92626 — Eval Aud Funcj 1st Hour
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). EVAL AUD FUNCJ 1ST HOUR (CPT 92626) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/92626?code_type=CPT
MLA (9th ed.)
“EVAL AUD FUNCJ 1ST HOUR (CPT 92626) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/92626?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“EVAL AUD FUNCJ 1ST HOUR (CPT 92626) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/92626?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $147–$345 (25th–75th percentile) across 1,525 hospitals · 4,293 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 92626 — 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
$147
$203 typical
$345
The middle 50% of negotiated facility rates for this procedure, measured across 1,525 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. | $203 |
| Physician fee Estimate national typical Medicare $60 × 1.22 commercial. | $73 |
| Likely subtotal | $276 |
Complete-episode estimate (typical)
~$276
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 |
|---|---|---|---|---|---|---|---|
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.46 | $124.00 | $117.80 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.46 | $124.00 | $117.80 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $0.50 | $124.00 | $117.80 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.60 | $124.00 | $117.80 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.60 | $124.00 | $117.80 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.61 | $124.00 | $117.80 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $0.61 | $124.00 | $117.80 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $0.61 | $124.00 | $117.80 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.61 | $124.00 | $117.80 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $0.67 | $124.00 | $117.80 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.22 | $331.00 | $314.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $1.22 | $331.00 | $314.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.22 | $331.00 | $314.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.26 | $331.00 | $314.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.29 | $331.00 | $314.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $1.32 | $331.00 | $314.45 | 2026-02-20 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Multiplan | Commercial | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna | Medicare Advantage | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana Choicecare | Commercial | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Carolina Complete Health | Managed Medicaid | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Longevity | Medicare Advantage | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Wellcare | Medicare Advantage | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Troy | Medicare Advantage | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Managed Medicaid | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Cigna | Commercial | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Liberty Advantage | Medicare Advantage | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna Nc State Health Plan | Commercial | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana Choicecare | Medicare Advantage | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Onenet Ppo | $1.63 | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Healthy Blue | Managed Medicaid | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | New Hanover | Medicare Advantage | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Blue Medicare Partner Health Plan | Medicare | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Medcost | Commercial | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Wellcare | Managed Medicaid | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Compass | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | First Carolina Care | Medicare Advantage | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Tricare | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna | Commercial | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Medicare Advantage | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Commercial | — | $300.00 | $180.00 | 2026-05-23 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.67 | $348.00 | $330.60 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.67 | $348.00 | $330.60 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $1.71 | $348.00 | $330.60 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.71 | $348.00 | $330.60 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.77 | $348.00 | $330.60 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.96 | $400.00 | $380.00 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.96 | $400.00 | $380.00 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $2.00 | $400.00 | $380.00 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $2.08 | $400.00 | $380.00 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $2.16 | $400.00 | $380.00 | 2026-02-20 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.98 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.00 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.00 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $3.42 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $3.44 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $3.44 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $3.72 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $3.75 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $3.75 | — | — | 2026-03-18 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $12.29 | $91.00 | $68.25 | 2026-01-16 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC HEALTHCHOICE | ALL PRODUCTS | $12.57 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC HEALTHCHOICE | ALL PRODUCTS | $12.57 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $13.05 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $13.05 | $476.00 | $285.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $13.05 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $13.05 | $79.00 | $47.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $13.05 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $13.05 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $13.05 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $13.05 | $476.00 | $285.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $13.05 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $13.05 | $476.00 | $285.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $13.05 | — | — | 2026-01-01 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $13.23 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $13.23 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $13.23 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $13.23 | — | — | 2026-04-16 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC LCD | ALL PRODUCTS | $13.23 | — | — | 2026-01-01 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $13.23 | — | — | 2026-04-16 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC LCD | ALL PRODUCTS | $13.23 | — | — | 2026-01-01 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $13.23 | — | — | 2026-04-16 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | WITH UFC | $13.89 | — | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | WITH UFC | $13.89 | — | — | 2026-01-01 | MRF ↗ |
| ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL OutpatientFacility | Wellpoint | NJ Family Care | $14.17 | $970.00 | $206.90 | 2026-03-04 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | $476.00 | $285.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | $476.00 | $285.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | $476.00 | $285.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | $476.00 | $285.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | $79.00 | $47.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | $520.00 | $312.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | $476.00 | $285.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | $476.00 | $285.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | $476.00 | $285.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $15.74 | $520.00 | $312.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | $79.00 | $47.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $15.74 | $476.00 | $285.60 | 2026-01-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | COMMUNITY ELDERCARE [1027] | MEDI-CAL | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | BLUE CROSS [1013] | BLUE CROSS MEDI-CAL UNLISTED IPA [10130011] | $16.04 | $600.00 | $330.00 | 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 | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | UNLISTED MCAL HMO NON-CONTRACT [1049] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $16.04 | $600.00 | $330.00 | 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 | $16.04 | $600.00 | $330.00 | 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 | $16.04 | $600.00 | $330.00 | 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 | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | LA Care Health | Medi-cal | $16.04 | — | — | 2026-03-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | HEALTH PLAN OF SAN JOAQUIN [2032] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | BLUE CROSS [1013] | MEDI-CAL | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | CAREMORE [2028] | MEDI-CAL | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | BRAND NEW DAY [1089] | MEDI-CAL | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | BLUE CROSS [1013] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $16.04 | $600.00 | $330.00 | 2026-04-01 | 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) | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MEDICAID - OUT OF STATE [1047] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | FEDERAL PRISON [1031] | FEDERAL PRISON [10310001] | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | XIMED [2016] | MEDI-CAL | $16.04 | $600.00 | $330.00 | 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 | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | FEDERAL PRISON [1031] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $16.04 | $600.00 | $330.00 | 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 | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | CALIFORNIA DEPARTMENT OF PUBLIC HEALTH [1237] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $16.04 | $600.00 | $330.00 | 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 | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | ALTERNATE MEDI-CAL [2001] | MEDI-CAL | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | SAN DIEGO COUNTY [1071] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | STATE OF CALIFORNIA [1082] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | CMS - COUNTY MEDICAL SERVICES [1025] | COUNTY MEDICAL SERVICES | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | COMMUNITY CARE IPA [1131] | Community Care IPA Medi-Cal Managed Care | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| Riverside Community Hospital Outpatient | Molina | MCD | $16.04 | — | — | 2026-03-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | VANTAGE [1092] | PROSPECT VANTAGE MEDICAL GROUP MEDI-CAL | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Community Care IPA | All Commercial Products | $16.04 | $631.00 | — | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | MEDI-CAL [1048] | MEDI-CAL | $16.04 | $600.00 | $330.00 | 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 | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Both | KERN HEALTH SYSTEMS [2033] | UCSD HB NON-CONTRACTED MEDI-CAL MANAGED CARE | $16.04 | $600.00 | $330.00 | 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 | $16.04 | $600.00 | $330.00 | 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 | $16.04 | $600.00 | $330.00 | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | AllCare IPA | All Commercial Products | $16.04 | $631.00 | — | 2026-04-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | CHIP | $16.31 | — | — | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | Amerigroup | MCD | $16.31 | — | — | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | MCD | $16.31 | — | — | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Amerigroup | MCD | $16.31 | — | — | 2026-03-01 | MRF ↗ |
| HEART HOSPITAL OF AUSTIN Outpatient | Amerigroup | MCD | $16.31 | — | — | 2026-03-01 | MRF ↗ |
| HEART HOSPITAL OF AUSTIN Outpatient | Amerigroup | CHIP | $16.31 | — | — | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | CHIP | $16.31 | — | — | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Amerigroup | MCD | $16.31 | — | — | 2026-03-01 | MRF ↗ |
| ST DAVID'S MEDICAL CENTER Outpatient | Amerigroup | MCD | $16.31 | — | — | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | Amerigroup | CHIP | $16.31 | — | — | 2026-03-01 | MRF ↗ |
| St. David's Georgetown Hospital Outpatient | Amerigroup | CHIP | $16.31 | — | — | 2026-03-01 | MRF ↗ |
| ST DAVID'S MEDICAL CENTER Outpatient | Amerigroup | CHIP | $16.31 | — | — | 2026-03-01 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $16.45 | $253.00 | $164.45 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $16.45 | $253.00 | $164.45 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $16.45 | $253.00 | $164.45 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $16.45 | $253.00 | $164.45 | 2026-03-12 | MRF ↗ |
| PROVIDENCE MEDICAL CENTER Outpatient | Non-contracted Medicaid | Non-Contracted Medicaid | $17.22 | $756.37 | $180.00 | 2024-12-19 | MRF ↗ |
| PROVIDENCE MEDICAL CENTER Outpatient | UHC | UHC Medicaid | $17.22 | $756.37 | $180.00 | 2024-12-19 | MRF ↗ |
| WAMEGO HEALTH CENTER Outpatient | KANCARE UHC | 859_MEDICAID ADVANTAGE KANCARE UNITED HEALTH CARE 20250701 | $17.22 | — | — | 2026-01-01 | MRF ↗ |
| PROVIDENCE MEDICAL CENTER Outpatient | Traditional Medicaid | Traditional Medicaid | $17.22 | $756.37 | $180.00 | 2024-12-19 | MRF ↗ |
| SAINT JOHN HOSPITAL Outpatient | UHC | UHC Medicaid | $17.22 | $849.86 | $121.00 | 2026-03-17 | MRF ↗ |
| LEE'S SUMMIT MEDICAL CENTER Outpatient | United | KSMGMCD | $17.22 | — | — | 2026-03-01 | MRF ↗ |
| PROVIDENCE MEDICAL CENTER Outpatient | Non-contracted Medicaid | Non-Contracted Medicaid | $17.22 | $756.37 | $180.00 | 2024-12-19 | MRF ↗ |
| SAINT JOHN HOSPITAL Outpatient | UHC | UHC Medicaid | $17.22 | $756.37 | $180.00 | 2024-12-19 | MRF ↗ |
| PROVIDENCE MEDICAL CENTER Outpatient | Traditional Medicaid | Traditional Medicaid | $17.22 | $849.86 | $121.00 | 2026-03-17 | MRF ↗ |
| SAINT JOHN HOSPITAL Outpatient | Non-Contracted Medicaid | Non-Contracted Medicaid | $17.22 | $756.37 | $180.00 | 2024-12-19 | MRF ↗ |
| CENTERPOINT MEDICAL CENTER Outpatient | United | KSMGMCD | $17.22 | — | — | 2026-03-01 | MRF ↗ |
| BELTON REGIONAL MEDICAL CENTER Outpatient | United | KSMGMCD | $17.22 | — | — | 2026-03-01 | MRF ↗ |
| PROVIDENCE MEDICAL CENTER Outpatient | UHC | UHC Medicaid | $17.22 | $849.86 | $121.00 | 2026-03-17 | MRF ↗ |
| LABETTE HEALTH OutpatientFacility | UHCCP | Managed Medicaid | $17.22 | — | — | 2025-06-28 | MRF ↗ |
| PROVIDENCE MEDICAL CENTER Outpatient | UHC | UHC Medicaid | $17.22 | $756.37 | $180.00 | 2024-12-19 | MRF ↗ |
| SAINT JOHN HOSPITAL Outpatient | Traditional Medicaid | Traditional Medicaid | $17.22 | $849.86 | $121.00 | 2026-03-17 | MRF ↗ |
| SAINT JOHN HOSPITAL Outpatient | Traditional Medicaid | Traditional Medicaid | $17.22 | $756.37 | $180.00 | 2024-12-19 | MRF ↗ |
| Research Medical Center Outpatient | United | KSMGMCD | $17.22 | — | — | 2026-03-01 | MRF ↗ |
| MOSAIC LIFE CARE AT ST JOSEPH OutpatientFacility | Aetna of Kansas | Managed Medicaid | $17.22 | — | — | 2025-09-26 | MRF ↗ |
| LABETTE HEALTH OutpatientFacility | UHCCP | Managed Medicaid | $17.22 | — | — | 2025-06-28 | MRF ↗ |
| PROVIDENCE MEDICAL CENTER Outpatient | Traditional Medicaid | Traditional Medicaid | $17.22 | $756.37 | $180.00 | 2024-12-19 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | United Healthcare | MGMCD | $17.22 | — | — | 2026-03-01 | MRF ↗ |
| MOSAIC LIFE CARE AT ST JOSEPH OutpatientFacility | Sunflower of Kansas | Managed Medicaid | $17.22 | — | — | 2025-09-26 | MRF ↗ |
| MOSAIC LIFE CARE AT ST JOSEPH OutpatientFacility | United Healthcare of Kansas | Managed Medicaid | $17.22 | — | — | 2025-09-26 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Bcbs - Western Ny | Medicaid Managed Care Plan | $17.47 | — | — | 2026-04-01 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | AETNA | MEDICARE | $17.52 | $155.00 | $23.25 | 2025-12-23 | MRF ↗ |
| LEE'S SUMMIT MEDICAL CENTER Outpatient | HealthyBlue | MGMCD | $17.56 | — | — | 2026-03-01 | MRF ↗ |
| PROVIDENCE MEDICAL CENTER Outpatient | Celtic | Celtic Medicaid | $17.56 | $756.37 | $180.00 | 2024-12-19 | MRF ↗ |
| PROVIDENCE MEDICAL CENTER Outpatient | Aetna | Aetna Medicaid | $17.56 | $756.37 | $180.00 | 2024-12-19 | MRF ↗ |
| PROVIDENCE MEDICAL CENTER Outpatient | Aetna | Aetna Medicaid | $17.56 | $756.37 | $180.00 | 2024-12-19 | MRF ↗ |
| PROVIDENCE MEDICAL CENTER Outpatient | Celtic | Celtic Medicaid | $17.56 | $756.37 | $180.00 | 2024-12-19 | 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.