95991 — Spin/brain Pump Refil & Main
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). SPIN/BRAIN PUMP REFIL & MAIN (CPT 95991) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/95991?code_type=CPT
MLA (9th ed.)
“SPIN/BRAIN PUMP REFIL & MAIN (CPT 95991) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/95991?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“SPIN/BRAIN PUMP REFIL & MAIN (CPT 95991) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/95991?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $193–$568 (25th–75th percentile) across 2,001 hospitals · 4,331 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 95991 — 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
$193
$327 typical
$568
The middle 50% of negotiated facility rates for this procedure, measured across 2,001 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. | $327 |
| Physician fee Estimate national typical Medicare $34 × 1.22 commercial. | $41 |
| Likely subtotal | $368 |
Complete-episode estimate (typical)
~$368
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge
- Complications, revisions, or readmissions
- Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)
The biggest swing: which insurer's rate applies — negotiated prices here run $193–$568.
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 | — | — | — | $722.80 | $361.40 | 2024-12-15 | MRF ↗ |
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | — | — | — | $722.80 | $361.40 | 2024-12-15 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $0.22 | $20.95 | $20.95 | 2026-04-24 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.49 | — | — | 2026-09-01 | MRF ↗ |
| James Cancer Hospital & Solove Research Institute Outpatient | Cigna | Cigna - Transplant | $0.62 | $784.00 | — | 2026-07-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | $1,734.00 | $1,300.50 | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | $1,384.00 | $1,038.00 | 2026-05-20 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | $1,384.00 | $1,038.00 | 2026-05-20 | MRF ↗ |
| SIERRA MEDICAL CENTER BothFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | $1,734.00 | $1,300.50 | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW BUSINESS | $1.00 | $1,384.00 | $1,038.00 | 2026-05-20 | MRF ↗ |
| SIERRA MEDICAL CENTER BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE CHARTER | $1.00 | $1,734.00 | $1,300.50 | 2026-09-01 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | $1,384.00 | $1,038.00 | 2026-05-20 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Medicaid | Medicaid | $1.00 | $835.00 | $417.50 | 2026-07-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | $1,384.00 | $1,038.00 | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW BUSINESS | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NON OPTIONS PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE COMMERCIAL | $1.00 | $1,384.00 | $1,038.00 | 2026-05-20 | MRF ↗ |
| SIERRA MEDICAL CENTER BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE - OPTIONS | $1.00 | $1,734.00 | $1,300.50 | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA HMO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | $1,384.00 | $1,038.00 | 2026-05-20 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA HMO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | $1,734.00 | $1,300.50 | 2026-09-01 | MRF ↗ |
| METROWEST MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NONOPTIONS | $1.00 | — | — | 2026-06-05 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | $1,384.00 | $1,038.00 | 2026-05-20 | MRF ↗ |
| SIERRA MEDICAL CENTER BothFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | $1,734.00 | $1,300.50 | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OF FLORIDA EXCHANGE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | $1,384.00 | $1,038.00 | 2026-05-20 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NON OPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE COMMERCIAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | $1,384.00 | $1,038.00 | 2026-05-20 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE CHARTER | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE - OPTIONS | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE OPTIONS | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | $1,384.00 | $1,038.00 | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE EXCHANGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $1.07 | $835.00 | $417.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $1.10 | $835.00 | $417.50 | 2026-07-01 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Outpatient | United Healthcare Medicare | Medicare Advantage | $1.12 | $100.00 | $60.00 | 2026-02-12 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Outpatient | United Healthcare Medicare | Medicare Advantage | $1.12 | $100.00 | $60.00 | 2026-02-12 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $1.16 | $95.00 | $18.05 | 2026-05-20 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $1.18 | $835.00 | $417.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Jefferson Health Plan | Jefferson Health Plan - Managed Medicaid | $1.20 | $835.00 | $417.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - Managed Medicaid | $1.47 | $835.00 | $417.50 | 2026-07-01 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.64 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $1.64 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.64 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.68 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.73 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $1.77 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $2.13 | $1,184.00 | $298.51 | 2024-12-31 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $2.17 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $2.17 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $2.21 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $2.30 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $2.39 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - CHIP - Managed Medicare | $2.50 | $835.00 | $417.50 | 2026-07-01 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.20 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.22 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.22 | — | — | 2026-03-18 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $3.36 | — | — | 2026-07-15 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $3.67 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $3.69 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $3.69 | — | — | 2026-03-18 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $3.84 | $192.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $3.84 | $192.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $3.84 | $192.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $3.84 | $192.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $3.84 | $192.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $3.84 | $192.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $3.84 | $192.00 | — | 2026-03-31 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $4.00 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $4.02 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $4.02 | — | — | 2026-03-18 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $6.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $6.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $6.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $6.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $6.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $6.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $6.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $6.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $6.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $6.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6790_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ASIN 20230101 | $6.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $6.78 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | MRF ↗ |
| CENTRA BEDFORD MEMORIAL HOSPITAL Both | Anthem | Healthkeepers Medicaid Plans | $8.55 | $1,455.00 | $480.15 | 2026-07-15 | MRF ↗ |
| SOUTHSIDE COMMUNITY HOSPITAL, INC Both | Aetna | Better Health Medicaid Plans | $8.55 | $1,455.00 | $480.15 | 2026-09-21 | MRF ↗ |
| CENTRA BEDFORD MEMORIAL HOSPITAL Both | Aetna | Better Health Medicaid Plans | $8.55 | $1,455.00 | $480.15 | 2026-07-15 | MRF ↗ |
| SOUTHSIDE COMMUNITY HOSPITAL, INC Both | Anthem | Healthkeepers Medicaid Plans | $8.55 | $1,455.00 | $480.15 | 2026-09-21 | MRF ↗ |
| SOUTHSIDE COMMUNITY HOSPITAL, INC Both | Sentara Medicaid | — | $8.64 | $1,455.00 | $480.15 | 2026-09-21 | MRF ↗ |
| CENTRA BEDFORD MEMORIAL HOSPITAL Both | Sentara Medicaid | — | $8.64 | $1,455.00 | $480.15 | 2026-07-15 | MRF ↗ |
| SOUTHSIDE COMMUNITY HOSPITAL, INC Both | United Healthcare | Medicaid | $8.72 | $1,455.00 | $480.15 | 2026-09-21 | MRF ↗ |
| CENTRA BEDFORD MEMORIAL HOSPITAL Both | United Healthcare | Medicaid | $8.72 | $1,455.00 | $480.15 | 2026-07-15 | MRF ↗ |
| CENTRA BEDFORD MEMORIAL HOSPITAL Both | Molina | Medicaid | $8.81 | $1,455.00 | $480.15 | 2026-07-15 | MRF ↗ |
| SOUTHSIDE COMMUNITY HOSPITAL, INC Both | Molina | Medicaid | $8.81 | $1,455.00 | $480.15 | 2026-09-21 | MRF ↗ |
| HARLAN COUNTY HEALTH SYSTEM Outpatient | NE TOTAL CARE MCAID | NE TOTAL CARE MCAID | $10.07 | $348.00 | $278.40 | 2026-07-15 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | UHC MCAID | UHC MCAID | $10.07 | $224.70 | $146.06 | 2026-08-10 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | MOLINA MCAID - ALL OTHER PLANS | MOLINA MCAID - ALL OTHER PLANS | $10.27 | $228.25 | $228.25 | 2026-04-24 | MRF ↗ |
| HARLAN COUNTY HEALTH SYSTEM Outpatient | HEALTHY BLUE MCAID-ALL PLANS | HEALTHY BLUE MCAID-ALL PLANS | $10.57 | $348.00 | $278.40 | 2026-07-15 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | MOLINA MCR ADV | MOLINA MCR ADV | $11.44 | $20.95 | $20.95 | 2026-04-24 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | MOLINA MCAID - ALL OTHER PLANS | MOLINA MCAID - ALL OTHER PLANS | $13.04 | $20.95 | $20.95 | 2026-04-24 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | HEALTHNET MEDI-CAL | HEALTHNET MEDI-CAL | $14.25 | $95.00 | $18.05 | 2026-05-20 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid | Medicaid Nhhf | $14.89 | $162.00 | $48.60 | 2026-07-15 | MRF ↗ |
| HIGHLAND HOSPITAL Both | EXCELLUS BC/BS MEDICAID [1706], EXCELLUS BC/BS [2201] | BLUE CHOICE OPTION MEDICAID [170601], EXCELLUS CHILD HEALTH PLUS [220108],EXCELLUS HEALTHY NY [220110], EXCELLUS ESSENTIAL (NO MEDICAID) [220109], EXCELLUS ESSENTIAL (W/ MEDICAID) [170604], UNIVERA HEALTHY NY [220112], UNIVERA ESSENTIAL (NO MEDICAID) [220 | $15.23 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Both | EXCELLUS BC/BS MEDICAID [1706], EXCELLUS BC/BS [2201] | BLUE CHOICE OPTION MEDICAID [170601], EXCELLUS CHILD HEALTH PLUS [220108],EXCELLUS HEALTHY NY [220110], EXCELLUS ESSENTIAL (NO MEDICAID) [220109], EXCELLUS ESSENTIAL (W/ MEDICAID) [170604], UNIVERA HEALTHY NY [220112], UNIVERA ESSENTIAL (NO MEDICAID) [220 | $15.23 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Both | HIGHMARK BC/BS OF WESTERN NY MEDICAID [1702], AMERIGROUP (BSWNY ALTERNATE) [1720], HIGHMARK BC/BS OF WESTERN NY [5143] | HIGHMARK BC/BS OF WESTERN NY MEDICAID [170201], AMERIGROUP (BSWNY ALTERNATE) [172001], COMMUNITY BLUE CHILD HEALTH PLUS [514306], BC/BS OF WNY ESSENTIAL (NO MEDICAID) [514307] | $15.84 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Both | HIGHMARK BC/BS OF WESTERN NY MEDICAID [1702], AMERIGROUP (BSWNY ALTERNATE) [1720], HIGHMARK BC/BS OF WESTERN NY [5143] | HIGHMARK BC/BS OF WESTERN NY MEDICAID [170201], AMERIGROUP (BSWNY ALTERNATE) [172001], COMMUNITY BLUE CHILD HEALTH PLUS [514306], BC/BS OF WNY ESSENTIAL (NO MEDICAID) [514307] | $15.84 | — | — | 2026-04-01 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $15.93 | $118.00 | $88.50 | 2026-01-16 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $16.05 | — | — | 2026-03-18 | MRF ↗ |
| TUG VALLEY ARH REGIONAL MEDICAL CENTER | Aetna Medicaid Kentucky | — | $16.06 | $146.00 | $87.60 | 2026-08-01 | MRF ↗ |
| TUG VALLEY ARH REGIONAL MEDICAL CENTER | Humana Medicaid Kentucky | — | $16.06 | $146.00 | $87.60 | 2026-08-01 | MRF ↗ |
| TUG VALLEY ARH REGIONAL MEDICAL CENTER | Anthem Medicaid Kentucky | — | $16.06 | $146.00 | $87.60 | 2026-08-01 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid | Medicaid-Trad | $16.20 | $162.00 | $48.60 | 2026-07-15 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid-Amerihealth | Medicaid-Amerihealth | $16.36 | $162.00 | $48.60 | 2026-07-15 | MRF ↗ |
| TUG VALLEY ARH REGIONAL MEDICAL CENTER | Molina Medicaid Kentucky | — | $16.38 | $146.00 | $87.60 | 2026-08-01 | MRF ↗ |
| SGMC HEALTH | Humana | — | $16.63 | $103.00 | $77.25 | 2026-07-30 | MRF ↗ |
| HIGHLAND HOSPITAL Both | EXCELLUS BC/BS MEDICAID [1706], EXCELLUS BC/BS [2201] | BLUE CHOICE OPTION MEDICAID [170601], EXCELLUS CHILD HEALTH PLUS [220108],EXCELLUS HEALTHY NY [220110], EXCELLUS ESSENTIAL (NO MEDICAID) [220109], EXCELLUS ESSENTIAL (W/ MEDICAID) [170604], UNIVERA HEALTHY NY [220112], UNIVERA ESSENTIAL (NO MEDICAID) [220 | $17.92 | — | — | 2026-04-01 | MRF ↗ |
| MONTEFIORE MEDICAL CENTER Both | New York Medicaid | Medicaid | $17.92 | $690.00 | $451.26 | 2026-04-01 | MRF ↗ |
| Memorial Hospital For Cancer And Allied Diseases Both | [EMBLEM] | [HIP_ESS_3_4_MR/DD/TBI Pts] | $17.92 | $455.00 | $455.00 | 2024-09-15 | MRF ↗ |
| Memorial Hospital For Cancer And Allied Diseases Both | [EMBLEM] | [HIP_ESS_1_2_AMB_SURG] | $17.92 | $455.00 | $455.00 | 2024-09-15 | MRF ↗ |
| Memorial Hospital For Cancer And Allied Diseases Both | [EMBLEM] | [HIP_ESS_1_2_HOSP_OP_DEPT] | $17.92 | $455.00 | $455.00 | 2024-09-15 | MRF ↗ |
| Memorial Hospital For Cancer And Allied Diseases Both | [EMBLEM] | [HIP_ESS_3_4_HOSP_OP_DEPT] | $17.92 | $455.00 | $455.00 | 2024-09-15 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Both | EXCELLUS BC/BS MEDICAID [1706], EXCELLUS BC/BS [2201] | BLUE CHOICE OPTION MEDICAID [170601], EXCELLUS CHILD HEALTH PLUS [220108],EXCELLUS HEALTHY NY [220110], EXCELLUS ESSENTIAL (NO MEDICAID) [220109], EXCELLUS ESSENTIAL (W/ MEDICAID) [170604], UNIVERA HEALTHY NY [220112], UNIVERA ESSENTIAL (NO MEDICAID) [220 | $17.92 | — | — | 2026-04-01 | MRF ↗ |
| Memorial Hospital For Cancer And Allied Diseases Both | [EMBLEM] | [HIP_ESS_3_4_AMB_SURG] | $17.92 | $455.00 | $455.00 | 2024-09-15 | MRF ↗ |
| Memorial Hospital For Cancer And Allied Diseases Both | [EMBLEM] | [HIP_ESS_1_2_MR/DD/TBI Pts] | $17.92 | $455.00 | $455.00 | 2024-09-15 | MRF ↗ |
| UPMC COLE OutpatientFacility | Highmark BCBS of PA | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $18.02 | $65.00 | $39.00 | 2026-03-06 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | HEALTHNET MCARE | HEALTHNET MCARE | $18.05 | $95.00 | $25.65 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | UHC MCR ADV | UHC MCR ADV | $18.05 | $95.00 | $25.65 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | UNIVERSAL IPA MCR ADV OP/PROFEE ONLY-ALL OTHER PLA | UNIVERSAL IPA MCR ADV OP/PROFEE ONLY-ALL OTHER PLA | $18.05 | $95.00 | $25.65 | 2026-01-31 | MRF ↗ |
| ADVENTIST HEALTH TEHACHAPI VALLEY Outpatient | TRICARE BLUE SHIELD | TRICARE BLUE SHIELD | $18.05 | $95.00 | $25.65 | 2026-01-31 | MRF ↗ |
| SUSAN B ALLEN MEMORIAL HOSPITAL Outpatient | BCBSKS VALUE BLUE | BCBSKS VALUE BLUE | $18.05 | $430.00 | $258.00 | 2024-04-10 | MRF ↗ |
| UPMC COLE OutpatientFacility | United Healthcare | Medicare | $18.20 | $65.00 | $39.00 | 2026-03-06 | MRF ↗ |
| UPMC COLE OutpatientFacility | AmeriHealth Caritas | Medicare | $18.20 | $65.00 | $39.00 | 2026-03-06 | MRF ↗ |
| UPMC COLE OutpatientFacility | UPMC Health Plan | Managed Medicare | $18.20 | $65.00 | $39.00 | 2026-03-06 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Caresource Oh | Managed Care Medicaid Plan | $18.22 | $246.00 | $125.46 | 2026-07-18 | 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.