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 $20–$1,108 (25th–75th percentile) across 1,507 hospitals · 3,510 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
$20
$540 typical
$1,108
The middle 50% of negotiated facility rates for this procedure, measured across 1,507 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. | $540 |
| Physician fee Estimate national typical Medicare $4 × 1.22 commercial. | $4 |
| Likely subtotal | $544 |
Complete-episode estimate (typical)
~$544
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 |
|---|---|---|---|---|---|---|---|
| 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 ↗ |
| North Central Bronx Hospital OutpatientFacility | UNITED | HARP | $0.50 | — | — | 2025-09-05 | 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 | 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 | Mountain CoOp | All | $0.55 | — | — | 2026-05-22 | MRF ↗ |
| BITTERROOT HEALTH - DALY HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Montana | Traditional | — | — | — | 2026-05-22 | MRF ↗ |
| BITTERROOT HEALTH - DALY HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Montana | PPO | — | — | — | 2026-05-22 | MRF ↗ |
| BITTERROOT HEALTH - DALY HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Montana | Tricare | — | — | — | 2026-05-22 | MRF ↗ |
| BITTERROOT HEALTH - DALY HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Montana | Blue Options | — | — | — | 2026-05-22 | MRF ↗ |
| BITTERROOT HEALTH - DALY HOSPITAL OutpatientFacility | Pacific Source | All | $0.55 | — | — | 2026-05-22 | MRF ↗ |
| BITTERROOT HEALTH - DALY HOSPITAL OutpatientFacility | Missoula County Employee Benefits Plan | All | — | — | — | 2026-05-22 | MRF ↗ |
| BITTERROOT HEALTH - DALY HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Montana | Medicare Advantage | — | — | — | 2026-05-22 | MRF ↗ |
| Southern California Hospital At Culver City 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 ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $0.70 | — | — | 2026-03-18 | 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 ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Medica | MHSO Medicare Cost & Select | — | $3.00 | $2.55 | 2026-02-12 | MRF ↗ |
| UNITED HOSPITAL DISTRICT InpatientFacility | Medica | Commercial | — | $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 ↗ |
| HELEN NEWBERRY JOY HOSPITAL Outpatient | MI WC - ALL PLANS | MI WC - ALL PLANS | $0.84 | $2.34 | $1.47 | 2026-01-27 | 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 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 MERCY 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 ↗ |
| ASCENSION ST VINCENT KOKOMO 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 CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 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 RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $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 MERCY 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 KOKOMO 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 | 9470_UNITED HEALTHCARE VEIN 20250101 | $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 WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $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 CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON 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 WILLIAMSPORT 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 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 HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $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 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 | 9470_UNITED HEALTHCARE VEIN 20250101 | $0.86 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH 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 CLAY 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 SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $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 ↗ |
| 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 ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | SCAN Health Plan | Medicare Advantage | — | $1,663.21 | $1,081.09 | 2025-11-26 | MRF ↗ |
| PRAIRIE RIDGE HOSPITAL AND HEALTH SERVICES InpatientFacility | Humana | 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 | Medica | Managed Medicaid | — | $5.00 | $3.18 | 2026-03-17 | 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 | 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 | UCare | 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 | Blue Cross Blue Shield of Minnesota | 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 ↗ |
| AMERY HOSPITAL & CLINIC BothFacility | HP MEDICARE REPLACEMENT [950306] | HP MEDICARE ADVANTAGE [95307] | $1.08 | $3.00 | $1.56 | 2026-03-31 | 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 | Medica | Medicare Advantage | — | $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 | PrimeWest | Managed Medicaid | — | $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 ↗ |
| AMERY HOSPITAL & CLINIC BothFacility | BCBS MEDICARE REPLACEMENT [950296] | BCBS MEDICARE ADVANTAGE [50299] | $1.09 | $3.00 | $1.56 | 2026-03-31 | MRF ↗ |
| AMERY HOSPITAL & CLINIC BothFacility | UHC MEDICARE REPLACEMENT [950281] | UHC MEDICARE ADVANTAGE PPO [50275] | $1.11 | $3.00 | $1.56 | 2026-03-31 | MRF ↗ |
| AMERY HOSPITAL & CLINIC BothFacility | MEDICA MEDICARE REPLACEMENT [950299] | MEDICA GOVERNMENT ADVANTAGE [50316] | $1.12 | $3.00 | $1.56 | 2026-03-31 | 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 | 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 | UNITED | Medicare|All Plans | $1.20 | $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 ↗ |
| 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 ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Upmc | All Commercial Plans | $1.34 | — | — | 2026-04-01 | 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 | HIGHMARK [114] | HIGHMARK MEDICARE [11402] | — | $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 | 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 ↗ |
| ROCHESTER GENERAL HOSPITAL Outpatient | CHAMPUS/TRICARE [103] | CHAMPUS/TRICARE [10301] | — | $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 Inpatient | HIGHMARK [114] | HIGHMARK [11401] | — | $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 ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 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 ↗ |
| 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 CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 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 HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 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 ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $1.45 | — | — | 2026-01-01 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center Commercial | $1.48 | — | — | 2026-04-14 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Geisinger Health Plan | F8109_Geisinger Health Plan - Medicaid Chip | $1.50 | — | — | 2026-04-01 | MRF ↗ |
| GEISINGER SOUTH WILKES-BARRE Outpatient | Medicaid | Medicaid | $1.50 | $288.00 | $178.56 | 2026-04-01 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Health Partners | 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 | 2026-02-12 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Health Partners | Managed Medicaid | $1.50 | $4.00 | $2.40 | 2026-02-12 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Geisinger | Managed Medicaid | $1.50 | $45.00 | $27.00 | 2026-02-12 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Health Partners | Managed Medicaid | $1.50 | $45.00 | $27.00 | 2026-02-12 | 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 | $4.00 | $2.40 | 2026-02-12 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Amerihealth | Managed Medicaid | $1.50 | $4.00 | $2.40 | 2025-02-18 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | Medicaid | Medicaid | $1.50 | $551.00 | $341.62 | 2025-07-01 | MRF ↗ |
| ARNOT OGDEN MEDICAL CENTER OutpatientFacility | AmeriHealth | All Products | $1.50 | — | — | 2026-03-27 | MRF ↗ |
| SURGICAL INSTITUTE OF READING OutpatientFacility | Unison | Med Plus | $1.50 | — | $1,238.87 | 2026-04-08 | MRF ↗ |
| SKAGIT VALLEY HOSPITAL Outpatient | CHPW | Medicaid | $1.50 | $35.00 | $28.00 | 2026-03-26 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Amerihealth | F8102_Amerihealth | $1.50 | — | — | 2026-04-01 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Amerihealth | Managed Medicaid | $1.50 | $45.00 | $27.00 | 2025-02-18 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Amerihealth | Managed Medicaid | $1.50 | $4.00 | $2.40 | 2025-02-18 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Health Partners | Managed Medicaid | $1.50 | $4.00 | $2.40 | 2025-02-18 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Health Partners | Managed Medicaid | $1.50 | $4.00 | $2.40 | 2025-02-18 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Geisinger Health Plan | F8109_Geisinger Health Plan - Medicaid Chip | $1.50 | — | — | 2026-04-01 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Amerihealth | F8102_Amerihealth | $1.50 | — | — | 2026-04-01 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $1.50 | — | — | 2026-04-14 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Amerihealth | Managed Medicaid | $1.50 | $45.00 | $27.00 | 2025-02-18 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Aetna | Aetna Better Health CHIP | $1.50 | — | — | 2026-04-14 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Health Partners | 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 ↗ |
| GEISINGER MEDICAL CENTER Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $1.54 | $551.00 | $341.62 | 2025-07-01 | MRF ↗ |
| GEISINGER SOUTH WILKES-BARRE Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $1.54 | $288.00 | $178.56 | 2026-04-01 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL Both | BCBS [800] | PHU HB UPSTATE BLUE EXCHANGE REEDY - OMH | $1.56 | $13.00 | $8.45 | 2026-03-01 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Geisinger | Managed Medicaid | $1.58 | $4.00 | $2.40 | 2025-02-18 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Geisinger | Managed Medicaid | $1.58 | $4.00 | $2.40 | 2025-02-18 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $1.58 | — | — | 2026-04-14 | MRF ↗ |
| MEADVILLE MEDICAL CENTER Outpatient | Geisinger | Managed Medicaid | $1.58 | $4.00 | $2.40 | 2026-02-12 | MRF ↗ |
| MAGEE WOMENS HOSPITAL OF UPMC HEALTH SYSTEM OutpatientFacility | United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $1.65 | $27.00 | $16.20 | 2026-03-06 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | GEISINGER | MANAGED MEDICAID | $1.65 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $1.65 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | GEISINGER | MANAGED MEDICAID | $1.65 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $1.65 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $1.65 | — | — | 2025-08-01 | MRF ↗ |
| MAGEE WOMENS HOSPITAL OF UPMC HEALTH SYSTEM OutpatientFacility | UPMC Health Plan | Managed Medicaid | $1.65 | $27.00 | $16.20 | 2026-03-06 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $1.65 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $1.65 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $1.65 | — | — | 2026-04-14 | MRF ↗ |
| Upmc Presbyterian Shadyside OutpatientFacility | UPMC Health Plan | Managed Medicaid | $1.65 | $204.00 | $122.40 | 2026-03-06 | MRF ↗ |
| MAGEE WOMENS HOSPITAL OF UPMC HEALTH SYSTEM OutpatientFacility | UPMC Health Plan | Managed Medicaid | $1.65 | $27.00 | $16.20 | 2026-03-06 | MRF ↗ |
| MAGEE WOMENS HOSPITAL OF UPMC HEALTH SYSTEM OutpatientFacility | United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $1.65 | $27.00 | $16.20 | 2026-03-06 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | Ambetter | Commercial|All Plans | $1.70 | $9.00 | $1.58 | 2026-02-28 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | CHIP | $1.73 | — | — | 2025-08-01 | MRF ↗ |
| GEISINGER SOUTH WILKES-BARRE Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $1.73 | $288.00 | $178.56 | 2026-04-01 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $1.73 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $1.73 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $1.73 | — | — | 2025-08-01 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $1.73 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $1.73 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $1.73 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | CHIP | $1.73 | — | — | 2025-08-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $1.73 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $1.73 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $1.73 | — | — | 2025-08-01 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $1.73 | $551.00 | $341.62 | 2025-07-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | CHIP | $1.73 | — | — | 2025-08-01 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $1.73 | — | — | 2026-04-14 | MRF ↗ |
| ST LUKE'S HOSPITAL - GRAND VIEW CAMPUS OutpatientFacility | United Healthcare Community | Managed Medicaid | $1.73 | — | — | 2024-12-31 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $1.73 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $1.73 | — | — | 2025-08-01 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $1.76 | $551.00 | $341.62 | 2025-07-01 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | Wellpoint | Commercial|Exchange | $1.76 | $9.00 | $1.58 | 2026-02-28 | MRF ↗ |
| GEISINGER SOUTH WILKES-BARRE Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $1.76 | $288.00 | $178.56 | 2026-04-01 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.