96112 — Devel Tst Phys/qhp 1st Hr
Cite this view
HANK Price Transparency. (n.d.). DEVEL TST PHYS/QHP 1ST HR (CPT 96112) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/96112?code_type=CPT
“DEVEL TST PHYS/QHP 1ST HR (CPT 96112) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/96112?code_type=CPT. Accessed .
“DEVEL TST PHYS/QHP 1ST HR (CPT 96112) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/96112?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $151–$393 (25th–75th percentile) across 1,566 hospitals · 4,348 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 96112 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
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.
The middle 50% of negotiated facility rates for this procedure, measured across 1,566 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. | $228 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $107 × 1.22 commercial. | $130 |
| Likely subtotal | $359 |
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.
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 |
|---|---|---|---|---|---|---|---|
| ST BARNABAS HOSPITAL OutpatientFacility | Optum | Medicaid | $0.83 | $419.00 | — | 2026-02-27 | MRF ↗ |
| ST BARNABAS HOSPITAL OutpatientFacility | Optum | Medicaid | $0.83 | $419.00 | — | 2026-02-27 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | SCAN Health Plan | Medicare Advantage | — | $3,969.24 | $2,580.01 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $3,969.24 | $2,580.01 | 2025-11-26 | MRF ↗ |
| SAN ANTONIO REGIONAL HOSPITAL Outpatient | ANTHEM BLUE CROSS EXCHG | ANTHEM BLUE CROSS EXCHG | $1.51 | $690.00 | $933.00 | 2026-04-02 | MRF ↗ |
| GROVE HILL MEMORIAL HOSPITAL BothFacility | United Healthcare | All Other Plans | $1.82 | $2.60 | $1.56 | 2026-05-05 | MRF ↗ |
| GROVE HILL MEMORIAL HOSPITAL BothFacility | Aetna | All Other Plans | $1.95 | $2.60 | $1.56 | 2026-05-05 | MRF ↗ |
| GROVE HILL MEMORIAL HOSPITAL BothFacility | Cigna | All Plans | $1.95 | $2.60 | $1.56 | 2026-05-05 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | BLUE CROSS MEDICAID [1612] | DCH ILLINOIS MEDICAID | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | COUNTYCARE IL COOK CO [1607] | DCH ILLINOIS MEDICAID | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | HEALTH ALLIANCE MEDICAID [1310] | DCH ILLINOIS MEDICAID | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | COUNTYCARE IL COOK CO [1607] | CDH ILLINOIS MEDICAID | $2.00 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | HEALTH ALLIANCE MEDICAID [1310] | KH ILLINOIS MEDICAID | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | COUNTYCARE IL COOK CO [1607] | KH ILLINOIS MEDICAID | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | BLUE CROSS MEDICAID [1612] | KH ILLINOIS MEDICAID | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | MERIDIAN HEALTH PLAN HMO [1604] | KH ILLINOIS MEDICAID | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | HEALTH ALLIANCE MEDICAID [1310] | CDH ILLINOIS MEDICAID | $2.00 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | CENPATICO BEHAVIORAL HEALTH [1603] | KH ILLINOIS MEDICAID | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | FAMILY HEALTH NETWORK HMO [1610] | KH ILLINOIS MEDICAID | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | BLUE CROSS MEDICAID [1612] | CDH ILLINOIS MEDICAID | $2.00 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | CIGNA HEALTHSPRING SPECIALCARE OF IL [1608] | KH ILLINOIS MEDICAID | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | ALTERNATE BLUE CROSS [1402] | CDH BCBS BLUECHOICE SELECT | $3.22 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | ALTERNATE BLUE CROSS [1402] | CDH BCBS BLUECHOICE OPTIONS | $3.22 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | CDH BCBS BLUECHOICE SELECT | $3.22 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | CDH BCBS BLUECHOICE PREFERRED | $3.22 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | CDH BCBS BLUECHOICE OPTIONS | $3.22 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | ALTERNATE BLUE CROSS [1402] | CDH BCBS BLUECHOICE PREFERRED | $3.22 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | GLOBAL EXCEL [1712] | CDH MEDICARE | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | GLOBAL EXCEL [1712] | KH MEDICARE | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | ALTERNATE BLUE CROSS MEDICARE ADV [2304] | KH MEDICARE | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | ALTERNATE BLUE CROSS MEDICARE ADV [2304] | CDH MEDICARE | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.44 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.46 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.46 | — | — | 2026-03-18 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Humana | Choice Care Network | $3.62 | $1,216.00 | $912.00 | 2026-04-01 | MRF ↗ |
| Marianjoy Rehabilitation Hospital Outpatient | ALTERNATE HUMANA MEDICARE ADV [2409] | MRH MEDICARE | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | GLOBAL EXCEL [1712] | DCH MEDICARE | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| Marianjoy Rehabilitation Hospital Outpatient | GLOBAL EXCEL [1712] | MRH MEDICARE | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| Marianjoy Rehabilitation Hospital Outpatient | ALTERNATE BLUE CROSS MEDICARE ADV [2304] | MRH MEDICARE | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | GLOBAL EXCEL [1712] | NLFH MEDICARE | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $3.94 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $3.96 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $3.96 | — | — | 2026-03-18 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | CDH AETNA NM EMPLOYEES | $4.15 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $4.17 | $379.93 | $227.96 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $4.17 | $379.93 | $227.96 | 2025-08-11 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $4.29 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $4.32 | — | — | 2026-03-18 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | DCH BCBS BLUECHOICE OPTIONS | $4.32 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | DCH BCBS BLUECHOICE SELECT | $4.32 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $4.32 | — | — | 2026-03-18 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MVP Commercial | CIGNA All Products | $4.50 | $6.00 | $3.00 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL InpatientFacility | United Healthcare | All Products | $4.50 | $6.00 | $3.00 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MVP Commercial | Individual_Student Health Plan | $4.50 | $6.00 | $3.00 | 2025-12-31 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | PH BCBS BLUECHOICE PREFERRED | $4.64 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | PH BCBS BLUECHOICE OPTIONS | $4.64 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | PH BCBS BLUECHOICE OPTIONS SELECT | $4.64 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | DCH AETNA NM EMPLOYEES | $4.73 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | Emblem | SelectCare | $4.80 | $6.00 | $3.00 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products-Transplant | $4.80 | $6.00 | $3.00 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | United Healthcare | All Products | $4.80 | $6.00 | $3.00 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | Emblem_GHI | Commercial_All Products | $4.80 | $6.00 | $3.00 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | Empire Plan NYSHIP | All Products | $4.80 | $6.00 | $3.00 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $4.80 | $6.00 | $3.00 | 2025-12-31 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | NLFH AETNA NM EMPLOYEES | $4.81 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | CDH BCBS PPO | $5.10 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | Multiplan | PPO | $5.10 | $6.00 | $3.00 | 2025-12-31 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | ALTERNATE BLUE CROSS [1402] | CDH BCBS PPO | $5.10 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $5.17 | $379.93 | $227.96 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $5.17 | $379.93 | $227.96 | 2025-08-11 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | DCH BCBS BLUECHOICE PREFERRED | $5.22 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | KH AETNA NM EMPLOYEES | $5.31 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | CIGNA HEALTH PLAN [178] | PH CIGNA ALTERNATIVE | $5.42 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| VALLEY WEST COMMUNITY HOSPITAL Outpatient | ALTERNATE HUMANA MEDICARE ADV [2409] | VWH MEDICARE | $5.51 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| VALLEY WEST COMMUNITY HOSPITAL Outpatient | ALTERNATE BLUE CROSS MEDICARE ADV [2304] | VWH BLUE CROSS MEDICARE ADVT | $5.51 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| VALLEY WEST COMMUNITY HOSPITAL Outpatient | GLOBAL EXCEL [1712] | VWH MEDICARE | $5.51 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | ALTERNATE BLUE CROSS [1402] | PH BCBS PPO | $5.57 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | PH BCBS PPO | $5.57 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | United Healthcare | Medicare Advantage | $6.00 | $6.00 | $3.00 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | Blue Shield | Indemnity_PPO | $6.00 | $6.00 | $3.00 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | Blue Shield | HMO_POS | $6.00 | $6.00 | $3.00 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | United Healthcare | Veterans Affairs Community Care Network (VACCN) | $6.00 | $6.00 | $3.00 | 2025-12-31 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | CIGNA HEALTH PLAN [178] | NLFH CIGNA ALTERNATIVE | $6.09 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | NLFH BCBS HMO | $6.15 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | ALTERNATE BLUE CROSS [1402] | NLFH BCBS HMO | $6.15 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | CIGNA HEALTH PLAN [178] | CDH CIGNA ALTERNATIVE | $6.21 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | PH AETNA NM EMPLOYEES | $6.24 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | CIGNA HEALTH PLAN [178] | DCH CIGNA ALTERNATIVE | $6.32 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | DCH BCBS PPO | $6.76 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | ALTERNATE BLUE CROSS [1402] | DCH BCBS PPO | $6.76 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | NLFH BCBS BLUECHOICE SELECT | $6.79 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | NLFH BCBS BLUECHOICE OPTIONS | $6.79 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | NLFH BCBS BLUECHOICE PREFERRED | $6.79 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $7.28 | $231.00 | $231.00 | 2026-02-13 | MRF ↗ |
| VALLEY WEST COMMUNITY HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | VWH AETNA NM EMPLOYEES | $7.37 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | ALTERNATE BLUE CROSS [1402] | NLFH BCBS PPO | $7.92 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | NLFH BCBS PPO | $7.92 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Outpatient | Aetna | Commercial | $8.00 | $20.00 | $12.00 | 2026-05-22 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | CIGNA HEALTH PLAN [178] | PH CIGNA BROAD | $8.58 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | CDH AETNA BP | $8.70 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $9.01 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID | $9.01 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $9.01 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $9.01 | — | — | 2026-04-16 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $9.01 | — | — | 2026-04-16 | MRF ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $9.01 | — | — | 2026-04-16 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | CDH AETNA APCN/SP | $9.11 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | WITH UFC | $9.46 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | WITH UFC | $9.46 | $688.00 | — | 2026-01-01 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | Aetna Government Program | Medicare Advantage | $9.63 | $45.86 | $22.93 | 2025-12-31 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | PH AETNA IL PREFERRED | $9.83 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | KH AETNA NIU | $9.86 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| VALLEY WEST COMMUNITY HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | VWH AETNA IL PREFERRED | $10.09 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | CDH AETNA IL PREFERRED | $10.15 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| WABASH GENERAL HOSPITAL 1 Outpatient | BCBS MMAI MCR/MCAID | BCBS MMAI MCR/MCAID | $10.15 | $34.48 | $34.48 | 2026-03-25 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | KH AETNA IL PREFERRED | $10.41 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| GENESIS MEDICAL CENTER-DEWITT OutpatientFacility | Naphcare | All Products | $10.54 | $31.00 | $18.60 | 2026-03-31 | MRF ↗ |
| GENESIS MEDICAL CENTER-DEWITT OutpatientFacility | Wellmark | Medicare Advantage | $10.54 | $31.00 | $18.60 | 2026-03-31 | MRF ↗ |
| GENESIS MEDICAL CENTER-DEWITT OutpatientFacility | Wellmark | Medicare Advantage | $10.54 | $31.00 | $18.60 | 2026-03-31 | MRF ↗ |
| GENESIS MEDICAL CENTER-DEWITT OutpatientFacility | Naphcare | All Products | $10.54 | $31.00 | $18.60 | 2026-03-31 | MRF ↗ |
| WABASH GENERAL HOSPITAL 1 Outpatient | BCBS MCAID | BCBS MCAID | $10.69 | $34.48 | $34.48 | 2026-03-25 | MRF ↗ |
| WABASH GENERAL HOSPITAL 1 Outpatient | UHC VA CCN | UHC VA CCN | $10.69 | $34.48 | $34.48 | 2026-03-25 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | HEALTH CHOICE AZ | HEALTH CHOICE AZ | $10.80 | $395.00 | $138.25 | 2026-02-25 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | APIPA - AHCCCS-ALL OTHER PLANS | APIPA - AHCCCS-ALL OTHER PLANS | $10.80 | $395.00 | $138.25 | 2026-02-25 | MRF ↗ |
| WABASH GENERAL HOSPITAL 1 Outpatient | HEALTH ALLIANCE MCR ADV - ALL PLANS | HEALTH ALLIANCE MCR ADV - ALL PLANS | $10.90 | $34.48 | $34.48 | 2026-03-25 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | Aetna Government Program | Medicare Advantage | $11.17 | $53.17 | $26.59 | 2025-12-31 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | Aetna Government Program | Medicare Advantage | $11.17 | $53.17 | $26.59 | 2025-12-31 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | CARE 1ST MCAID | CARE 1ST MCAID | $11.34 | $395.00 | $138.25 | 2026-02-25 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | PH BCBS HMO | $11.35 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | ALTERNATE BLUE CROSS [1402] | PH BCBS HMO | $11.35 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | MERCY CARE AHCCCS DDD | MERCY CARE AHCCCS DDD | $11.88 | $395.00 | $138.25 | 2026-02-25 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | CDH BCBS HMO | $11.91 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | ALTERNATE BLUE CROSS [1402] | CDH BCBS HMO | $11.91 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | CIGNA HEALTH PLAN [178] | CDH CIGNA BROAD | $11.98 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Outpatient | Superior Health Plan | HMO | $12.00 | $20.00 | $12.00 | 2026-05-22 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Outpatient | Superior Health Plan | PPO | $12.00 | $20.00 | $12.00 | 2026-05-22 | MRF ↗ |
| Marianjoy Rehabilitation Hospital Outpatient | IMAGINE HEALTH [6032] | MRH IMAGINE HEALTH | $12.18 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| Marianjoy Rehabilitation Hospital Outpatient | AETNA HEALTH PLAN [171] | MRH IMAGINE HEALTH | $12.18 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | NLFH AETNA | $12.47 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| VALLEY WEST COMMUNITY HOSPITAL Outpatient | HEALTH'S FINEST NETWORK [126] | VWH HFN NMH TIER ONE | $13.05 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | NLFH BC LAKE COUNTY PHYS ASSOC IPA | $13.05 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | HEALTH'S FINEST NETWORK [126] | KH HFN NMH TIER ONE | $13.05 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| VALLEY WEST COMMUNITY HOSPITAL Outpatient | CIGNA HEALTH PLAN [178] | VWH CIGNA ALTERNATIVE | $13.14 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | NLFH AETNA ASA | $13.20 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| GENESIS MEDICAL CENTER-DEWITT InpatientFacility | Wellmark | All Products | $13.33 | $31.00 | $18.60 | 2026-03-31 | MRF ↗ |
| GENESIS MEDICAL CENTER-DEWITT InpatientFacility | Wellmark | All Products | $13.33 | $31.00 | $18.60 | 2026-03-31 | MRF ↗ |
| Marianjoy Rehabilitation Hospital Outpatient | AETNA HEALTH PLAN [171] | MRH AETNA NM EMPLOYEES | $13.63 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| VALLEY WEST COMMUNITY HOSPITAL Outpatient | CIGNA HEALTH PLAN [178] | VWH CIGNA BROAD | $14.01 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | CIGNA HEALTH PLAN [178] | NLFH CIGNA BROAD | $14.09 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | CIGNA HEALTH PLAN [178] | DCH CIGNA BROAD | $14.21 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | HEALTH'S FINEST NETWORK [126] | CDH HFN NMH TIER ONE | $14.50 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | CARELON BEHAVIORAL HEALTH [159] | CDH VALUE OPTIONS BHS | $14.50 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | HEALTH'S FINEST NETWORK [126] | DCH HFN NMH TIER ONE | $14.50 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | CARELON BEHAVIORAL HEALTH [159] | DCH BEACON HEALTH OPTIONS BHS | $14.50 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | HEALTHLINK [125] | NLFH SEIU HEALTHLINK | $14.50 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | HEALTHLINK [125] | PH SEIU HEALTHLINK | $14.50 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | CARELON BEHAVIORAL HEALTH [159] | PH VALUE OPTIONS BHO | $14.50 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| VALLEY WEST COMMUNITY HOSPITAL Outpatient | UNITED HEALTHCARE [158] | VWH UHC CORE | $14.56 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | UNITED HEALTHCARE [158] | CDH UHC CORE | $14.56 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | UNITED HEALTHCARE [158] | KH UHC CORE | $14.56 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | CIGNA HEALTH PLAN [178] | KH CIGNA BROAD | $15.28 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | CDH AETNA | $15.31 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | CIGNA HEALTH PLAN [178] | KH CIGNA ALTERNATIVE | $15.40 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| GENESIS MEDICAL CENTER-DEWITT OutpatientFacility | Wellmark | All Products | $15.50 | $31.00 | $18.60 | 2026-03-31 | MRF ↗ |
| GENESIS MEDICAL CENTER-DEWITT OutpatientFacility | Wellmark | All Products | $15.50 | $31.00 | $18.60 | 2026-03-31 | MRF ↗ |
| Marianjoy Rehabilitation Hospital Outpatient | THE ALLIANCE [1703] | MRH THE ALLIANCE | $15.76 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| VALLEY WEST COMMUNITY HOSPITAL Outpatient | THE ALLIANCE [1703] | VWH THE ALLIANCE | $15.76 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| Marianjoy Rehabilitation Hospital Outpatient | BLUE CROSS BLUE SHIELD [1401] | MRH BCBS BLUECHOICE PREFERRED | $15.81 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| Marianjoy Rehabilitation Hospital Outpatient | BLUE CROSS BLUE SHIELD [1401] | MRH BCBS BLUECHOICE SELECT | $15.81 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| Marianjoy Rehabilitation Hospital Outpatient | BLUE CROSS BLUE SHIELD [1401] | MRH BCBS BLUECHOICE OPTIONS | $15.81 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Outpatient | United Healthcare of Texas | Commercial | $16.00 | $20.00 | $12.00 | 2026-05-22 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Outpatient | Blue Cross Blue Shield of Texas | Commercial | $16.00 | $20.00 | $12.00 | 2026-05-22 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Outpatient | Blue Cross Blue Shield of Texas | Blue Essentials | $16.00 | $20.00 | $12.00 | 2026-05-22 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Outpatient | Blue Cross Blue Shield of Texas | HMO | $16.00 | $20.00 | $12.00 | 2026-05-22 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | W/O DAP | $16.04 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | W/O DAP | $16.04 | $688.00 | — | 2026-01-01 | MRF ↗ |
| Marianjoy Rehabilitation Hospital Outpatient | BLUE CROSS BLUE SHIELD [1401] | MRH BCBS PAR/INDEMNITY ADP | $16.21 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | DCH BCBS PAR/INDEMNITY ADP | $16.21 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| VALLEY WEST COMMUNITY HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | VWH BCBS PAR/INDEMNITY ADP | $16.21 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | KH BCBS PAR/INDEMNITY ADP | $16.21 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CMDP | ALL PRODUCTS | $16.36 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC IHS | ALL PRODUCTS | $16.36 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | BEHAVIORAL HEALTH | $16.36 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC APIPA | ALL PRODUCTS | $16.36 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | ONLY | $16.36 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | PARTIAL | $16.36 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CMDP | ALL PRODUCTS | $16.36 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC MERCY CARE | ALL PRODUCTS | $16.36 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC IHS | ALL PRODUCTS | $16.36 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC APIPA | ALL PRODUCTS | $16.36 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC MERCY CARE | ALL PRODUCTS | $16.36 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | PARTIAL | $16.36 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | BEHAVIORAL HEALTH | $16.36 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHC CRS | ONLY | $16.36 | $688.00 | — | 2026-01-01 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | PH AETNA | $16.47 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | FIRST HEALTH PLAN [6034] | PH AETNA | $16.47 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE CENTRAL DUPAGE HOSPITAL Outpatient | MULTIPLAN/PHCS [142] | CDH SAGAMORE HEALTH PPO | $16.65 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | New York State Office of Victim Services | Managed Medicaid | $16.68 | — | — | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | Blue Cross Family Health Plus | Managed Medicaid | $16.68 | — | — | 2025-06-20 | MRF ↗ |
| RIVER HOSPITAL CLINICS OutpatientFacility | United Healthcare | Managed Medicaid | $16.68 | — | — | 2025-06-20 | 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.