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 $216–$543 (25th–75th percentile) across 1,673 hospitals · 4,099 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 surgeon and anesthesia figures are estimates from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$216
$335 typical
$543
The middle 50% of negotiated facility rates for this procedure, measured across 1,673 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. | $335 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $34 × 1.22 commercial. | $41 |
| Likely subtotal | $376 |
Surgical episode (typical)
~$376
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)
~$4,161
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 |
|---|---|---|---|---|---|---|---|
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | None | — | — | $722.80 | $361.40 | 2024-12-15 | MRF ↗ |
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | None | — | — | $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 ↗ |
| 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 ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $1.64 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.64 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.64 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.68 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.73 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $1.77 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $2.13 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $2.13 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $2.13 | $1,184.00 | $298.51 | 2024-12-31 | 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 | Security Health Plan (SHP) | Medicare Advantage | $2.17 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $2.17 | $443.00 | $420.85 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $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 - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $2.26 | $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 ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.20 | — | — | 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 ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.22 | — | — | 2026-03-18 | 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 | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $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 ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $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 BEACON HEALTH | $3.84 | $192.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $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 KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $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 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 HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $6.78 | — | — | 2026-01-01 | 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 CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 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 WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 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 RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $6.78 | — | — | 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 FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $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 ANDERSON 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 CARMEL 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 EVANSVILLE 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 RANDOLPH 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 HOSPITAL 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 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 | 9470_UNITED HEALTHCARE VEIN 20250101 | $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 HOSPITAL 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 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 ANDERSON 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 | 9470_UNITED HEALTHCARE VEIN 20250101 | $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 RANDOLPH 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 ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $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 ↗ |
| 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 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 WILLIAMSPORT 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 WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $7.43 | — | — | 2026-01-01 | 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 ↗ |
| 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 ↗ |
| 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 | 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 | 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 ↗ |
| 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 ↗ |
| 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 ↗ |
| ALBANY MEDICAL CENTER HOSPITAL InpatientFacility | United Healthcare | All Products | $17.09 | $22.78 | $11.39 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MVP Commercial | Individual_Student Health Plan | $17.09 | $22.78 | $11.39 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MVP Commercial | CIGNA All Products | $17.09 | $22.78 | $11.39 | 2025-12-31 | 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 ↗ |
| 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 ↗ |
| 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 ↗ |
| 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_AMB_SURG] | $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_1_2_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_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_HOSP_OP_DEPT] | $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 ↗ |
| 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 ↗ |
| UPMC COLE OutpatientFacility | United Healthcare | Medicare | $18.20 | $65.00 | $39.00 | 2026-03-06 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $18.22 | $22.78 | $11.39 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | Emblem | SelectCare | $18.22 | $22.78 | $11.39 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | United Healthcare | All Products | $18.22 | $22.78 | $11.39 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products-Transplant | $18.22 | $22.78 | $11.39 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | Empire Plan NYSHIP | All Products | $18.22 | $22.78 | $11.39 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | Emblem_GHI | Commercial_All Products | $18.22 | $22.78 | $11.39 | 2025-12-31 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Humana Oh | Managed Care Medicaid Plan | $18.22 | $246.00 | $125.46 | 2026-05-09 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Anthem Oh | Managed Care Medicaid Plan | $18.22 | $246.00 | $125.46 | 2026-05-09 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Caresource Oh | Managed Care Medicaid Plan | $18.22 | $246.00 | $125.46 | 2026-05-09 | MRF ↗ |
| UPMC COLE OutpatientFacility | Humana | Medicare | $18.38 | $65.00 | $39.00 | 2026-03-06 | 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 | $18.63 | — | — | 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] | $18.63 | — | — | 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] | $18.63 | — | — | 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 | $18.63 | — | — | 2026-04-01 | MRF ↗ |
| UPMC COLE OutpatientFacility | AmeriHealth Caritas | Medicaid | $18.66 | $65.00 | $39.00 | 2026-03-06 | MRF ↗ |
| UPMC COLE OutpatientFacility | AmeriHealth Caritas | Community HealthChoices (CHC) | $18.66 | $65.00 | $39.00 | 2026-03-06 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Amerihealth Caritas Oh | Managed Care Medicaid Plan | $18.74 | $246.00 | $125.46 | 2026-05-09 | MRF ↗ |
| UPMC COLE OutpatientFacility | UPMC Health Plan | Managed Medicaid | $18.85 | $65.00 | $39.00 | 2026-03-06 | MRF ↗ |
| MEDICAL CITY ARGYLE HOSPITAL Outpatient | Superior Health Plan | CHIP | $18.99 | $271.26 | $271.26 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY ARGYLE HOSPITAL Outpatient | Superior Health Plan | MCDSTAR | $18.99 | $271.26 | $271.26 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY ARGYLE HOSPITAL Outpatient | Superior Health Plan | STARHealth | $18.99 | $271.26 | $271.26 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY ARGYLE HOSPITAL Outpatient | Superior Health Plan | STARPLUS | $18.99 | $271.26 | $271.26 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY ARGYLE HOSPITAL Outpatient | Superior Health Plan | STARKids | $18.99 | $271.26 | $271.26 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY DENTON Outpatient | Superior Health Plan | STARHealth | $18.99 | $271.26 | $271.26 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY DENTON Outpatient | Superior Health Plan | STARKids | $18.99 | $271.26 | $271.26 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY DENTON Outpatient | Superior Health Plan | MCDSTAR | $18.99 | $271.26 | $271.26 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY DENTON Outpatient | Superior Health Plan | STARPLUS | $18.99 | $271.26 | $271.26 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY DENTON Outpatient | Superior Health Plan | CHIP | $18.99 | $271.26 | $271.26 | 2026-03-01 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Molina Oh | Managed Care Medicaid Plan | $19.09 | $246.00 | $125.46 | 2026-05-09 | MRF ↗ |
| UPMC COLE OutpatientFacility | Cigna | Medicare | $19.11 | $65.00 | $39.00 | 2026-03-06 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | Multiplan | PPO | $19.36 | $22.78 | $11.39 | 2025-12-31 | MRF ↗ |
| BOULDER COMMUNITY HEALTH OutpatientFacility | Cigna Individual | Commercial | $19.59 | $78.00 | $39.00 | 2025-12-23 | MRF ↗ |
| UPMC COLE OutpatientFacility | PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $19.66 | $65.00 | $39.00 | 2026-03-06 | MRF ↗ |
| UPMC COLE OutpatientFacility | PA Health & Wellness | Allwell Medicare Advantage DSNP | $19.66 | $65.00 | $39.00 | 2026-03-06 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Blue Cross Complete | MEDICAID | $19.70 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | McLaren | MEDICAID | $19.70 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Priority Health | MEDICAID | $19.70 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $19.70 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | HAP CareSource | MEDICAID | $19.70 | — | — | 2025-06-28 | MRF ↗ |
| UPMC COLE OutpatientFacility | Aetna | Medicare | $19.82 | $65.00 | $39.00 | 2026-03-06 | MRF ↗ |
| UMD REHABILITATION & ORTHOPAEDIC INSTITUTE Both | None | — | — | $20.31 | $19.90 | 2025-11-05 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Buckeye Oh | Managed Care Medicaid Plan | $19.96 | $246.00 | $125.46 | 2026-05-09 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | MIDLANDS CHOICE-ALL PLANS | MIDLANDS CHOICE-ALL PLANS | $20.11 | $20.95 | $20.95 | 2026-04-24 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | BCBS-ALL PLANS | BCBS-ALL PLANS | $20.11 | $20.95 | $20.95 | 2026-04-24 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | UHC-ALL PLANS | UHC-ALL PLANS | $20.22 | $20.95 | $20.95 | 2026-04-24 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | MULTIPLAN-ALL PLANS | MULTIPLAN-ALL PLANS | $20.32 | $20.95 | $20.95 | 2026-04-24 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | TLC ADVANTAGE-ALL PLANS | TLC ADVANTAGE-ALL PLANS | $20.32 | $20.95 | $20.95 | 2026-04-24 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AVERA ASO PPO | AVERA ASO PPO | $20.32 | $20.95 | $20.95 | 2026-04-24 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | FIRST CHOICE-ALL PLANS | FIRST CHOICE-ALL PLANS | $20.32 | $20.95 | $20.95 | 2026-04-24 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AVERA ACA PPO | AVERA ACA PPO | $20.32 | $20.95 | $20.95 | 2026-04-24 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | PHCS-ALL PLANS | PHCS-ALL PLANS | $20.32 | $20.95 | $20.95 | 2026-04-24 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AVERA NON-ACA PPO - ALL OTHER PLANS | AVERA NON-ACA PPO - ALL OTHER PLANS | $20.32 | $20.95 | $20.95 | 2026-04-24 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AVERA HMO | AVERA HMO | $20.32 | $20.95 | $20.95 | 2026-04-24 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Aetna Better Health | MEDICAID | $20.69 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Blue Cross Complete | MEDICAID | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | HAP Caresource Medicaid | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Priority Health | MEDICAID | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Aetna Better Health | MEDICAID | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Aetna Better Health | MEDICAID | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Priority Health | MEDICAID | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | McLaren | MEDICAID | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | HAP | HAP Caresource Medicaid | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Aetna Better Health | MEDICAID | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Priority Health | MEDICAID | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | HAP | HAP Caresource Medicaid | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Blue Cross Complete | MEDICAID | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | McLaren | MEDICAID | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | HAP Caresource Medicaid | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | McLaren | MEDICAID | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Priority Health | MEDICAID | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna Better Health | MEDICAID | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | McLaren | MEDICAID | $21.24 | $240.00 | — | 2025-06-28 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Quartz | Managed Medicaid | $21.35 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Dean Health Plan | Managed Medicaid | $21.35 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | MEDICAID | MEDICAID | $21.35 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Anthem | Managed Medicaid | $21.35 | — | — | 2025-07-22 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $21.42 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICAID 1702 | HIGHMARK BCBS MEDICAID 170201 CHILD HEALTH PLUS 170204 | $21.42 | — | — | 2026-01-01 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Caresource Oh | Managed Care Medicaid Plan | $21.44 | $246.00 | $125.46 | 2026-05-09 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Humana Oh | Managed Care Medicaid Plan | $21.44 | $246.00 | $125.46 | 2026-05-09 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Anthem Oh | Managed Care Medicaid Plan | $21.44 | $246.00 | $125.46 | 2026-05-09 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Aetna Better Health Ky | Managed Care Medicaid Plan | $21.45 | $246.00 | $125.46 | 2026-05-09 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | United Health Care Oh | Managed Care Medicaid Plan | $21.70 | $246.00 | $125.46 | 2026-05-09 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $21.78 | — | — | 2025-07-22 | MRF ↗ |
| Children's Hospital & Medical Center Transplant Inpatient | Amerihealth Caritas Oh | Managed Care Medicaid Plan | $22.05 | $246.00 | $125.46 | 2026-05-09 | MRF ↗ |
| BOULDER COMMUNITY HEALTH OutpatientFacility | Cigna | Commercial | $22.14 | $78.00 | $39.00 | 2025-12-23 | 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.