95004 — Perq Tests W/alrgnc Xtrcs
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PERQ TESTS W/ALRGNC XTRCS (CPT 95004) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/95004?code_type=CPT
MLA (9th ed.)
“PERQ TESTS W/ALRGNC XTRCS (CPT 95004) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/95004?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“PERQ TESTS W/ALRGNC XTRCS (CPT 95004) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/95004?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $15–$1,072 (25th–75th percentile) across 1,800 hospitals · 3,394 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 95004 — 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
$15
$368 typical
$1,072
The middle 50% of negotiated facility rates for this procedure, measured across 1,800 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. | $368 |
| Physician fee Estimate national typical Medicare $4 × 1.22 commercial. | $4 |
| Likely subtotal | $373 |
Complete-episode estimate (typical)
~$373
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 $15–$1,072.
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 |
|---|---|---|---|---|---|---|---|
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $0.03 | $9.00 | $8.55 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $0.03 | $9.00 | $8.55 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.03 | $9.00 | $8.55 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.03 | $9.00 | $8.55 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $0.04 | $9.00 | $8.55 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $0.04 | $9.00 | $8.55 | 2026-02-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $0.12 | $12.00 | $2.28 | 2026-08-02 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $0.12 | — | — | 2026-07-15 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $0.24 | $31.00 | $31.00 | 2026-02-13 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid | Medicaid Nhhf | $0.28 | $3.00 | $0.90 | 2026-07-15 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid-Amerihealth | Medicaid-Amerihealth | $0.30 | $3.00 | $0.90 | 2026-07-15 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid | Medicaid-Trad | $0.30 | $3.00 | $0.90 | 2026-07-15 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid | Medicaid-Wellsense | $0.38 | $3.00 | $0.90 | 2026-07-15 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Bcbs Medicare | Medicare | $0.40 | $11.00 | $8.25 | 2026-10-01 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Medicare | Medicare | $0.40 | $11.00 | $8.25 | 2026-10-01 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Vaccn | Medicare | $0.40 | $11.00 | $8.25 | 2026-10-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.49 | — | — | 2026-09-01 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | UNITED | HARP | $0.50 | — | — | 2025-09-05 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | UNITED | Managed Medicaid | $0.50 | — | — | 2025-09-05 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | UNITED | Managed Medicaid | $0.50 | — | — | 2025-09-05 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | UNITED | HARP | $0.50 | — | — | 2025-09-05 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Upmc | Chip | $0.51 | — | — | 2026-07-19 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $0.54 | — | — | 2025-09-05 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $0.54 | — | — | 2025-09-05 | MRF ↗ |
| BITTERROOT HEALTH - DALY HOSPITAL OutpatientFacility | Missoula County Employee Benefits Plan | All | — | — | — | 2026-07-31 | MRF ↗ |
| BITTERROOT HEALTH - DALY HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Montana | Tricare | — | — | — | 2026-07-31 | MRF ↗ |
| BITTERROOT HEALTH - DALY HOSPITAL OutpatientFacility | Pacific Source | All | $0.55 | — | — | 2026-07-31 | MRF ↗ |
| BITTERROOT HEALTH - DALY HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Montana | Traditional | — | — | — | 2026-07-31 | MRF ↗ |
| BITTERROOT HEALTH - DALY HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Montana | Blue Options | — | — | — | 2026-07-31 | MRF ↗ |
| BITTERROOT HEALTH - DALY HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Montana | Medicare Advantage | — | — | — | 2026-07-31 | MRF ↗ |
| BITTERROOT HEALTH - DALY HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Montana | PPO | — | — | — | 2026-07-31 | MRF ↗ |
| BITTERROOT HEALTH - DALY HOSPITAL OutpatientFacility | Mountain CoOp | All | $0.55 | — | — | 2026-07-31 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Upmc | Mcd Advantage | $0.56 | — | — | 2026-07-15 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $0.70 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $0.70 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $0.70 | — | — | 2026-03-18 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Medica | Commercial | — | $3.00 | $2.55 | 2026-02-12 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Medica | MHSO Medicare Cost & Select | — | $3.00 | $2.55 | 2026-02-12 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Medica | Minnesota Health Care Programs | — | $3.00 | $2.55 | 2026-02-12 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Medica | Medicare Advantage | — | $3.00 | $2.55 | 2026-02-12 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Medica | Choice Care | — | $3.00 | $2.55 | 2026-02-12 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Blue Cross Blue Shield | Minnesota Health Care Programs | $0.72 | $3.00 | $2.55 | 2026-02-12 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Harvard | Harvard Mktplace | $0.77 | $3.00 | $0.90 | 2026-07-15 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | $176.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | $138.00 | $82.80 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | $176.00 | $105.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | $138.00 | $82.80 | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $0.95 | $7.00 | $5.25 | 2026-01-16 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Blue Cross Blue Shield | Minnesota Health Care Programs | $0.96 | $4.00 | $3.40 | 2026-02-12 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | SCAN Health Plan | Medicare Advantage | — | $1,663.21 | $1,081.09 | 2025-11-26 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| MASON DISTRICT HOSPITAL Outpatient | Bcbs | Medicare | $1.00 | $5.00 | $4.00 | 2026-08-01 | MRF ↗ |
| MASON DISTRICT HOSPITAL Outpatient | Humana | Medicare | $1.00 | $5.00 | $4.00 | 2026-08-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| MASON DISTRICT HOSPITAL Outpatient | Uhc | Medicare | $1.00 | $5.00 | $4.00 | 2026-08-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | $6,955.00 | $5,216.25 | 2026-09-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Medicaid | Medicaid | $1.00 | $551.00 | $275.50 | 2026-07-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $1,663.21 | $1,081.09 | 2025-11-26 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS BothFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | $6,955.00 | $5,216.25 | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| MASON DISTRICT HOSPITAL Outpatient | Cigna | Medicare | $1.05 | $5.00 | $4.00 | 2026-08-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $1.07 | $551.00 | $275.50 | 2026-07-01 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Sanford Health | Medicare Advantage | — | $5.00 | $3.18 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Medica | Medicare Advantage | — | $5.00 | $3.18 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | UCare | Medicare Advantage | — | $5.00 | $3.18 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | UCare | Managed Medicaid | — | $5.00 | $3.18 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | PrimeWest | Medicare Advantage | — | $5.00 | $3.18 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | PrimeWest | Managed Medicaid | — | $5.00 | $3.18 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Health Partners | Medicare Advantage | — | $5.00 | $3.18 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Medica | Managed Medicaid | — | $5.00 | $3.18 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Triwest Healthcare Alliance | Tricare/Champus | — | $5.00 | $3.18 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Aetna-Allina | Medicare Advantage | — | $5.00 | $3.18 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Blue Cross Blue Shield of Minnesota | Managed Medicaid | $1.08 | $5.00 | $3.18 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Blue Cross Blue Shield of Minnesota | Medicare Advantage | — | $5.00 | $3.18 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | United Healthcare | Medicare Advantage/VACCN | — | $5.00 | $3.18 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | UCare | Commercial | — | $5.00 | $3.18 | 2026-03-17 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Humana | Medicare Advantage | — | $5.00 | $3.18 | 2026-03-17 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $1.10 | $551.00 | $275.50 | 2026-07-01 | MRF ↗ |
| MONTEFIORE ST LUKE'S CORNWALL Outpatient | HealthFirst | Essential Plan 1 & 2 | $1.13 | — | $1,071.95 | 2026-04-01 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | PGT | Medicare|All Plans | $1.15 | $9.00 | $1.58 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | PGT | Medicare|All Plans | $1.15 | $9.00 | $1.58 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AETNA | Medicare|All Plans | $1.17 | $9.00 | $1.58 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | BCBS | Medicare|All Plans | $1.17 | $9.00 | $1.58 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | BCBS | Medicare|All Plans | $1.17 | $9.00 | $1.58 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AETNA | Medicare|All Plans | $1.17 | $9.00 | $1.58 | 2026-02-28 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $1.18 | $551.00 | $275.50 | 2026-07-01 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | UNITED | Medicare|All Plans | $1.20 | $9.00 | $1.58 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | UNITED | Medicare|All Plans | $1.20 | $9.00 | $1.58 | 2026-02-28 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Jefferson Health Plan | Jefferson Health Plan - Managed Medicaid | $1.20 | $551.00 | $275.50 | 2026-07-01 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AMERIVANTAGE | Medicare|All Plans | $1.21 | $9.00 | $1.58 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AMERIVANTAGE | Medicare|All Plans | $1.21 | $9.00 | $1.58 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | SCANHealth | Medicare|All Plans | $1.26 | $9.00 | $1.58 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | SCANHealth | Medicare|All Plans | $1.26 | $9.00 | $1.58 | 2026-02-28 | MRF ↗ |
| SKAGIT VALLEY HOSPITAL Outpatient | Molina | Medicaid | $1.26 | $35.00 | $28.00 | 2026-03-26 | MRF ↗ |
| SKAGIT VALLEY HOSPITAL Outpatient | United Healthcare | Medicaid | $1.26 | $35.00 | $28.00 | 2026-03-26 | MRF ↗ |
| SKAGIT VALLEY HOSPITAL Outpatient | Molina | Medicaid | $1.26 | $35.00 | $28.00 | 2026-03-26 | MRF ↗ |
| SKAGIT VALLEY HOSPITAL Outpatient | United Healthcare | Medicaid | $1.26 | $35.00 | $28.00 | 2026-03-26 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | UNITED BEHAVORIAL HEALTH [120] | UNITED BEHAVORIAL HEALTH [12001] | — | $10.50 | $10.50 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | MULTIPLAN [141] | MULTIPLAN [14101] | — | $10.50 | $10.50 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK MEDICARE [11402] | — | $10.50 | $10.50 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | GENERIC MEDICARE HMO [125] | GENERIC MEDICARE HMO [12505] | — | $10.50 | $10.50 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | UNITED HEALTHCARE [101] | UHC COMMUNITY PLAN [10104] | $1.34 | $10.50 | $10.50 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | GENERIC CARRIER [107] | COMMERCIAL [10701] | — | $10.50 | $10.50 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE [10301] | — | $10.50 | $10.50 | 2024-12-30 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Upmc | All Commercial Plans | $1.34 | — | — | 2026-04-01 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Inpatient | HIGHMARK [114] | HIGHMARK [11401] | — | $10.50 | $10.50 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | EMBLEM GHI [113] | EMBLEM GHI [11301] | — | $10.50 | $10.50 | 2024-12-30 | MRF ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | HIGHMARK [114] | HIGHMARK ESSENTIALS [11404] | — | $10.50 | $10.50 | 2024-12-30 | MRF ↗ |
| GRITMAN MEDICAL CENTER OutpatientFacility | Molina of ID | Medicaid Advantage | $1.35 | — | — | 2026-08-19 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Upmc | Commercial | $1.39 | — | — | 2026-07-15 | MRF ↗ |
| MASON DISTRICT HOSPITAL Outpatient | Meridian | Medicaid | $1.40 | $5.00 | $4.00 | 2026-08-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6790_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ASIN 20230101 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $1.45 | $7.00 | $5.25 | 2026-01-16 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - Managed Medicaid | $1.47 | $551.00 | $275.50 | 2026-07-01 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center Commercial | $1.48 | — | — | 2026-04-14 | MRF ↗ |
| MOUNT NITTANY MEDICAL CENTER Outpatient | Upmc | Medicaid | $1.50 | — | — | 2026-07-15 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Traditional Medicaid | Traditional Medicaid | $1.50 | — | — | 2026-07-15 | MRF ↗ |
| PENN PRESBYTERIAN MEDICAL CENTER Outpatient | Managed Medicaid Other | Managed Medicaid Other | $1.50 | $134.00 | $134.00 | 2026-07-15 | MRF ↗ |
| PENN PRESBYTERIAN MEDICAL CENTER Outpatient | Pa Medical Assistance | Medicaid | $1.50 | $134.00 | $134.00 | 2026-07-15 | MRF ↗ |
| PENN PRESBYTERIAN MEDICAL CENTER Outpatient | Gateway Health Plan Medicaid | Gateway Health Plan Medicaid | $1.50 | $134.00 | $134.00 | 2026-07-15 | MRF ↗ |
| MOUNT NITTANY MEDICAL CENTER Outpatient | Amerihealth | Medicaid | $1.50 | — | — | 2026-07-15 | MRF ↗ |
| WEST VIRGINIA UNIVERSITY HOSPITALS, INC Outpatient | Pennsylvania Health And Wellness | Mgd Medicaid | $1.50 | $47.00 | $23.50 | 2026-07-15 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Traditional Medicaid | Traditional Medicaid | $1.50 | — | — | 2026-07-15 | MRF ↗ |
| WEST VIRGINIA UNIVERSITY HOSPITALS, INC Outpatient | Upmc For You Medicaid | Upmc For You Medicaid | $1.50 | $47.00 | $23.50 | 2026-07-15 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Anthem | Anthem Hmo Pos | $1.50 | $3.00 | $0.90 | 2026-07-15 | MRF ↗ |
| MOUNT NITTANY MEDICAL CENTER Outpatient | Ghp | Medicaid | $1.50 | — | — | 2026-07-15 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Geisinger | Mcd Advantage | $1.50 | — | — | 2026-07-15 | MRF ↗ |
| PRINCETON COMMUNITY HOSPITAL ASSN INC Outpatient | Pennsylvania Health & Wellness | Medicaid | $1.50 | $42.00 | $21.00 | 2026-07-15 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Upmc | Mcd Advantage | $1.50 | — | — | 2026-07-15 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Geisinger | Mcd Advantage | $1.50 | — | — | 2026-07-15 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Geisinger | Managed Medicaid | $1.50 | $45.00 | $27.00 | 2025-02-18 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Geisinger | Managed Medicaid | $1.50 | $45.00 | $27.00 | 2025-02-18 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Amerihealth | Managed Medicaid | $1.50 | $45.00 | $27.00 | 2025-02-18 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Health Partners | Managed Medicaid | $1.50 | $45.00 | $27.00 | 2025-02-18 | MRF ↗ |
| PRINCETON COMMUNITY HOSPITAL ASSN INC Outpatient | Molina Managed Medicaid | Molina Managed Medicaid | $1.50 | $42.00 | $21.00 | 2026-07-15 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $1.50 | — | — | 2026-04-14 | 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.