferred IPA < 21 | $3.98 | $850.00 | $365.50 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | CMS - COUNTY MEDICAL SERVICES [1025] | COUNTY MEDICAL SERVICES | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | IMPERIAL HEALTH HOLDINGS [1132] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | LA Care Health | Medi-cal | $3.98 | — | — | 2026-03-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | Molina | MCD | $3.98 | — | — | 2026-03-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | BRAND NEW DAY [1089] | MEDI-CAL | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | REGAL MG 'HERITAGE PROVIDER NETWORK' [2019] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | LA CARE HEALTH PLAN [2025] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | ALTERNATE MEDI-CAL [2001] | MEDI-CAL | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | BRAND NEW DAY [1089] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | SD PHYSICIANS MED GRP [1076] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | ALAMEDA ALLIANCE FOR HEALTH [2027] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| MERCY GENERAL HOSPITAL Outpatient | United | Medicaid|< 21 | $3.98 | $250.00 | $54.50 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | UNLISTED MCAL HMO NON-CONTRACT [1049] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | COMMUNITY CARE IPA [1131] | Community Care IPA Medi-Cal Managed Care | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | HEMET COMMUNITY MED GRP - PROMISECARE [1040] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| MERCY SAN JUAN MEDICAL CENTER Outpatient | United | Medicaid|> 21 | $3.98 | $250.00 | $68.50 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | BLUE CROSS [1013] | MEDI-CAL | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | BLUE CROSS [1013] | BLUE CROSS MEDI-CAL UNLISTED IPA [10130011] | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MEDI-CAL [1048] | MEDI-CAL | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | OPTUM CARE NETWORK - PRIMECARE MED GRP [1065] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| MERCY GENERAL HOSPITAL Outpatient | United | Medicaid|> 21 | $3.98 | $250.00 | $54.50 | 2026-02-28 | MRF ↗ |
| WOODLAND MEMORIAL HOSPITAL Outpatient | United | Medicaid|< 21 | $3.98 | $250.00 | $68.50 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | STATE OF CALIFORNIA [1082] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | VANTAGE [1092] | PROSPECT VANTAGE MEDICAL GROUP MEDI-CAL | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| MERCY SAN JUAN MEDICAL CENTER Outpatient | United | Medicaid|< 21 | $3.98 | $250.00 | $68.50 | 2026-02-28 | MRF ↗ |
| WOODLAND MEMORIAL HOSPITAL Outpatient | United | Medicaid|> 21 | $3.98 | $250.00 | $68.50 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | CAREMORE [2028] | MEDI-CAL | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| METHODIST HOSPITAL OF SACRAMENTO Outpatient | United | Medicaid|> 21 | $3.98 | $250.00 | $72.00 | 2026-02-28 | MRF ↗ |
| ST MARY MEDICAL CENTER Outpatient | Partnership Health Plan | Medicaid|< 21 | $3.98 | $850.00 | $365.50 | 2026-02-28 | MRF ↗ |
| ST MARY MEDICAL CENTER Outpatient | Inland Empire Health Plan | Medicaid|All Plans | $3.98 | $850.00 | $365.50 | 2026-02-28 | MRF ↗ |
| WOODLAND MEMORIAL HOSPITAL Outpatient | BCBS - Anthem | Medicaid|< 21 | $3.98 | $250.00 | $68.50 | 2026-02-28 | MRF ↗ |
| WOODLAND MEMORIAL HOSPITAL Outpatient | BCBS - Anthem | Medicaid|> 21 | $3.98 | $250.00 | $68.50 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | CALIFORNIA DEPARTMENT OF PUBLIC HEALTH [1237] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | GOLD COAST HEALTH PLAN [2031] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL OF SAN BERNARDINO Outpatient | Kaiser | Medicaid|> 21 | $3.98 | $676.00 | $264.32 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | SAN DIEGO COUNTY [1071] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL OF SAN BERNARDINO Outpatient | Kaiser | Medicaid|< 21 | $3.98 | $676.00 | $264.32 | 2026-02-28 | MRF ↗ |
| COMMUNITY HOSPITAL OF SAN BERNARDINO Outpatient | LA Care | Medicaid|> 21 | $3.98 | $676.00 | $264.32 | 2026-02-28 | MRF ↗ |
| WOODLAND MEMORIAL HOSPITAL Outpatient | BCBS - Anthem | Medicaid|< 21 | $3.98 | $250.00 | $68.50 | 2026-02-28 | MRF ↗ |
| COMMUNITY HOSPITAL OF SAN BERNARDINO Outpatient | LA Care | Medicaid|< 21 | $3.98 | $676.00 | $264.32 | 2026-02-28 | MRF ↗ |
| COMMUNITY HOSPITAL OF SAN BERNARDINO Outpatient | Partnership Health Plan | Medicaid|< 21 | $3.98 | $676.00 | $264.32 | 2026-02-28 | MRF ↗ |
| WOODLAND MEMORIAL HOSPITAL Outpatient | United | Medicaid|< 21 | $3.98 | $250.00 | $68.50 | 2026-02-28 | MRF ↗ |
| NORTHRIDGE HOSPITAL MEDICAL CENTER Outpatient | HCLA | Medicaid|Preferred IPA > 21 | $3.98 | $420.00 | $117.18 | 2026-02-28 | MRF ↗ |
| WOODLAND MEMORIAL HOSPITAL Outpatient | United | Medicaid|> 21 | $3.98 | $250.00 | $68.50 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | COMMUNITY ELDERCARE [1027] | MEDI-CAL | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | BLUE CROSS [1013] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| NORTHRIDGE HOSPITAL MEDICAL CENTER Outpatient | Kaiser | Medicaid|> 21 | $3.98 | $420.00 | $117.18 | 2026-02-28 | MRF ↗ |
| COMMUNITY HOSPITAL OF SAN BERNARDINO Outpatient | Partnership Health Plan | Medicaid|> 21 | $3.98 | $676.00 | $264.32 | 2026-02-28 | MRF ↗ |
| COMMUNITY HOSPITAL OF SAN BERNARDINO Outpatient | Partnership Health Plan | Medicaid|< 21 | $3.98 | $676.00 | $264.32 | 2026-02-28 | MRF ↗ |
| COMMUNITY HOSPITAL OF SAN BERNARDINO Outpatient | Kaiser | Medicaid|< 21 | $3.98 | $676.00 | $264.32 | 2026-02-28 | MRF ↗ |
| COMMUNITY HOSPITAL OF SAN BERNARDINO Outpatient | Kaiser | Medicaid|> 21 | $3.98 | $676.00 | $264.32 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | HEALTH PLAN OF SAN JOAQUIN [2032] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL OF SAN BERNARDINO Outpatient | Partnership Health Plan | Medicaid|> 21 | $3.98 | $676.00 | $264.32 | 2026-02-28 | MRF ↗ |
| MERCY HOSPITAL OF FOLSOM Outpatient | United | Medicaid|< 21 | $3.98 | $250.00 | $97.25 | 2026-02-28 | MRF ↗ |
| METHODIST HOSPITAL OF SACRAMENTO Outpatient | United | Medicaid|< 21 | $3.98 | $250.00 | $72.00 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | CALIFORNIA HEALTH & WELLNESS MEDI-CAL [1122] | CALIFORNIA HEALTH AND WELLNESS MEDI-CAL (no longer Medi-Cal plan as of 1/1/24) | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| MERCY HOSPITAL OF FOLSOM Outpatient | United | Medicaid|> 21 | $3.98 | $250.00 | $97.25 | 2026-02-28 | MRF ↗ |
| COMMUNITY HOSPITAL OF SAN BERNARDINO Outpatient | LA Care | Medicaid|< 21 | $3.98 | $676.00 | $264.32 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | XIMED [2016] | MEDI-CAL | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Community Care IPA | All Commercial Products | $3.98 | $274.00 | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL OF SAN BERNARDINO Outpatient | LA Care | Medicaid|> 21 | $3.98 | $676.00 | $264.32 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | FEDERAL PRISON [1031] | FEDERAL PRISON [10310001] | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| NORTHRIDGE HOSPITAL MEDICAL CENTER Outpatient | Kaiser | Medicaid|< 21 | $3.98 | $420.00 | $117.18 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | FEDERAL PRISON [1031] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| NORTHRIDGE HOSPITAL MEDICAL CENTER Outpatient | Kaiser | Medicaid|< 21 | $3.98 | $420.00 | $117.18 | 2026-02-28 | MRF ↗ |
| NORTHRIDGE HOSPITAL MEDICAL CENTER Outpatient | Gold Coast Health Plan | Medicaid|All Plans | $3.98 | $420.00 | $117.18 | 2026-02-28 | MRF ↗ |
| NORTHRIDGE HOSPITAL MEDICAL CENTER Outpatient | HCLA | Medicaid|Preferred IPA < 21 | $3.98 | $420.00 | $117.18 | 2026-02-28 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | AllCare IPA | All Commercial Products | $3.98 | $274.00 | — | 2026-04-01 | MRF ↗ |
| WOODLAND MEMORIAL HOSPITAL Outpatient | BCBS - Anthem | Medicaid|> 21 | $3.98 | $250.00 | $68.50 | 2026-02-28 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | KERN HEALTH SYSTEMS [2033] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $3.98 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| NORTHRIDGE HOSPITAL MEDICAL CENTER Outpatient | Kaiser | Medicaid|> 21 | $3.98 | $420.00 | $117.18 | 2026-02-28 | MRF ↗ |
| NORTHRIDGE HOSPITAL MEDICAL CENTER Outpatient | Gold Coast Health Plan | Medicaid|All Plans | $3.98 | $420.00 | $117.18 | 2026-02-28 | MRF ↗ |
| NORTHRIDGE HOSPITAL MEDICAL CENTER Outpatient | HCLA | Medicaid|Preferred IPA < 21 | $3.98 | $420.00 | $117.18 | 2026-02-28 | MRF ↗ |
| NORTHRIDGE HOSPITAL MEDICAL CENTER Outpatient | HCLA | Medicaid|Preferred IPA > 21 | $3.98 | $420.00 | $117.18 | 2026-02-28 | MRF ↗ |
| ST MARY MEDICAL CENTER Outpatient | HCLA | Medicaid|Preferred IPA > 21 | $3.98 | $850.00 | $365.50 | 2026-02-28 | MRF ↗ |
| ST MARY MEDICAL CENTER Outpatient | Partnership Health Plan | Medicaid|> 21 | $3.98 | $850.00 | $365.50 | 2026-02-28 | MRF ↗ |
| GROSSMONT HOSPITAL Outpatient | Aetna | Aetna - PPO | $4.00 | $455.00 | $341.25 | 2026-04-01 | MRF ↗ |
| GEISINGER SOUTH WILKES-BARRE Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $4.03 | $238.00 | $147.56 | 2026-04-01 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $4.03 | $238.00 | $147.56 | 2025-07-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Kaiser | Managed Medicaid | $4.03 | $274.00 | — | 2026-04-01 | MRF ↗ |
| GEISINGER SOUTH WILKES-BARRE Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $4.11 | $238.00 | $147.56 | 2026-04-01 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $4.11 | $238.00 | $147.56 | 2025-07-01 | MRF ↗ |
| GEISINGER SOUTH WILKES-BARRE Outpatient | Health Partners | Health Partners - Managed Medicaid | $4.20 | $238.00 | $147.56 | 2026-04-01 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | Health Partners | Health Partners - Managed Medicaid | $4.20 | $238.00 | $147.56 | 2025-07-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Community Care Behavorial Health University of Pittsburgh Medical Center | Community Care Behavorial Health University of Pittsburgh Medical Center Commercial (BHS) | $4.31 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Community Care Behavorial Health University of Pittsburgh Medical Center | Community Care Behavorial Health University of Pittsburgh Medical Center Kids (CHIP) | $4.31 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Community Care Behavorial Health HealthChoices | Community Care Behavorial Health HealthChoices Northcentral (HCNC) | $4.31 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Community Care Behavorial Health HealthChoices | Community Care Behavorial Health HealthChoices Allegheny (HCAL) | $4.31 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Community Care Behavorial Health University of Pittsburgh Medical Center | Community Care Behavorial Health University of Pittsburgh Medical Center for You Advantage (SNP) | $4.31 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Community Care Behavorial Health University of Pittsburgh Medical Center | Community Care Behavorial Health University of Pittsburgh Medical Center For Life (LIFE) | $4.31 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Community Care Behavorial Health HealthChoices | Community Care Behavorial Health HealthChoices Erie (HCER) | $4.31 | — | — | 2026-04-14 | MRF ↗ |
| GROSSMONT HOSPITAL Outpatient | Health Net | Health Net - PPO | $4.33 | $455.00 | $341.25 | 2026-04-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $4.35 | $416.00 | $249.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $4.35 | $336.00 | $201.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $4.35 | $336.00 | $201.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $4.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $4.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $4.35 | $661.00 | $396.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $4.35 | $448.00 | $268.80 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $4.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $4.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $4.35 | $448.00 | $268.80 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $4.35 | — | — | 2026-01-01 | MRF ↗ |
| GEISINGER SOUTH WILKES-BARRE Outpatient | UPMC CHIP | UPMC CHIP - Managed Medicaid | $4.38 | $238.00 | $147.56 | 2026-04-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Brand New Day | MCD | $4.38 | — | — | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | Gold Coast Health Plan | MCD | $4.38 | — | — | 2026-03-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | Brand New Day | MCD | $4.38 | — | — | 2026-03-01 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | UPMC CHIP | UPMC CHIP - Managed Medicaid | $4.38 | $238.00 | $147.56 | 2025-07-01 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $4.51 | $107.00 | $107.00 | 2025-10-04 | MRF ↗ |
| TAHOE FOREST HOSPITAL Outpatient | PARTNERSHIP HEALTH PLAN- ALL PLANS | PARTNERSHIP HEALTH PLAN- ALL PLANS | $4.51 | $107.00 | $107.00 | 2025-10-04 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | BLUE SHIELD PROMISE [1017] | BLUE SHIELD PROMISE (FKA CARE1ST HEALTHPLAN MEDI-CAL) | $4.58 | $229.00 | $125.95 | 2026-04-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $4.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $4.67 | $448.00 | $268.80 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $4.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $4.67 | $448.00 | $268.80 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $4.67 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $4.67 | — | — | 2026-01-01 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.