93624 — Ep F-up Study Pacg&rec
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). EP F-UP STUDY PACG&REC (CPT 93624) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/93624?code_type=CPT
MLA (9th ed.)
“EP F-UP STUDY PACG&REC (CPT 93624) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/93624?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“EP F-UP STUDY PACG&REC (CPT 93624) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/93624?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $4,000–$11,815 (25th–75th percentile) across 1,951 hospitals · 5,190 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 93624 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | — | — | — | $33,748.17 | $16,874.08 | 2024-12-15 | MRF ↗ |
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | — | — | — | $33,748.17 | $16,874.08 | 2024-12-15 | MRF ↗ |
| COREWELL HEALTH WAYNE HOSPITAL OutpatientFacility | Bcbs | Exchange | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| COREWELL HEALTH TRENTON HOSPITAL OutpatientFacility | Bcbs | All Commercial Plans | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| BEAUMONT HOSPITAL - TAYLOR OutpatientFacility | Bcbs | Exchange | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| BEAUMONT HOSPITAL - DEARBORN OutpatientFacility | Bcbs | All Commercial Plans | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| BEAUMONT HOSPITAL - DEARBORN OutpatientFacility | Bcbs | Exchange | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| COREWELL HEALTH WAYNE HOSPITAL OutpatientFacility | Bcbs | All Commercial Plans | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| BEAUMONT HOSPITAL, TROY OutpatientFacility | Bcbs | All Commercial Plans | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| BEAUMONT HOSPITAL, TROY OutpatientFacility | Bcbs | Exchange | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| BEAUMONT HOSPITAL - TAYLOR OutpatientFacility | Bcbs | All Commercial Plans | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| COREWELL HEALTH TRENTON HOSPITAL OutpatientFacility | Bcbs | Exchange | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| BEAUMONT HOSPITAL - FARMINGTON HILLS OutpatientFacility | Bcbs | Exchange | $0.04 | — | — | 2026-04-01 | MRF ↗ |
| BEAUMONT HOSPITAL - FARMINGTON HILLS OutpatientFacility | Bcbs | All Commercial Plans | $0.04 | — | — | 2026-04-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | $15,659.00 | $11,744.25 | 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 BothFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | $15,659.00 | $11,744.25 | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | $15,659.00 | $11,744.25 | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL BothFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.49 | $46,538.00 | $34,903.50 | 2026-09-01 | MRF ↗ |
| James Cancer Hospital & Solove Research Institute Outpatient | Cigna | Cigna - Transplant | $0.62 | $11,529.00 | — | 2026-07-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | HUMANA | HUMANA MEDICARE- MIDTOWN IMAGING | $0.72 | $15,659.00 | $11,744.25 | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | HUMANA | HUMANA- MIDTOWN IMAGING | $0.82 | $15,659.00 | $11,744.25 | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AETNA | AETNA WORKERS COMP | $0.95 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | AETNA | AETNA WORKERS COMP | $0.95 | $15,659.00 | $11,744.25 | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE COMMERCIAL | $1.00 | $9,928.00 | $7,446.00 | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE - OPTIONS | $1.00 | $9,124.00 | $6,843.00 | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS PPO | $1.00 | $46,538.00 | $34,903.50 | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | $9,928.00 | $7,446.00 | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW BUSINESS | $1.00 | $25,881.00 | $19,410.75 | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | $25,881.00 | $19,410.75 | 2026-05-20 | 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 BothFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | $9,928.00 | $7,446.00 | 2026-09-02 | MRF ↗ |
| PIEDMONT MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE - MEDICAID | $1.00 | $21,772.00 | $16,329.00 | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | $25,881.00 | $19,410.75 | 2026-05-20 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA HMO | $1.00 | $15,659.00 | $11,744.25 | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | $21,772.00 | $16,329.00 | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | $25,881.00 | $19,410.75 | 2026-05-20 | MRF ↗ |
| SIERRA MEDICAL CENTER BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | $9,124.00 | $6,843.00 | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | $25,881.00 | $19,410.75 | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | $25,881.00 | $19,410.75 | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | $25,881.00 | $19,410.75 | 2026-05-20 | MRF ↗ |
| PIEDMONT MEDICAL CENTER BothFacility | HUMANA | HUMANA MEDICAID | $1.00 | $21,772.00 | $16,329.00 | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE CHARTER | $1.00 | $9,124.00 | $6,843.00 | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | $9,124.00 | $6,843.00 | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | $9,124.00 | $6,843.00 | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA HMO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA PPO | $1.00 | $15,659.00 | $11,744.25 | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA EXCHANGE | $1.00 | $15,659.00 | $11,744.25 | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | $25,881.00 | $19,410.75 | 2026-05-20 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | $9,928.00 | $7,446.00 | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE - OPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER BothFacility | MOLINA | MOLINA MANAGED MEDICAID PROGRAM | $1.00 | $21,772.00 | $16,329.00 | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NON OPTIONS PPO | $1.00 | $21,772.00 | $16,329.00 | 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 BothFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | $9,928.00 | $7,446.00 | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE COMMERCIAL | $1.00 | $25,881.00 | $19,410.75 | 2026-05-20 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | $9,928.00 | $7,446.00 | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE CHARTER | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | $9,928.00 | $7,446.00 | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | $25,881.00 | $19,410.75 | 2026-05-20 | MRF ↗ |
| SIERRA MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $1.00 | $9,124.00 | $6,843.00 | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NON OPTIONS | $1.00 | $46,538.00 | $34,903.50 | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | $9,928.00 | $7,446.00 | 2026-09-02 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | $46,538.00 | $34,903.50 | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW BUSINESS | $1.00 | $9,928.00 | $7,446.00 | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | $9,124.00 | $6,843.00 | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | $9,928.00 | $7,446.00 | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS PPO | $1.00 | $21,772.00 | $16,329.00 | 2026-09-01 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $3.67 | $991.00 | $941.45 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $3.67 | $991.00 | $941.45 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $3.67 | $991.00 | $941.45 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $3.77 | $991.00 | $941.45 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $3.86 | $991.00 | $941.45 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $3.96 | $991.00 | $941.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $4.86 | $991.00 | $941.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $4.86 | $991.00 | $941.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $4.96 | $991.00 | $941.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $5.15 | $991.00 | $941.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $5.35 | $991.00 | $941.45 | 2026-02-20 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $8.95 | — | — | 2026-07-15 | MRF ↗ |
| DECATUR MEMORIAL HOSPITAL Outpatient | Commercial Workers Compensation | Commercial Workers Compensation | $15.18 | $9,102.00 | $9,102.00 | 2026-07-15 | MRF ↗ |
| JACKSONVILLE MEMORIAL HOSPITAL Outpatient | Commercial Workers Compensation | Commercial Workers Compensation | $15.18 | $9,102.00 | $9,102.00 | 2026-07-15 | MRF ↗ |
| DECATUR MEMORIAL HOSPITAL Outpatient | Hfn | Hfn Workers Compensation | $15.18 | $9,102.00 | $9,102.00 | 2026-07-15 | MRF ↗ |
| ST JOE MERCY HOSPITAL SYSTEM LIVONIA OutpatientFacility | VACCN United | Veterans Affairs | $20.50 | $10,402.00 | $6,761.30 | 2025-01-01 | MRF ↗ |
| ST JOE MERCY HOSPITAL SYSTEM LIVONIA OutpatientFacility | VACCN United | Veterans Affairs | $20.50 | $10,402.00 | $6,761.30 | 2025-01-01 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Aetna | Aetna - Hmo/Pos/Ppo | $31.45 | — | — | 2026-07-18 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | $13,975.00 | $10,481.25 | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | $13,975.00 | $10,481.25 | 2024-12-08 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $35.64 | $264.00 | $198.00 | 2026-01-16 | MRF ↗ |
| Centra Specialty Hospital Both | Anthem | Healthkeepers Medicaid Plans | $39.81 | $13,564.00 | $4,476.12 | 2026-07-15 | MRF ↗ |
| Centra Specialty Hospital Both | Aetna | Better Health Medicaid Plans | $39.81 | $13,564.00 | $4,476.12 | 2026-07-15 | MRF ↗ |
| CENTRA HEALTH - LYNCHBURG GEN HOSPITAL Both | Aetna | Better Health Medicaid Plans | $39.81 | $13,564.00 | $4,476.12 | 2026-09-21 | MRF ↗ |
| CENTRA HEALTH - LYNCHBURG GEN HOSPITAL Both | Anthem | Healthkeepers Medicaid Plans | $39.81 | $13,564.00 | $4,476.12 | 2026-09-21 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan | $40.08 | — | — | 2026-03-01 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan – Hmo | $40.08 | — | — | 2026-03-01 | MRF ↗ |
| Centra Specialty Hospital Both | Sentara Medicaid | — | $40.21 | $13,564.00 | $4,476.12 | 2026-07-15 | MRF ↗ |
| CENTRA HEALTH - LYNCHBURG GEN HOSPITAL Both | Sentara Medicaid | — | $40.21 | $13,564.00 | $4,476.12 | 2026-09-21 | MRF ↗ |
| Centra Specialty Hospital Both | United Healthcare | Medicaid | $40.61 | $13,564.00 | $4,476.12 | 2026-07-15 | MRF ↗ |
| CENTRA HEALTH - LYNCHBURG GEN HOSPITAL Both | United Healthcare | Medicaid | $40.61 | $13,564.00 | $4,476.12 | 2026-09-21 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | Aetna | Medicare Advantage Hmo | $40.74 | — | — | 2026-07-15 | MRF ↗ |
| CENTRA HEALTH - LYNCHBURG GEN HOSPITAL Both | Molina | Medicaid | $41.00 | $13,564.00 | $4,476.12 | 2026-09-21 | MRF ↗ |
| Centra Specialty Hospital Both | Molina | Medicaid | $41.00 | $13,564.00 | $4,476.12 | 2026-07-15 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Beacon Health Strategies/Carelon | Wellsense - Nh Managed Medicaid Beh Health - Dhp | $47.29 | — | — | 2026-07-18 | MRF ↗ |
| GILLETTE CHILDRENS SPECIALTY HOSPITAL Outpatient | Ucare | Managed Medicaid | $48.09 | — | — | 2026-07-15 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | $8,814.00 | $5,288.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $48.14 | $8,091.00 | $4,854.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | $8,814.00 | $5,288.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | $8,814.00 | $5,288.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $48.14 | $8,814.00 | $5,288.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | $8,814.00 | $5,288.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $48.14 | $8,091.00 | $4,854.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | $8,814.00 | $5,288.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $48.14 | $8,091.00 | $4,854.60 | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | $8,091.00 | $4,854.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $48.14 | $8,814.00 | $5,288.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | $8,091.00 | $4,854.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.14 | — | — | 2026-01-01 | MRF ↗ |
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