92549 — Cdp-sot 6 Cond W/i&r Mct&adt
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). CDP-SOT 6 COND W/I&R MCT&ADT (CPT 92549) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/92549?code_type=CPT
MLA (9th ed.)
“CDP-SOT 6 COND W/I&R MCT&ADT (CPT 92549) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/92549?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“CDP-SOT 6 COND W/I&R MCT&ADT (CPT 92549) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/92549?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $109–$218 (25th–75th percentile) across 1,495 hospitals · 1,931 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 92549 — 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 physician fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$109
$144 typical
$218
The middle 50% of negotiated facility rates for this procedure, measured across 1,495 hospitals. The physician 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. | $144 |
| Physician fee Estimate national typical Medicare $62 × 1.22 commercial. | $76 |
| Likely subtotal | $221 |
Complete-episode estimate (typical)
~$221
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge
- Complications, revisions, or readmissions
- Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)
The biggest swing: which insurer's rate applies — negotiated prices here run $109–$218.
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Physician 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 |
|---|---|---|---|---|---|---|---|
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.49 | — | — | 2026-09-01 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Healthplan Medicaid | Wv Medicaid | $0.53 | — | — | 2026-05-06 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.55 | $304.00 | $127.48 | 2024-12-31 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Wellpoint | Wv Medicaid | $0.56 | — | — | 2026-05-06 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | HUMANA | HUMANA MEDICARE- MIDTOWN IMAGING | $0.72 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | HUMANA | HUMANA- MIDTOWN IMAGING | $0.82 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $1.86 | — | — | 2026-07-15 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $2.13 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $2.58 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $2.60 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $2.60 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $2.60 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $3.01 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $3.15 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $3.15 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $3.15 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $3.20 | — | — | 2026-09-02 | MRF ↗ |
| SUMMIT MEDICAL CENTER Outpatient | BCBS Advantage PPO | BCBS Advantage PPO | $8.09 | — | — | 2026-08-30 | MRF ↗ |
| SUMMIT MEDICAL CENTER Outpatient | BCBS Blue Lincs HMO | BCBS Blue Lincs HMO | $8.09 | — | — | 2026-08-30 | MRF ↗ |
| COMMUNITY HOSPITAL, LLC OutpatientFacility | BCBS-OK | Blue Lincs | $8.23 | — | $383.88 | 2026-03-31 | MRF ↗ |
| NORTHWEST SURGICAL HOSPITAL OutpatientFacility | BCBS-OK | Traditional | $8.23 | — | $383.88 | 2026-03-31 | MRF ↗ |
| COMMUNITY HOSPITAL, LLC OutpatientFacility | BCBS-OK | Blue Advantage | $8.23 | — | $383.88 | 2026-03-31 | MRF ↗ |
| NORTHWEST SURGICAL HOSPITAL OutpatientFacility | BCBS-OK | Blue Lincs | $8.23 | — | $383.88 | 2026-03-31 | MRF ↗ |
| COMMUNITY HOSPITAL, LLC OutpatientFacility | BCBS-OK | Blue Preferred | $8.23 | — | $383.88 | 2026-03-31 | MRF ↗ |
| NORTHWEST SURGICAL HOSPITAL OutpatientFacility | BCBS-OK | Blue Preferred | $8.23 | — | $383.88 | 2026-03-31 | MRF ↗ |
| NORTHWEST SURGICAL HOSPITAL OutpatientFacility | BCBS-OK | Blue Choice | $8.23 | — | $383.88 | 2026-03-31 | MRF ↗ |
| COMMUNITY HOSPITAL, LLC OutpatientFacility | BCBS-OK | Traditional | $8.23 | — | $383.88 | 2026-03-31 | MRF ↗ |
| COMMUNITY HOSPITAL, LLC OutpatientFacility | BCBS-OK | Blue Choice | $8.23 | — | $383.88 | 2026-03-31 | MRF ↗ |
| NORTHWEST SURGICAL HOSPITAL OutpatientFacility | BCBS-OK | Blue Advantage | $8.23 | — | $383.88 | 2026-03-31 | MRF ↗ |
| OKLAHOMA SURGICAL HOSPITAL, LLC OutpatientFacility | BCBS | Choice | $8.40 | — | — | 2025-10-31 | MRF ↗ |
| OKLAHOMA SURGICAL HOSPITAL, LLC OutpatientFacility | BCBS | Preferred | $8.40 | — | — | 2025-10-31 | MRF ↗ |
| OKLAHOMA SURGICAL HOSPITAL, LLC OutpatientFacility | BCBS | Traditional | $8.40 | — | — | 2025-10-31 | MRF ↗ |
| OKLAHOMA SURGICAL HOSPITAL, LLC OutpatientFacility | BCBS | Bluelincs | $8.40 | — | — | 2025-10-31 | MRF ↗ |
| OKLAHOMA SURGICAL HOSPITAL, LLC OutpatientFacility | BCBS | Advantage | $8.40 | — | — | 2025-10-31 | MRF ↗ |
| SUMMIT MEDICAL CENTER Outpatient | BCBS Preferred | BCBS Preferred | $9.82 | — | — | 2026-08-30 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $10.55 | $497.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Priority Health | MEDICAID | $10.55 | $497.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna Better Health | MEDICAID | $10.55 | $497.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | HAP Caresource Medicaid | $10.55 | $497.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | McLaren | MEDICAID | $10.55 | $497.00 | — | 2025-06-28 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $10.75 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $10.75 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $10.75 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $10.75 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $10.75 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $10.75 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $10.75 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $10.75 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6790_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ASIN 20230101 | $10.75 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $10.75 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $10.75 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $10.75 | — | — | 2026-01-01 | MRF ↗ |
| NYACK HOSPITAL Outpatient | Empire | Connection | $11.15 | — | — | 2025-06-27 | MRF ↗ |
| NYACK HOSPITAL Outpatient | Empire | Connection | $11.15 | — | — | 2025-06-27 | MRF ↗ |
| SUMMIT MEDICAL CENTER Outpatient | BCBS Choice | BCBS Choice | $11.56 | — | — | 2026-08-30 | MRF ↗ |
| NYACK HOSPITAL Outpatient | Empire | Blue_Access | $11.89 | — | — | 2025-06-27 | MRF ↗ |
| NYACK HOSPITAL Outpatient | Empire | Blue_Access | $11.89 | — | — | 2025-06-27 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | KANCARE UHC | 859_MEDICAID ADVANTAGE KANCARE UNITED HEALTH CARE 20250701 | $12.00 | — | — | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | KANCARE UHC | 859_MEDICAID ADVANTAGE KANCARE UNITED HEALTH CARE 20250701 | $12.00 | — | — | 2026-01-01 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Beacon Health Strategies/Carelon | Wellsense - Nh Managed Medicaid Beh Health - Dhp | $12.25 | — | — | 2026-07-18 | MRF ↗ |
| MCALESTER REGIONAL HEALTH CENTER OutpatientFacility | Cigna | HMO | — | — | — | 2026-03-15 | MRF ↗ |
| MCALESTER REGIONAL HEALTH CENTER OutpatientFacility | Cigna | PPO | — | — | — | 2026-03-15 | MRF ↗ |
| MCALESTER REGIONAL HEALTH CENTER OutpatientFacility | Okla Health Network | All Plans | — | — | — | 2026-03-15 | MRF ↗ |
| MCALESTER REGIONAL HEALTH CENTER OutpatientFacility | PHCS | Savility Network | — | — | — | 2026-03-15 | MRF ↗ |
| MCALESTER REGIONAL HEALTH CENTER OutpatientFacility | OSMA Health | All Plans | — | — | — | 2026-03-15 | MRF ↗ |
| MCALESTER REGIONAL HEALTH CENTER OutpatientFacility | Preferred Choice Community | PPO | — | — | — | 2026-03-15 | MRF ↗ |
| MCALESTER REGIONAL HEALTH CENTER OutpatientFacility | Beech Street | PPO | — | — | — | 2026-03-15 | MRF ↗ |
| MCALESTER REGIONAL HEALTH CENTER OutpatientFacility | GEHA | PPO | — | — | — | 2026-03-15 | MRF ↗ |
| MCALESTER REGIONAL HEALTH CENTER OutpatientFacility | Blue Cross Blue Shield of Oklahoma | Blue Linc | $12.42 | — | — | 2026-03-15 | MRF ↗ |
| MCALESTER REGIONAL HEALTH CENTER OutpatientFacility | Coventry | First Health PPO | — | — | — | 2026-03-15 | MRF ↗ |
| MCALESTER REGIONAL HEALTH CENTER OutpatientFacility | Blue Cross Blue Shield of Oklahoma | Blue Advantage | $12.42 | — | — | 2026-03-15 | MRF ↗ |
| MCALESTER REGIONAL HEALTH CENTER OutpatientFacility | Coventry | PPO | — | — | — | 2026-03-15 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | KANCARE SUNFLOWER | 858_MEDICAID ADVANTAGE KANCARE SUNFLOWER 20250701 | $12.48 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | KANCARE AETNA | 856_MEDICAID ADVANTAGE KANCARE AETNA 20250701 | $12.48 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | KANCARE HEALTHY BLUE | 861_MEDICAID ADVANTAGE KANCARE HEALTHY BLUE 20250701 | $12.48 | — | — | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | KANCARE SUNFLOWER | 858_MEDICAID ADVANTAGE KANCARE SUNFLOWER 20250701 | $12.48 | — | — | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | KANCARE AETNA | 856_MEDICAID ADVANTAGE KANCARE AETNA 20250701 | $12.48 | — | — | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | KANCARE HEALTHY BLUE | 861_MEDICAID ADVANTAGE KANCARE HEALTHY BLUE 20250701 | $12.48 | — | — | 2026-01-01 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan – Hmo | $12.57 | — | — | 2026-03-01 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan | $12.57 | — | — | 2026-03-01 | MRF ↗ |
| ASCENSION VIA CHRISTI HOSPITAL MANHATTAN, INC Outpatient | KANCARE AMERIGROUP | 857_MEDICAID ADVANTAGE KANCARE AMERIGROUP 20250701 | $12.60 | — | — | 2026-01-01 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | KANCARE AMERIGROUP | 857_MEDICAID ADVANTAGE KANCARE AMERIGROUP 20250701 | $12.60 | — | — | 2026-01-01 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Granite State Health Plan | New Hampshire Healthy Families - Nh Managed Medicaid - Dhp | $12.62 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Amerihealth Caritas Nh | Amerihealth Caritas - Nh Managed Medicaid - Dhp | $12.62 | — | — | 2026-07-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $12.69 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $12.69 | — | — | 2026-09-15 | MRF ↗ |
| BRIDGEPORT HOSPITAL Outpatient | Medicaid Managed UHC | All Plans | $12.71 | $395.98 | $201.95 | 2025-01-10 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Bcbs | Bcwyn Medicare Managed Care Plan | $12.75 | — | — | 2026-04-01 | MRF ↗ |
| KAHUKU MEDICAL CENTER Outpatient | HMSA | Mcd_ABD | $12.77 | — | — | 2024-06-28 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Granite State Health Plan | New Hampshire Healthy Families - Nh Managed Medicaid Beh Health - Dhp | $12.86 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Granite State Health Plan | New Hampshire Healthy Families - Nh Managed Medicaid | $12.98 | — | — | 2026-07-18 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Cdphp | Medicaid | $12.99 | — | — | 2026-07-18 | MRF ↗ |
| SUMMIT MEDICAL CENTER Outpatient | BCBS Traditional | BCBS Traditional | $13.27 | — | — | 2026-08-30 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | UHC | UHC Medicare | $13.34 | $56.00 | $30.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT WILSON COUNTY HOSPITAL Both | Humana | Humana Military East | $13.34 | $56.00 | $16.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | Humana | Humana Military East | $13.34 | $56.00 | $30.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT WILSON COUNTY HOSPITAL Both | UHC | UHC Medicare | $13.34 | $56.00 | $16.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT BEDFORD HOSPITAL Both | Humana | Humana Military East | $13.34 | $56.00 | $16.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT TULLAHOMA-HARTON HOSPITAL Both | Humana | Humana Military East | $13.34 | $56.00 | $16.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT TULLAHOMA-HARTON HOSPITAL Both | UHC | UHC Medicare | $13.34 | $56.00 | $16.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT BEDFORD HOSPITAL Both | UHC | UHC Medicare | $13.34 | $56.00 | $16.24 | 2025-10-01 | MRF ↗ |
| Roswell Park Cancer Institute OutpatientFacility | Univera | Special Programs Medicaid Managed Care Plan | $13.56 | — | — | 2026-04-01 | MRF ↗ |
| MCALESTER REGIONAL HEALTH CENTER OutpatientFacility | Blue Cross Blue Shield of Oklahoma | Blue Preferred | $13.67 | — | — | 2026-03-15 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | UHC | UHC Community Plan/DSNP | $13.74 | $56.00 | $30.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT WILSON COUNTY HOSPITAL Both | UHC | UHC Community Plan/DSNP | $13.74 | $56.00 | $16.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT BEDFORD HOSPITAL Both | UHC | UHC Community Plan/DSNP | $13.74 | $56.00 | $16.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT TULLAHOMA-HARTON HOSPITAL Both | UHC | UHC Community Plan/DSNP | $13.74 | $56.00 | $16.24 | 2025-10-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Inpatient | UHC Apple Health | NORTHWEST PHYSICIAN NETWORK | $13.94 | — | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Inpatient | UHC Apple Health | UNITED HEALTH CARE AH | $13.94 | — | — | 2024-07-01 | MRF ↗ |
| CONFLUENCE HEALTH HOSPITAL Inpatient | UHC Apple Health | UNITED HEALTHCARE BEHAVIORAL HEALTH ONLY | $13.94 | — | — | 2024-07-01 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | Wellpoint | Wellpoint Medicare | $14.00 | $56.00 | $30.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT TULLAHOMA-HARTON HOSPITAL Both | Wellpoint | Wellpoint Medicare | $14.00 | $56.00 | $16.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT WILSON COUNTY HOSPITAL Both | Wellpoint | Wellpoint Medicare | $14.00 | $56.00 | $16.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT BEDFORD HOSPITAL Both | Wellpoint | Wellpoint Medicare | $14.00 | $56.00 | $16.24 | 2025-10-01 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Aetna | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Cigna | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Aetna | MA | — | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Medica | All Plans | — | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Aetna | POS | — | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Medica | All Plans | — | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Aetna | MA | — | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Oklahoma | Advantage PPO | $14.11 | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Aetna | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | HealthSmart | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Cigna | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Aetna | POS | — | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Oklahoma | Advantage PPO | $14.11 | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Cigna | POS | — | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | HealthSmart | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| COMANCHE COUNTY MEMORIAL HOSPITAL OutpatientFacility | Cigna | POS | — | — | — | 2026-03-05 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $14.19 | $340.00 | $204.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $14.19 | — | — | 2026-01-01 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Bcbs - Western Ny | Medicaid Managed Care Plan | $14.22 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Bcbs | Bcwyn Medicare Managed Care Plan | $14.35 | — | — | 2026-04-01 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | Aetna | Aetna Medicare | $14.40 | $56.00 | $30.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | Cigna | Cigna Medicare | $14.40 | $56.00 | $30.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT WILSON COUNTY HOSPITAL Both | Aetna | Aetna Medicare | $14.40 | $56.00 | $16.24 | 2025-10-01 | MRF ↗ |
| VANDERBILT TULLAHOMA-HARTON HOSPITAL Both | Cigna | Cigna Medicare | $14.40 | $56.00 | $16.24 | 2025-10-01 | 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.