95813 — EEG Extnd Mntr 61-119 Min
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). EEG EXTND MNTR 61-119 MIN (CPT 95813) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/95813?code_type=CPT
MLA (9th ed.)
“EEG EXTND MNTR 61-119 MIN (CPT 95813) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/95813?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“EEG EXTND MNTR 61-119 MIN (CPT 95813) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/95813?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $321–$1,292 (25th–75th percentile) across 2,207 hospitals · 7,345 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 95813 — 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 surgeon and anesthesia figures are estimates from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$321
$620 typical
$1,292
The middle 50% of negotiated facility rates for this procedure, measured across 2,207 hospitals. Surgeon & anesthesia 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. | $620 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $480 × 1.22 commercial. | $585 |
| Likely subtotal | $1,206 |
Surgical episode (typical)
~$1,206
Your recovery plan — adjust to what your surgeon told you
After surgery, recovery care is billed separately. We pre-fill the typical plan; change it to your situation.
Recovery cost modeled
~$3,785
With your recovery plan (typical)
~$4,990
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Surgeon (professional 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 |
|---|---|---|---|---|---|---|---|
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $1,945.00 | $1,594.90 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $1,945.00 | $1,594.90 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | Covered | — | $1,945.00 | $1,594.90 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $1,945.00 | $1,594.90 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $1,945.00 | $1,594.90 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | Health Net of California, Inc. | HMO | — | $1,945.00 | $1,594.90 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | SCAN Health Plan | Medicare Advantage | — | $3,969.24 | $2,580.01 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $3,969.24 | $2,580.01 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | United Healthcare | HMO | — | $1,945.00 | $1,594.90 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $1,945.00 | $1,594.90 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | HMO | — | $1,945.00 | $1,594.90 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | United Healthcare | POS | — | $1,945.00 | $1,594.90 | 2025-11-26 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $2.30 | $1,280.00 | $307.48 | 2024-12-31 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $4.30 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $4.33 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $4.33 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $4.93 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $4.96 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $4.96 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $5.37 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $5.40 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $5.40 | — | — | 2026-03-18 | MRF ↗ |
| ST JOSEPH MEDICAL CENTER Outpatient | UHC | UHC KS Medicaid | $7.92 | $1,476.76 | $215.00 | 2026-03-17 | MRF ↗ |
| ST JOSEPH MEDICAL CENTER Outpatient | UHC | UHC KS Medicaid | $7.92 | $1,476.76 | $380.00 | 2025-12-09 | MRF ↗ |
| LAFAYETTE REGIONAL HEALTH CENTER Outpatient | United | KSMGMCD | $7.92 | — | — | 2025-01-01 | MRF ↗ |
| LAFAYETTE REGIONAL HEALTH CENTER Outpatient | HealthyBlue | MGMCD | $8.08 | — | — | 2025-01-01 | MRF ↗ |
| LAFAYETTE REGIONAL HEALTH CENTER Outpatient | Sunflower State Health Plan | MCD | $8.16 | — | — | 2025-01-01 | MRF ↗ |
| LAFAYETTE REGIONAL HEALTH CENTER Outpatient | Amerigroup | MGMCD | $8.24 | — | — | 2025-01-01 | MRF ↗ |
| LAFAYETTE REGIONAL HEALTH CENTER Outpatient | Aetna Better Health | MCD | $8.24 | — | — | 2025-01-01 | MRF ↗ |
| LAFAYETTE REGIONAL HEALTH CENTER Outpatient | Unicare | MGMCD | $8.24 | — | — | 2025-01-01 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Blue Cross Blue Shield | Ppo | — | $20.90 | $7.32 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Union Medical | Hmo | — | $20.90 | $7.32 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Health Alliance | Public Exchange | — | $20.90 | $7.32 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Health Alliance | Commercial | — | $20.90 | $7.32 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | United Healthcare | Navigate, Core, Charter, Aco Tiered | — | $20.90 | $7.32 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Aetna | Commercial | — | $20.90 | $7.32 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Multiplan | Ppo | — | $20.90 | $7.32 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | United Healthcare | All Other Plans | — | $20.90 | $7.32 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Blue Cross Blue Shield | Hmo Illinois | — | $20.90 | $7.32 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Joliet | Hmo | — | $20.90 | $7.32 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Blue Cross Blue Shield | Blue Precision Hmo | — | $20.90 | $7.32 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Blue Cross Blue Shield | Blue Choice | — | $20.90 | $7.32 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Professional Benefits Administrator | Ppo | — | $20.90 | $7.32 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Cigna | Hmo, Ppo, Pos | — | $20.90 | $7.32 | 2026-05-08 | MRF ↗ |
| SILVER CROSS HOSPITAL AND MEDICAL CENTERS Both | Cigna | Local Plus | — | $20.90 | $7.32 | 2026-05-08 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Healthplan Medicaid | Wv Medicaid | $9.31 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Wellpoint | Wv Medicaid | $9.78 | — | — | 2026-05-06 | MRF ↗ |
| ASCENSION PROVIDENCE HOSPITAL, SOUTHFIELD AND NOVI Outpatient | BLUE CARE NETWORK | 1143_SJPK BLUE CROSS BLUE SHIELD BCN 20220401 | $11.13 | $1,418.00 | $794.08 | 2026-01-01 | MRF ↗ |
| ASCENSION PROVIDENCE HOSPITAL, SOUTHFIELD AND NOVI Outpatient | BLUE CROSS TRADITIONAL | 1147_SJPK BLUE CROSS BLUE SHIELD OF MICHIGAN TRADITIONAL 20220401 | $11.13 | $1,418.00 | $794.08 | 2026-01-01 | MRF ↗ |
| ASCENSION PROVIDENCE HOSPITAL, SOUTHFIELD AND NOVI Outpatient | BCN LOCAL NETWORK SOUTHEAST | 1149_SJPK BLUE CROSS BLUE SHIELD BCN LOCAL NETWORK SE 20220401 | $11.13 | $1,418.00 | $794.08 | 2026-01-01 | MRF ↗ |
| ASCENSION PROVIDENCE HOSPITAL, SOUTHFIELD AND NOVI Outpatient | BC METRO DETROIT EPO | 1139_SJPK BLUE CROSS BLUE SHIELD METRO DETROIT EPO 20220401 | $11.13 | $1,418.00 | $794.08 | 2026-01-01 | MRF ↗ |
| ASCENSION PROVIDENCE HOSPITAL, SOUTHFIELD AND NOVI Outpatient | BLUE CROSS PPO | 1145_SJPK BLUE CROSS BLUE SHIELD PPO 20220401 | $11.13 | $1,418.00 | $794.08 | 2026-01-01 | MRF ↗ |
| ASCENSION PROVIDENCE HOSPITAL, SOUTHFIELD AND NOVI Outpatient | BC METRO DETROIT HMO | 1141_SJPK BLUE CROSS BLUE SHIELD METRO DETROIT HMO 20220401 | $11.13 | $1,418.00 | $794.08 | 2026-01-01 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | HUMANA | HUMANA COMMERCIALEXCHHMO | $13.77 | $30.60 | $30.60 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | HUMANA | HUMANA COMMERCIALEXCHPPO | $13.77 | $30.60 | $30.60 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | UNITED HEALTHCARE | UNITED COMMERCIAL | $13.77 | $30.60 | $30.60 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | HUMANA | HUMANA COMMERCIALEXCHHMO | $13.77 | $30.60 | $30.60 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | HUMANA | HUMANA COMMERCIALEXCHPPO | $13.77 | $30.60 | $30.60 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | UNITED HEALTHCARE | UNITED COMMERCIAL | $13.77 | $30.60 | $30.60 | 2026-03-27 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $14.82 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $14.82 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $14.82 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $14.82 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $14.82 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $14.82 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $15.22 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $15.22 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | HMO, Non-City of LA, Vivity | — | $3,969.24 | $2,580.01 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | HMO, City of LA, Vivity | — | $3,969.24 | $2,580.01 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Blue Cross of California, dba Anthem Blue Cross and its Affiliates | HMO | — | $3,969.24 | $2,580.01 | 2025-11-26 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $15.52 | — | — | 2026-03-18 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $15.62 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $15.62 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $16.02 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $16.02 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $18.55 | $3,865.00 | $3,671.75 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $18.55 | $3,865.00 | $3,671.75 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $18.55 | $3,865.00 | $3,671.75 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $18.55 | $3,865.00 | $3,671.75 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $18.94 | $3,865.00 | $3,671.75 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $18.94 | $3,865.00 | $3,671.75 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $18.94 | $3,865.00 | $3,671.75 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $18.94 | $3,865.00 | $3,671.75 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $19.63 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $19.63 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $19.63 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $19.63 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $19.71 | $3,865.00 | $3,671.75 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $19.71 | $3,865.00 | $3,671.75 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $20.03 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $20.03 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| ST JOE MERCY HOSPITAL SYSTEM LIVONIA OutpatientFacility | VACCN United | Veterans Affairs | $20.50 | $1,600.00 | $1,040.00 | 2025-01-01 | MRF ↗ |
| ST JOE MERCY HOSPITAL SYSTEM LIVONIA OutpatientFacility | VACCN United | Veterans Affairs | $20.50 | $1,600.00 | $1,040.00 | 2025-01-01 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $20.83 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $20.83 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| MOUNT SINAI WEST OutpatientFacility | United Healthcare | United Medicaid Schip/Child - Slw | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| MOUNT SINAI WEST OutpatientFacility | United Healthcare | United Medicaid Family - Bi | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | United Healthcare | United Healthcare - Essential Plan - Msq | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| MOUNT SINAI WEST OutpatientFacility | United Healthcare | United Medicaid Schip/Child - Bi | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| MOUNT SINAI WEST OutpatientFacility | United Healthcare | United Medicaid Family - Slw | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | United Healthcare | United Healthcare - Essential Plan - Brook | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | United Healthcare | United Medicaid Family - Brook | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | United Healthcare | United Medicaid Family - Msq | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | United Healthcare | United Medicaid Schip/Child - Msq | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| Mount Sinai Behavioral Health Center OutpatientFacility | United Healthcare | United Medicaid Schip/Child - Brook | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| MOUNT SINAI WEST OutpatientFacility | United Healthcare | United Healthcare - Essential Plan - Bi | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| MOUNT SINAI HOSPITAL OutpatientFacility | United Healthcare | United Medicaid Schip/Child - Tmsh | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| MOUNT SINAI HOSPITAL OutpatientFacility | United Healthcare | United Medicaid Family - Tmsh | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| MOUNT SINAI HOSPITAL OutpatientFacility | United Healthcare | United Healthcare - Essential Plan - Tmsh | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - Molina | Medicaid - Molina | $21.00 | $187.00 | $93.00 | 2025-02-03 | MRF ↗ |
| MOUNT SINAI SOUTH NASSAU OutpatientFacility | United Healthcare | United Healthcare - Essential Plan - Snch | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| MOUNT SINAI WEST OutpatientFacility | United Healthcare | United Healthcare - Essential Plan - Slw | $21.00 | — | — | 2026-04-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 5143 | HIGHMARK BCBS ESSENTIAL 1-2 200-250 5143 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Mohawk Valley Physician's Health Plan (MVP) | Managed Medicaid | $21.21 | — | — | 2025-06-20 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | United Healthcare Essential Plan | Managed Medicaid | $21.21 | — | — | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Fidelis Essential Plan | Managed Medicaid | $21.21 | — | — | 2025-06-20 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Fidelis Child Health Plus | Managed Medicaid | $21.21 | — | — | 2025-06-20 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Blue Cross Family Health Plus | Managed Medicaid | $21.21 | — | — | 2025-06-20 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 5143 | HIGHMARK BCBS ESSENTIAL 1-2 200-250 5143 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Capital District Physicians' Health Plan (CDPHP) | Managed Medicaid | $21.21 | — | — | 2025-06-20 | 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 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Blue Cross Child Health Plus | Managed Medicaid | $21.21 | — | — | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | United Healthcare | Managed Medicaid | $21.21 | — | — | 2025-06-20 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | United Healthcare Well 4 Me | Managed Medicaid | $21.21 | — | — | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Mohawk Valley Physician's Health Plan (MVP) HARP | Managed Medicaid | $21.21 | — | — | 2025-06-20 | 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 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Fidelis Medicaid | Managed Medicaid | $21.21 | — | — | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Blue Cross HMO | Managed Medicaid | $21.21 | — | — | 2025-06-20 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | BLUE CHOICE OPTION MEDICAID 170601 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | United Healthcare Child Health Plus | Managed Medicaid | $21.21 | — | — | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Blue Cross Essential | Managed Medicaid | $21.21 | — | — | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | New York State Office of Victim Services | Managed Medicaid | $21.21 | — | — | 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 | $21.21 | — | — | 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 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $21.21 | — | — | 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 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Cape Vincent Correctional Facility | Managed Medicaid | $21.21 | — | — | 2025-06-20 | 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 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 5143 | HIGHMARK BCBS ESSENTIAL 1-2 200-250 5143 | $21.21 | — | — | 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 | $21.21 | — | — | 2026-01-01 | 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 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOC MEDICAID 1710 | INDEPENDENT HEALTH MEDICAID 171001, INDEPENDENT HEALTH CHILD HEALTH PLUS 515604 | $21.21 | — | — | 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 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOC MEDICAID 1710 | INDEPENDENT HEALTH MEDICAID 171001, INDEPENDENT HEALTH CHILD HEALTH PLUS 515604 | $21.21 | — | — | 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 | $21.21 | — | — | 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 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | BLUE CHOICE OPTION MEDICAID 170601 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD MEDICAID 1706 | BLUE CHOICE OPTION MEDICAID 170601 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOC MEDICAID 1710 | INDEPENDENT HEALTH MEDICAID 171001, INDEPENDENT HEALTH CHILD HEALTH PLUS 515604 | $21.21 | — | — | 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 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOC MEDICAID 1710 | INDEPENDENT HEALTH MEDICAID 171001, INDEPENDENT HEALTH CHILD HEALTH PLUS 515604 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 5143 | HIGHMARK BCBS ESSENTIAL 1-2 200-250 5143 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICAID 5158 | UNITED HEALTHCARE ESSENTIAL 1-2 200-250 5158 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | FIDELIS 5155 | FIDELIS METAL TIERS 515501 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | FIDELIS MEDICAID 1708 | FIDELIS MEDICAID 170801, FIDELIS CHILD HEALTH PLUS 515502 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Fidelis Ambetter | Managed Medicaid | $21.21 | — | — | 2025-06-20 | 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 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | AMERIGROUP (BLUE CROSS BLUE SHIELD WNY ALTERNATE) 1720 | AMERIGROUP (BSWNY ALTERNATE) 172001 | $21.21 | — | — | 2026-01-01 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $21.63 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $21.63 | $4,006.00 | $3,805.70 | 2026-02-20 | MRF ↗ |
| CHENANGO MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | United Healthcare Medicaid Managed Care Plan | $21.85 | — | — | 2026-04-01 | MRF ↗ |
| CHENANGO MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | United Healthcare Child Health Plus | $21.85 | — | — | 2026-04-01 | MRF ↗ |
| CHENANGO MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | United Healthcare Child Health Plus | $21.85 | — | — | 2026-04-01 | MRF ↗ |
| CHENANGO MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | United Healthcare Medicaid Managed Care Plan | $21.85 | — | — | 2026-04-01 | MRF ↗ |
| UNITED HEALTH SERVICES HOSPITALS, INC OutpatientFacility | United Healthcare | United Healthcare Child Health Plus | $21.85 | — | — | 2026-04-01 | MRF ↗ |
| DELAWARE VALLEY HOSPITAL, INC OutpatientFacility | United Healthcare | United Child Health Plus | $21.85 | — | — | 2026-04-01 | MRF ↗ |
| UNITED HEALTH SERVICES HOSPITALS, INC OutpatientFacility | United Healthcare | United Healthcare Medicaid Managed Care Plan | $21.85 | — | — | 2026-04-01 | MRF ↗ |
| DELAWARE VALLEY HOSPITAL, INC OutpatientFacility | United Healthcare | United Healthcare Medicaid Managed Care Plan | $21.85 | — | — | 2026-04-01 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - Molina | Medicaid - Molina | $22.00 | $187.00 | $93.00 | 2025-02-03 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | UHC MCR ADV | UHC MCR ADV | $22.10 | $65.00 | $39.00 | 2025-11-18 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | VIVA | VIVA HEALTH | $22.95 | $30.60 | $30.60 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | VIVA | VIVA HEALTH | $22.95 | $30.60 | $30.60 | 2026-03-27 | MRF ↗ |
| MCLAREN BAY REGION Outpatient | Medicaid - United | Medicaid - United | $23.00 | $187.00 | $93.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $23.00 | $187.00 | $93.00 | 2025-02-03 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $23.10 | $2,211.00 | $2,211.00 | 2026-02-13 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | AETNA | AETNA COMMERCIAL | $23.87 | $30.60 | $30.60 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | AETNA | AETNA COMMERCIAL | $23.87 | $30.60 | $30.60 | 2026-03-27 | MRF ↗ |
| CHENANGO MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | United Healthcare Essential Plans | $24.39 | — | — | 2026-04-01 | MRF ↗ |
| CHENANGO MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | United Healthcare Essential Plans | $24.39 | — | — | 2026-04-01 | MRF ↗ |
| DELAWARE VALLEY HOSPITAL, INC OutpatientFacility | United Healthcare | United Healthcare Essential Plans | $24.39 | — | — | 2026-04-01 | MRF ↗ |
| UNITED HEALTH SERVICES HOSPITALS, INC OutpatientFacility | United Healthcare | United Healthcare Essential Plans | $24.39 | — | — | 2026-04-01 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - United | Medicaid - United | $25.00 | $187.00 | $93.00 | 2025-02-03 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | TRICARE - ALL PLANS | TRICARE - ALL PLANS | $25.22 | $65.00 | $39.00 | 2025-11-18 | 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.