94618 — Pulmonary Stress Testing
Cite this view
HANK Price Transparency. (n.d.). PULMONARY STRESS TESTING (CPT 94618) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/94618?code_type=CPT
“PULMONARY STRESS TESTING (CPT 94618) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/94618?code_type=CPT. Accessed .
“PULMONARY STRESS TESTING (CPT 94618) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/94618?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $120–$348 (25th–75th percentile) across 3,367 hospitals · 10,002 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 94618 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
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.
The middle 50% of negotiated facility rates for this procedure, measured across 3,367 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. | $185 |
| Physician fee Estimate national typical Medicare $37 × 1.22 commercial. | $45 |
| Likely subtotal | $230 |
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 $120–$348.
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 |
|---|---|---|---|---|---|---|---|
| NEWMAN MEMORIAL HOSPITAL Both | United Healthcare | Default | — | $0.01 | $0.01 | 2026-07-10 | MRF ↗ |
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | — | — | — | $1,032.51 | $516.26 | 2024-12-15 | MRF ↗ |
| NEWMAN MEMORIAL HOSPITAL Both | Medicare A OK JH | Default | — | $0.01 | $0.01 | 2026-07-10 | MRF ↗ |
| NEWMAN MEMORIAL HOSPITAL Both | United Healthcare | Default | — | $0.01 | $0.01 | 2026-07-10 | MRF ↗ |
| NEWMAN MEMORIAL HOSPITAL Both | Blue Cross Blue Shield of OK | All Plans | — | $0.01 | $0.01 | 2026-07-10 | MRF ↗ |
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | — | — | — | $1,032.51 | $516.26 | 2024-12-15 | MRF ↗ |
| NEWMAN MEMORIAL HOSPITAL Both | Medicare A OK JH | Default | — | $0.01 | $0.01 | 2026-07-10 | MRF ↗ |
| GIFFORD MEDICAL CENTER InpatientFacility | Blue Cross Blue Shield of Vermont | Managed Care | $0.03 | $0.03 | $0.01 | 2026-02-12 | MRF ↗ |
| GIFFORD MEDICAL CENTER InpatientFacility | Aetna of VT | Commercial | $0.03 | $0.03 | $0.01 | 2025-10-28 | MRF ↗ |
| GIFFORD MEDICAL CENTER InpatientFacility | Multiplan | Commercial | $0.03 | $0.03 | $0.01 | 2025-10-28 | MRF ↗ |
| GIFFORD MEDICAL CENTER InpatientFacility | MVP Health Care of NY | Commercial | $0.03 | $0.03 | $0.01 | 2025-10-28 | MRF ↗ |
| GIFFORD MEDICAL CENTER InpatientFacility | Blue Cross Blue Shield of Vermont | Managed Care | $0.03 | $0.03 | $0.01 | 2025-10-28 | MRF ↗ |
| GIFFORD MEDICAL CENTER InpatientFacility | MVP Health Care of NY | Commercial | $0.03 | $0.03 | $0.01 | 2026-02-12 | MRF ↗ |
| GIFFORD MEDICAL CENTER InpatientFacility | United Healthcare | Commercial | $0.03 | $0.03 | $0.01 | 2026-02-12 | MRF ↗ |
| GIFFORD MEDICAL CENTER InpatientFacility | Blue Cross Blue Shield of Vermont | Commercial | $0.03 | $0.03 | $0.01 | 2025-10-28 | MRF ↗ |
| GIFFORD MEDICAL CENTER InpatientFacility | Aetna of VT | Commercial | $0.03 | $0.03 | $0.01 | 2026-02-12 | MRF ↗ |
| GIFFORD MEDICAL CENTER OutpatientFacility | Blue Cross Blue Shield of New Hampshire | SHOP Off Exchange | $0.03 | $0.03 | $0.01 | 2026-02-12 | MRF ↗ |
| GIFFORD MEDICAL CENTER OutpatientFacility | Blue Cross Blue Shield of New Hampshire | Commercial | $0.03 | $0.03 | $0.01 | 2026-02-12 | MRF ↗ |
| GIFFORD MEDICAL CENTER InpatientFacility | Blue Cross Blue Shield of Vermont | Commercial | $0.03 | $0.03 | $0.01 | 2026-02-12 | MRF ↗ |
| GIFFORD MEDICAL CENTER OutpatientFacility | Blue Cross Blue Shield of New Hampshire | SHOP Off Exchange | $0.03 | $0.03 | $0.01 | 2025-10-28 | MRF ↗ |
| GIFFORD MEDICAL CENTER InpatientFacility | United Healthcare | Commercial | $0.03 | $0.03 | $0.01 | 2025-10-28 | MRF ↗ |
| GIFFORD MEDICAL CENTER InpatientFacility | Multiplan | Commercial | $0.03 | $0.03 | $0.01 | 2026-02-12 | MRF ↗ |
| GIFFORD MEDICAL CENTER OutpatientFacility | Blue Cross Blue Shield of New Hampshire | Commercial | $0.03 | $0.03 | $0.01 | 2025-10-28 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | $720.00 | $540.00 | 2026-09-01 | MRF ↗ |
| HANCOCK COUNTY HEALTH SYSTEM Outpatient | WELLMARK HMO-ALL OTHER PLANS | WELLMARK HMO-ALL OTHER PLANS | $0.26 | $343.00 | $257.25 | 2026-03-26 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | $720.00 | $540.00 | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Healthplan Medicaid | Wv Medicaid | $0.33 | — | — | 2026-05-06 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | $720.00 | $540.00 | 2026-09-01 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Wellpoint | Wv Medicaid | $0.35 | — | — | 2026-05-06 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL BothFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.49 | $779.00 | $584.25 | 2026-09-01 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.51 | $137.00 | $130.15 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.51 | $137.00 | $130.15 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $0.51 | $137.00 | $130.15 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $0.52 | $137.00 | $130.15 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $0.53 | $137.00 | $130.15 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $0.55 | $137.00 | $130.15 | 2026-02-20 | MRF ↗ |
| James Cancer Hospital & Solove Research Institute Outpatient | Cigna | Cigna - Transplant | $0.62 | $411.00 | — | 2026-07-01 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $0.65 | $54.00 | $10.26 | 2026-08-02 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | HUMANA | HUMANA MEDICARE- MIDTOWN IMAGING | $0.72 | — | — | 2026-09-01 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $0.73 | $440.00 | $176.00 | 2026-07-18 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $0.73 | $400.00 | $160.00 | 2026-07-18 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | HUMANA | HUMANA- MIDTOWN IMAGING | $0.82 | — | — | 2026-09-01 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $0.85 | $82.05 | $82.05 | 2026-04-24 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $0.97 | — | — | 2026-07-15 | MRF ↗ |
| DECATUR MEMORIAL HOSPITAL Outpatient | Hfn | Hfn Workers Compensation | $0.99 | $270.00 | $270.00 | 2026-07-15 | MRF ↗ |
| DECATUR MEMORIAL HOSPITAL Outpatient | Commercial Workers Compensation | Commercial Workers Compensation | $0.99 | $270.00 | $270.00 | 2026-07-15 | MRF ↗ |
| JACKSONVILLE MEMORIAL HOSPITAL Outpatient | Commercial Workers Compensation | Commercial Workers Compensation | $0.99 | $557.00 | $557.00 | 2026-07-15 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | $483.00 | $362.25 | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | $483.00 | $362.25 | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | $483.00 | $362.25 | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | $483.00 | $362.25 | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | $483.00 | $362.25 | 2026-05-20 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $1,074.29 | $698.29 | 2025-11-26 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | $483.00 | $362.25 | 2026-05-20 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | SCAN Health Plan | Medicare Advantage | — | $1,074.29 | $698.29 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $775.00 | $635.50 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $775.00 | $635.50 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | Covered | — | $775.00 | $635.50 | 2025-11-26 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | $2,638.00 | $1,978.50 | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | $683.00 | $512.25 | 2026-09-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | HMO | — | $775.00 | $635.50 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $775.00 | $635.50 | 2025-11-26 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | $2,638.00 | $1,978.50 | 2026-09-02 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | $2,638.00 | $1,978.50 | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | $645.00 | $483.75 | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | $2,638.00 | $1,978.50 | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | $683.00 | $512.25 | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | $2,638.00 | $1,978.50 | 2026-09-02 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | $2,638.00 | $1,978.50 | 2026-09-02 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $775.00 | $635.50 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | United Healthcare | POS | — | $775.00 | $635.50 | 2025-11-26 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Medicaid | Medicaid | $1.00 | $558.00 | $279.00 | 2026-07-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER BothFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | $720.00 | $540.00 | 2026-09-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | United Healthcare | HMO | — | $775.00 | $635.50 | 2025-11-26 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | $645.00 | $483.75 | 2026-09-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $775.00 | $635.50 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | Health Net of California, Inc. | HMO | — | $775.00 | $635.50 | 2025-11-26 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $1.01 | $217.00 | $80.29 | 2026-03-31 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $1.07 | $558.00 | $279.00 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $1.10 | $558.00 | $279.00 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $1.18 | $558.00 | $279.00 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Jefferson Health Plan | Jefferson Health Plan - Managed Medicaid | $1.20 | $558.00 | $279.00 | 2026-07-01 | MRF ↗ |
| SPRINGHILL MEDICAL CENTER Outpatient | Tricare Tdefic | Standard | — | $360.85 | $306.72 | 2026-07-15 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - Managed Medicaid | $1.47 | $558.00 | $279.00 | 2026-07-01 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.62 | $331.00 | $314.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.62 | $331.00 | $314.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.66 | $331.00 | $314.45 | 2026-02-20 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $1.68 | $935.00 | $127.48 | 2024-12-31 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.72 | $331.00 | $314.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $1.79 | $331.00 | $314.45 | 2026-02-20 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $1.90 | $245.00 | $245.00 | 2026-02-13 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Serenity Pace | Medicare Managed Care | $2.10 | $419.00 | $419.00 | 2026-06-05 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - CHIP - Managed Medicare | $2.50 | $558.00 | $279.00 | 2026-07-01 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.69 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.71 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.71 | — | — | 2026-03-18 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Wellpoint | All Commercial | $2.72 | $419.00 | $419.00 | 2026-06-05 | MRF ↗ |
| FLUSHING HOSPITAL MEDICAL CENTER Outpatient | United Healthcare | Community Plan | $2.90 | $222.00 | $222.00 | 2026-07-15 | MRF ↗ |
| MOUNT SINAI SOUTH NASSAU OutpatientFacility | United Healthcare | United Healthcare - Essential Plan - Snch | $2.90 | — | — | 2026-04-01 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | United Healthcare | United Medicaid Schip/Child - Brook | $2.90 | — | — | 2026-04-01 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | United Healthcare | United Healthcare - Essential Plan - Msq | $2.90 | — | — | 2026-04-01 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | United Healthcare | United Medicaid Family - Msq | $2.90 | — | — | 2026-04-01 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | United Healthcare | United Medicaid Family - Brook | $2.90 | — | — | 2026-04-01 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | United Healthcare | United Medicaid Schip/Child - Msq | $2.90 | — | — | 2026-04-01 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | United Healthcare | United Healthcare - Essential Plan - Brook | $2.90 | — | — | 2026-04-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | EXCELLUS ESSENTIAL 3-4 170604, EXCELLUS ESSENTIAL 1-2 200-250 2201, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS HLTHY NY 220110 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| CANTON-POTSDAM HOSPITAL Outpatient | FIDELIS EXCHANGE [157] | FIDELIS ESSENTIAL 1&2|FIDELIS ESSENTIAL 3&4 | — | $265.81 | $172.78 | 2024-12-30 | MRF ↗ |
| CANTON-POTSDAM HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN|UHC COMMUNITY MEDICAID DENTAL|UHC ESSENTIAL 1&2|UHC CHPS|UHC ESSENTIAL 3&4 | — | $265.81 | $172.78 | 2024-12-30 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 5143 | HIGHMARK BCBS ESSENTIAL 1-2 200-250 5143 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| CANTON-POTSDAM HOSPITAL Outpatient | FIDELIS CARE NEW YORK [112] | FIDELIS CARE NEW YORK|FIDELIS FHP|FIDELIS CHP | — | $265.81 | $172.78 | 2024-12-30 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| CANTON-POTSDAM HOSPITAL Outpatient | FIDELIS CARE NEW YORK [112] | FIDELIS CARE NEW YORK|FIDELIS FHP|FIDELIS CHP | $2.93 | $265.81 | $172.78 | 2024-12-30 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | BLUE CHOICE OPTION MEDICAID 170601 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Multiplan | All Commercial Plans | $2.93 | $419.00 | $419.00 | 2026-06-05 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOC MEDICAID 1710 | INDEPENDENT HEALTH MEDICAID 171001, INDEPENDENT HEALTH CHILD HEALTH PLUS 515604 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | BLUE CHOICE OPTION MEDICAID 170601 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 5143 | HIGHMARK BCBS ESSENTIAL 1-2 200-250 5143 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL 3-4 171602, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOC MEDICAID 1710 | INDEPENDENT HEALTH MEDICAID 171001, INDEPENDENT HEALTH CHILD HEALTH PLUS 515604 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 5143 | HIGHMARK BCBS ESSENTIAL 1-2 200-250 5143 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | EXCELLUS ESSENTIAL 3-4 170604, EXCELLUS ESSENTIAL 1-2 200-250 2201, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS HLTHY NY 220110 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 5143 | HIGHMARK BCBS ESSENTIAL 1-2 200-250 5143 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL 3-4 171602, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | EXCELLUS ESSENTIAL 3-4 170604, EXCELLUS ESSENTIAL 1-2 200-250 2201, EXCELLUS CHILD HEALTH PLUS 220108, EXCELLUS HLTHY NY 220110 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | BLUE CHOICE OPTION MEDICAID 170601 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOC MEDICAID 1710 | INDEPENDENT HEALTH MEDICAID 171001, INDEPENDENT HEALTH CHILD HEALTH PLUS 515604 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNIVERA HEALTHCARE 1706 | UNIVERA MEDICAID 170607, UNIVERA ESSENTIAL 3-4 170605, UNIVERA ESSENTIAL 1-2 200-250 2201, UNIVERA CHILD HEALTH PLUS 220118, UNIVERA HLTHY NY 220112 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Mohawk Valley Physician's Health Plan (MVP) | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Cape Vincent Correctional Facility | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOC MEDICAID 1710 | INDEPENDENT HEALTH MEDICAID 171001, INDEPENDENT HEALTH CHILD HEALTH PLUS 515604 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL 3-4 171602, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Blue Cross Family Health Plus | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | United Healthcare Well 4 Me | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | United Healthcare Essential Plan | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNIVERA HEALTHCARE 1706 | UNIVERA MEDICAID 170607, UNIVERA ESSENTIAL 3-4 170605, UNIVERA ESSENTIAL 1-2 200-250 2201, UNIVERA CHILD HEALTH PLUS 220118, UNIVERA HLTHY NY 220112 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | United Healthcare Child Health Plus | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Fidelis Ambetter | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | New York State Office of Victim Services | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Fidelis Child Health Plus | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOC MEDICAID 1710 | INDEPENDENT HEALTH MEDICAID 171001, INDEPENDENT HEALTH CHILD HEALTH PLUS 515604 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Fidelis Essential Plan | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 5143 | HIGHMARK BCBS ESSENTIAL 1-2 200-250 5143 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL 3-4 171602, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| The Burdett Care Center BothFacility | MVP MEDICAID ADVANTAGE | MVP MEDICAID | $2.93 | $365.00 | $237.25 | 2026-03-31 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | United Healthcare | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Blue Cross Child Health Plus | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Mohawk Valley Physician's Health Plan (MVP) HARP | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Blue Cross HMO | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Fidelis Medicaid | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Blue Cross Essential | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 1716 | UNITED HEALTHCARE MEDICAID 171601, UNITED HEALTHCARE ESSENTIAL 3-4 171602, UNITED HEALTHCARE CHILD HEALTH PLUS 515813 | $2.93 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Capital District Physicians' Health Plan (CDPHP) | Managed Medicaid | $2.93 | $105.04 | $105.04 | 2025-06-20 | MRF ↗ |
| KENMORE MERCY HOSPITAL OutpatientFacility | UNITED HEALTHCARE ESSENTIAL [100253] | UHC ESSENTIAL 3 AND 4 [10025302] | $2.99 | $262.00 | $262.00 | 2025-02-25 | MRF ↗ |
| KENMORE MERCY HOSPITAL OutpatientFacility | UNITED HEALTHCARE MEDICAID [350101] | UHC MEDICAID [35010101] | $2.99 | $262.00 | $262.00 | 2025-02-25 | MRF ↗ |
| MOUNT ST. MARY'S HOSPITAL & HEALTH CENTER OutpatientFacility | UNITED HEALTHCARE ESSENTIAL [100253] | UHC ESSENTIAL 3 AND 4 [10025302] | $2.99 | $262.00 | $262.00 | 2025-02-25 | MRF ↗ |
| MERCY HOSPITAL OF BUFFALO BothFacility | UNITED HEALTHCARE MEDICAID [350101] | UHC MEDICAID [35010101] | $2.99 | $343.00 | $343.00 | 2026-04-01 | MRF ↗ |
| MOUNT ST. MARY'S HOSPITAL & HEALTH CENTER OutpatientFacility | UNITED HEALTHCARE MEDICAID [350101] | UHC MEDICAID [35010101] | $2.99 | $262.00 | $262.00 | 2025-02-25 | MRF ↗ |
| KENMORE MERCY HOSPITAL BothFacility | UNITED HEALTHCARE MEDICAID [350101] | UHC MEDICAID [35010101] | $2.99 | $343.00 | $343.00 | 2026-04-01 | MRF ↗ |
| UNITED HEALTH SERVICES HOSPITALS, INC OutpatientFacility | United Healthcare | United Healthcare Child Health Plus | $3.02 | — | — | 2026-04-01 | MRF ↗ |
| CHENANGO MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | United Healthcare Medicaid Managed Care Plan | $3.02 | — | — | 2026-04-01 | MRF ↗ |
| UNITED HEALTH SERVICES HOSPITALS, INC OutpatientFacility | United Healthcare | United Healthcare Medicaid Managed Care Plan | $3.02 | — | — | 2026-04-01 | MRF ↗ |
| CHENANGO MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | United Healthcare Child Health Plus | $3.02 | — | — | 2026-04-01 | MRF ↗ |
| CHENANGO MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | United Healthcare Child Health Plus | $3.02 | — | — | 2026-04-01 | MRF ↗ |
| CHENANGO MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | United Healthcare Medicaid Managed Care Plan | $3.02 | — | — | 2026-04-01 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $3.09 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $3.10 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $3.10 | — | — | 2026-03-18 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | United Healthcare | All Commercial Plans | $3.10 | $419.00 | $419.00 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | HMO Commercial | $3.21 | $419.00 | $419.00 | 2026-06-05 | MRF ↗ |
| JAMAICA HOSPITAL MEDICAL CENTER Outpatient | United Healthcare | Community Plan | $3.22 | $222.00 | $222.00 | 2026-07-15 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | PPO Commercial | $3.23 | $419.00 | $419.00 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | Indemnity Commercial | $3.23 | $419.00 | $419.00 | 2026-06-05 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $3.31 | $165.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $3.31 | $165.50 | — | 2026-03-31 | 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.