95816 — EEG Awake And Drowsy
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). EEG AWAKE AND DROWSY (CPT 95816) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/95816?code_type=CPT
MLA (9th ed.)
“EEG AWAKE AND DROWSY (CPT 95816) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/95816?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“EEG AWAKE AND DROWSY (CPT 95816) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/95816?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $301–$958 (25th–75th percentile) across 2,468 hospitals · 8,445 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 95816 — 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
$301
$537 typical
$958
The middle 50% of negotiated facility rates for this procedure, measured across 2,468 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. | $537 |
| Physician fee Estimate national typical Medicare $413 × 1.22 commercial. | $504 |
| Likely subtotal | $1,041 |
Complete-episode estimate (typical)
~$1,041
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 |
|---|---|---|---|---|---|---|---|
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | None | — | — | $1,096.27 | $548.14 | 2024-12-15 | MRF ↗ |
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | None | — | — | $1,096.27 | $548.14 | 2024-12-15 | MRF ↗ |
| HANCOCK COUNTY HEALTH SYSTEM Outpatient | WELLMARK HMO-ALL OTHER PLANS | WELLMARK HMO-ALL OTHER PLANS | $0.76 | $875.00 | $656.25 | 2026-03-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $1,937.00 | $1,588.34 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | United Healthcare | HMO | — | $1,937.00 | $1,588.34 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | Covered | — | $1,937.00 | $1,588.34 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | Health Net of California, Inc. | HMO | — | $1,937.00 | $1,588.34 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $1,937.00 | $1,588.34 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $1,937.00 | $1,588.34 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $1,937.00 | $1,588.34 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | SCAN Health Plan | Medicare Advantage | — | $5,160.02 | $3,354.01 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | United Healthcare | POS | — | $1,937.00 | $1,588.34 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $1,937.00 | $1,588.34 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $5,160.02 | $3,354.01 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | HMO | — | $1,937.00 | $1,588.34 | 2025-11-26 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $2.94 | $1,631.00 | $307.48 | 2024-12-31 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $4.30 | $511.14 | $511.14 | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $4.33 | $1,184.31 | $1,184.31 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $4.33 | $1,184.31 | $1,184.31 | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $4.93 | $511.14 | $511.14 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $4.96 | $1,184.31 | $1,184.31 | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $4.96 | $1,184.31 | $1,184.31 | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $5.37 | $511.14 | $511.14 | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $5.40 | $1,184.31 | $1,184.31 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $5.40 | $1,184.31 | $1,184.31 | 2026-03-18 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Healthplan Medicaid | Wv Medicaid | $8.60 | — | — | 2026-05-06 | MRF ↗ |
| SAN ANTONIO REGIONAL HOSPITAL Outpatient | ANTHEM BLUE CROSS EXCHG | ANTHEM BLUE CROSS EXCHG | $8.73 | $3,995.00 | $871.00 | 2026-04-02 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $8.78 | $446.00 | $178.40 | 2026-05-13 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $8.78 | $405.00 | $162.00 | 2026-05-22 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $8.78 | $405.00 | $162.00 | 2026-05-13 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $8.78 | $446.00 | $178.40 | 2026-05-22 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Outpatient | Health Partners | Managed Medicaid | $9.00 | $1,186.00 | $711.60 | 2026-02-12 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Amerihealth | F8102_Amerihealth | $9.00 | — | — | 2026-04-01 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Amerihealth | F8102_Amerihealth | $9.00 | — | — | 2026-04-01 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Outpatient | Amerihealth | Managed Medicaid | $9.00 | $1,186.00 | $711.60 | 2026-02-12 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $9.00 | — | — | 2026-04-14 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Outpatient | Geisinger | Managed Medicaid | $9.00 | $1,186.00 | $711.60 | 2026-02-12 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Geisinger Health Plan | F8109_Geisinger Health Plan - Medicaid Chip | $9.00 | — | — | 2026-04-01 | MRF ↗ |
| OSS ORTHOPAEDIC HOSPITAL OutpatientFacility | Geisinger Health Plan | F8109_Geisinger Health Plan - Medicaid Chip | $9.00 | — | — | 2026-04-01 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Outpatient | Amerihealth | Managed Medicaid | $9.00 | $1,186.00 | $711.60 | 2026-02-12 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Outpatient | Health Partners | Managed Medicaid | $9.00 | $1,186.00 | $711.60 | 2026-02-12 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Aetna | Aetna Better Health CHIP | $9.00 | — | — | 2026-04-14 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Outpatient | Geisinger | Managed Medicaid | $9.00 | $1,186.00 | $711.60 | 2026-02-12 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Wellpoint | Wv Medicaid | $9.03 | — | — | 2026-05-06 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas D-SNP Medicare | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas Medicare (NY) | $9.45 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $9.90 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $9.90 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $9.90 | — | — | 2025-08-01 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $9.90 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $9.90 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | GEISINGER | MANAGED MEDICAID | $9.90 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | GEISINGER | MANAGED MEDICAID | $9.90 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $9.90 | — | — | 2025-08-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $10.35 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | CHIP | $10.35 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | CHIP | $10.35 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $10.35 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | CHIP | $10.35 | — | — | 2025-08-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $10.35 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $10.35 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $10.35 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $10.35 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $10.35 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $10.35 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $10.35 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $10.35 | — | — | 2025-08-01 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $10.35 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $10.35 | — | — | 2026-04-14 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Connecticut General Cigna | Default | — | $390.00 | $292.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | UHC Community Plan MS | Default | — | $390.00 | $292.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Primewell Vantage Health Plan | Default | — | $390.00 | $292.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | GEHA Multiplan Network | Default | — | $390.00 | $292.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Private Healthcare Systems PHCS | Default | — | $390.00 | $292.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Multiplan Inc. for American Family | Default | — | $390.00 | $292.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Magnolia Health Plan MCD Rep | Default | — | $390.00 | $292.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicaid Mississippi | Default | — | $390.00 | $292.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicare A MS JH | Default | — | $390.00 | $292.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicare B MS JH | Default | — | $390.00 | $292.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Mississippi Physicians Care Network | Default | — | $390.00 | $292.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | First Choice Health Network | Default | — | $390.00 | $292.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Mississippi Select Health Care | Default | — | $390.00 | $292.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $10.46 | $390.00 | $292.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Advanced Health | Default | — | $390.00 | $292.50 | 2025-03-07 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | GEISINGER | MANAGED MEDICAID | $10.71 | — | — | 2025-08-01 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $10.80 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $10.80 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $10.80 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Aetna | Aetna Better Health CHIP | $10.80 | — | — | 2026-04-14 | MRF ↗ |
| IBERIA MEDICAL CENTER Both | WebTPA | Default | $10.83 | $85.00 | $51.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Both | Multiplan Inc. for American Family | Default | $10.83 | $85.00 | $51.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Both | Gilsbar Inc | Default | $10.83 | $85.00 | $51.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Both | UHC Community Plan LA MCD Rep | Default | $10.83 | $85.00 | $51.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Both | Verity National Group | Default | $10.83 | $85.00 | $51.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Both | First Health | Default | $10.83 | $85.00 | $51.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Both | Healthy Blue Community Care of LA MCD | Default | $10.83 | $85.00 | $51.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Both | PHCS GEHA Govt Employee Health Assc | Default | $10.83 | $85.00 | $51.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Both | Louisiana Healthcare Connections MCD Rep | Default | $10.83 | $85.00 | $51.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Both | Peoples Health Network DOS lt 01012024 | Default | $10.83 | $85.00 | $51.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Both | PPO Plus LLC | Default | $10.83 | $85.00 | $51.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Both | Aetna | Medicaid Replacement | $10.83 | $85.00 | $51.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Both | Humana Healthy Horizons MCD Rep | Medicaid Replacement | $10.83 | $85.00 | $51.00 | 2025-07-16 | MRF ↗ |
| JEFFERSON LANSDALE HOSPITAL OutpatientFacility | Keystone First | JAB002 Caid CHIP | $11.07 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON LANSDALE HOSPITAL OutpatientFacility | Keystone First | JAB002 Caid MCO | $11.07 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON ABINGTON HOSPITAL OutpatientFacility | Keystone First | JAB001 Caid CHIP | $11.07 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON ABINGTON HOSPITAL OutpatientFacility | Keystone First | JAB001 Caid MCO | $11.07 | — | — | 2026-03-18 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $11.07 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MANAGED MEDICAID | $11.25 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | GEISINGER | MANAGED MEDICAID | $11.25 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | GEISINGER | MANAGED MEDICAID | $11.25 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $11.43 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $11.43 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $11.43 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $11.43 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $11.43 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | HIGHMARK WHOLECARE/GATEWAY | MANAGED MEDICAID | $11.43 | — | — | 2025-08-01 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | PA Health_Wellness CHC | JNJ001_JNJ002_JNJ003 CHC | $11.70 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | PA Health_Wellness CHC | JNJ001_JNJ002_JNJ003 CHC | $11.70 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | PA Health_Wellness CHC | JNE001_JNE002_JNE003 CHC | $11.70 | — | — | 2026-03-18 | MRF ↗ |
| Jefferson Methodist Hospital OutpatientFacility | PA Health_Wellness CHC | JCC001 JCC002 CHC | $11.70 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON ABINGTON HOSPITAL OutpatientFacility | PA Health_Wellness CHC | JAB001 CHC | $11.70 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON LANSDALE HOSPITAL OutpatientFacility | PA Health_Wellness CHC | JAB002 CHC | $11.70 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | PA Health_Wellness CHC | JNJ001_JNJ002_JNJ003 CHC | $11.70 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | PA Health_Wellness CHC | JNE001_JNE002_JNE003 CHC | $11.70 | — | — | 2026-03-18 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | AETNA | MANAGED MEDICAID | $11.70 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AETNA | MANAGED MEDICAID | $11.70 | — | — | 2025-08-01 | MRF ↗ |
| Magee Rehabilitation Hospital OutpatientFacility | Magee PA Health_Wellness | Medicaid | $11.70 | — | — | 2026-03-18 | MRF ↗ |
| THOMAS JEFFERSON UNIVERSITY HOSPITAL OutpatientFacility | PA Health_Wellness CHC | JCC001 JCC002 CHC | $11.70 | — | — | 2026-03-18 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $11.88 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $11.88 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $11.88 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $11.88 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $11.88 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $11.88 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $11.88 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $11.88 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $11.88 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $11.88 | — | — | 2026-04-14 | MRF ↗ |
| Magee Rehabilitation Hospital OutpatientFacility | Magee Aetna Better Health | CHIP | $11.89 | — | — | 2026-03-18 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $12.15 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $12.15 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $12.15 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $12.15 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $12.15 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $12.15 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $12.15 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $12.15 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $12.15 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $12.15 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | PA HEALTH & WELLNESS | MANAGED MEDICAID | $12.15 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - POCONO Outpatient | JEFFERSON HEALTH PARTNERS | MANAGED MEDICAID | $12.15 | — | — | 2025-08-01 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | Geisinger Medicaid | JNE001_JNE002_JNE003 Caid | $12.18 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | Geisinger Medicaid | JNE001_JNE002_JNE003 Caid | $12.18 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON LANSDALE HOSPITAL OutpatientFacility | Geisinger Medicaid | JAB002 Caid | $12.18 | — | — | 2026-03-18 | MRF ↗ |
| Magee Rehabilitation Hospital OutpatientFacility | Geisinger Health Plan | Medicaid | $12.18 | — | — | 2026-03-18 | MRF ↗ |
| Jefferson Methodist Hospital OutpatientFacility | Geisinger Medicaid | JCC001 JCC002 Caid MCO | $12.18 | — | — | 2026-03-18 | MRF ↗ |
| THOMAS JEFFERSON UNIVERSITY HOSPITAL OutpatientFacility | Geisinger Medicaid | JCC001 JCC002 Caid MCO | $12.18 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $12.42 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $12.42 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $12.42 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $12.42 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $12.42 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $12.42 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $12.42 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY GENERAL HOSPITAL Outpatient | Highmark Wholecare | Highmark Wholecare Medicaid HC | $12.42 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | UHC MCR ADV | UHC MCR ADV | $12.92 | $38.00 | $22.80 | 2025-11-18 | MRF ↗ |
| WEST PENN HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $13.05 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $13.05 | — | — | 2026-04-14 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $13.05 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AETNA | MANAGED MEDICAID | $13.05 | — | — | 2025-08-01 | MRF ↗ |
| SAINT VINCENT HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $13.05 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | KEYSTONE FIRST | MANAGED MEDICAID | $13.05 | — | — | 2025-08-01 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas CHC Medicaid | $13.05 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Geisinger | Geisinger Medicaid HC | $13.05 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $13.05 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | United Healthcare | United Healthcare Medicaid | $13.05 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $13.05 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Geisinger | Geisinger Medicaid HC | $13.05 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Inpatient | Geisinger | Geisinger CHIP | $13.05 | — | — | 2026-04-14 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AETNA | MANAGED MEDICAID | $13.05 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $13.05 | — | — | 2025-08-01 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Inpatient | Amerihealth | Amerihealth Caritas HC Medicaid | $13.05 | — | — | 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.