96112 — Devel Tst Phys/qhp 1st Hr
Cite this view
APA (7th ed.)
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
MLA (9th ed.)
“DEVEL TST PHYS/QHP 1ST HR (CPT 96112) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/96112?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“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 $149–$414 (25th–75th percentile) across 1,913 hospitals · 4,469 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.
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
$149
$233 typical
$414
The middle 50% of negotiated facility rates for this procedure, measured across 1,913 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. | $233 |
| Physician fee Estimate national typical Medicare $107 × 1.22 commercial. | $130 |
| Likely subtotal | $363 |
Complete-episode estimate (typical)
~$363
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 $149–$414.
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 |
|---|---|---|---|---|---|---|---|
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | 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 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 ↗ |
| 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 ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | SCAN Health Plan | Medicare Advantage | — | $3,969.24 | $2,580.01 | 2025-11-26 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 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 ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | — | — | 2026-09-01 | 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 ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $1.11 | $615.00 | $307.48 | 2024-12-31 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Kaiser Foundation Health Plan of Washington | Medicare Advantage | $1.14 | $2.60 | $2.60 | 2026-08-19 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Kaiser Foundation Health Plan of Washington | Medicare Advantage | $1.14 | $2.60 | $2.60 | 2026-04-30 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Tricare | POS | $1.14 | $2.60 | $2.60 | 2026-04-30 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Blue Cross of Idaho | Medicare Advantage | $1.14 | $2.60 | $2.60 | 2026-04-30 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Aetna | Medicare Advantage | $1.14 | $2.60 | $2.60 | 2026-08-19 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Aetna | Medicare Advantage | $1.14 | $2.60 | $2.60 | 2026-04-30 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Blue Cross of Idaho | Medicare Advantage | $1.14 | $2.60 | $2.60 | 2026-08-19 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | United Healthcare | Medicare Advantage | $1.14 | $2.60 | $2.60 | 2026-08-19 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Regence Blueshield of Idaho | Medicare Advantage | $1.14 | $2.60 | $2.60 | 2026-08-19 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Regence Blueshield of Idaho | Medicare Advantage | $1.14 | $2.60 | $2.60 | 2026-04-30 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Tricare | POS | $1.14 | $2.60 | $2.60 | 2026-08-19 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Molina | Medicare Advantage | $1.15 | $2.60 | $2.60 | 2026-08-19 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Pacific Source | Medicare Advantage | $1.18 | $2.60 | $2.60 | 2026-04-30 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Pacific Source | Medicare Advantage | $1.18 | $2.60 | $2.60 | 2026-08-19 | MRF ↗ |
| SAN ANTONIO REGIONAL HOSPITAL Outpatient | ANTHEM BLUE CROSS EXCHG | ANTHEM BLUE CROSS EXCHG | $1.51 | $690.00 | $933.00 | 2026-04-02 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Washington L & I | Workers Comp | $1.71 | $2.60 | $2.60 | 2026-08-19 | MRF ↗ |
| GROVE HILL MEMORIAL HOSPITAL BothFacility | United Healthcare | All Other Plans | $1.82 | $2.60 | $1.56 | 2026-05-28 | MRF ↗ |
| GROVE HILL MEMORIAL HOSPITAL BothFacility | Cigna | All Plans | $1.95 | $2.60 | $1.56 | 2026-05-28 | MRF ↗ |
| GROVE HILL MEMORIAL HOSPITAL BothFacility | Aetna | All Other Plans | $1.95 | $2.60 | $1.56 | 2026-05-28 | MRF ↗ |
| NORTHWESTERN MEDICINE DELNOR COMMUNITY HOSPITAL Outpatient | HEALTH ALLIANCE MEDICAID [1310] | 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 | BLUE CROSS MEDICAID [1612] | DCH ILLINOIS MEDICAID | — | $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 | HEALTH ALLIANCE MEDICAID [1310] | KH ILLINOIS MEDICAID | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Blue Cross of Idaho | All Other Plans | $2.00 | $2.60 | $2.60 | 2026-04-30 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | BLUE CROSS MEDICAID [1612] | KH ILLINOIS MEDICAID | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Blue Cross of Idaho | All Other Plans | $2.00 | $2.60 | $2.60 | 2026-08-19 | 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 KISHWAUKEE HOSPITAL Outpatient | MERIDIAN HEALTH PLAN HMO [1604] | 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 | FAMILY HEALTH NETWORK HMO [1610] | KH ILLINOIS MEDICAID | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | United Healthcare | POS | $2.39 | $2.60 | $2.60 | 2026-08-19 | MRF ↗ |
| CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC Outpatient | Amerihealth Caritas | All Products | $2.40 | $10.44 | $9.40 | 2026-07-18 | MRF ↗ |
| CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC Outpatient | Healthy Blue | All Products | $2.40 | $10.44 | $9.40 | 2026-07-18 | MRF ↗ |
| CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC Outpatient | Carolina Complete Health | Tailored Plan | $2.45 | $10.44 | $9.40 | 2026-07-18 | MRF ↗ |
| CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC Outpatient | Wellcare | All Products | $2.47 | $10.44 | $9.40 | 2026-07-18 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Cigna | PPO | $2.47 | $2.60 | $2.60 | 2026-08-19 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Cigna | PPO | $2.47 | $2.60 | $2.60 | 2026-04-30 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Aetna | All Other Plans | $2.47 | $2.60 | $2.60 | 2026-04-30 | MRF ↗ |
| GRITMAN MEDICAL CENTER BothFacility | Aetna | All Other Plans | $2.47 | $2.60 | $2.60 | 2026-08-19 | 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 ↗ |
| DECATUR MEMORIAL HOSPITAL Outpatient | Hfn | Hfn Workers Compensation | $3.38 | $505.00 | $505.00 | 2026-07-15 | MRF ↗ |
| DECATUR MEMORIAL HOSPITAL Outpatient | Commercial Workers Compensation | Commercial Workers Compensation | $3.38 | $505.00 | $505.00 | 2026-07-15 | MRF ↗ |
| JACKSONVILLE MEMORIAL HOSPITAL Outpatient | Commercial Workers Compensation | Commercial Workers Compensation | $3.38 | $505.00 | $505.00 | 2026-07-15 | 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 BLUE CROSS MEDICARE ADV [2304] | 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 | ALTERNATE HUMANA MEDICARE ADV [2409] | MRH 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 ↗ |
| NORTHWESTERN MEDICINE MCHENRY Outpatient | GLOBAL EXCEL [1712] | NWR MEDICARE | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $3.64 | $297.00 | $56.43 | 2026-05-20 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | GLOBAL EXCEL [1712] | NLFH MEDICARE | — | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $3.77 | — | — | 2026-07-15 | 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 ↗ |
| 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 Culver City 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 ↗ |
| 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 SELECT | $4.32 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | United Healthcare | Commercial - Inpatient | $4.50 | $6.00 | $3.00 | 2026-07-18 | 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 ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | PH BCBS BLUECHOICE PREFERRED | $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 Both | United Healthcare | Commercial - Outpatient | $4.80 | $6.00 | $3.00 | 2026-07-18 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | NLFH AETNA NM EMPLOYEES | $4.81 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Beech Street | Commercial | $5.10 | $6.00 | $3.00 | 2026-07-18 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Phcs | Commercial | $5.10 | $6.00 | $3.00 | 2026-07-18 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Hrgi | Commercial | $5.10 | $6.00 | $3.00 | 2026-07-18 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Excellus - Rmsco | Commercial | $5.10 | $6.00 | $3.00 | 2026-07-18 | 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 | GLOBAL EXCEL [1712] | 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 | ALTERNATE HUMANA MEDICARE ADV [2409] | 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 ↗ |
| NORTHWESTERN MEDICINE MCHENRY Outpatient | AETNA HEALTH PLAN [171] | NWR AETNA NM EMPLOYEES | $5.60 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE MCHENRY Outpatient | CIGNA HEALTH PLAN [178] | NWR CIGNA ALTERNATIVE | $5.71 | $29.00 | $20.30 | 2026-04-01 | 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 ↗ |
| 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 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 ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | NLFH BCBS BLUECHOICE SELECT | $6.79 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC Outpatient | Cigna | All Commercial Products | $6.93 | $10.44 | $9.40 | 2026-07-18 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $7.28 | $231.00 | $231.00 | 2026-06-03 | 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 | BLUE CROSS BLUE SHIELD [1401] | NLFH BCBS PPO | $7.92 | $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 ↗ |
| MULESHOE AREA MEDICAL CENTER Outpatient | Aetna | Commercial | $8.00 | $20.00 | $12.00 | 2025-12-16 | MRF ↗ |
| MCKAY-DEE HOSPITAL Inpatient | Donor Connect | Other | $8.33 | $833.01 | $624.76 | 2026-07-31 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | CIGNA HEALTH PLAN [178] | PH CIGNA BROAD | $8.58 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE MCHENRY Outpatient | MERCY CARE HEALTH PLANS [5013] | NWR MERCY CARE | $8.80 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE MCHENRY Outpatient | CIGNA HEALTH PLAN [178] | NWR CIGNA BROAD | $8.96 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| ABRAZO ARROWHEAD HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE MEDICAID | $9.01 | — | — | 2026-04-16 | 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 ↗ |
| CROSS CREEK HOSPITAL OutpatientFacility | MOLINA | MOLINA COMPLETE CARE 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 | UNITED HEALTHCARE | UNITED HEALTHCARE APIPA | $9.01 | — | — | 2026-04-16 | MRF ↗ |
| PHOENIX CHILDREN'S HOSPITAL OutpatientFacility | AHCCS | WITH UFC | $9.46 | $688.00 | — | 2026-01-01 | MRF ↗ |
| MCKAY-DEE HOSPITAL Inpatient | Donor Connect | Other | $9.46 | $946.36 | $709.77 | 2026-07-31 | 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 MCHENRY Outpatient | BLUE CROSS BLUE SHIELD [1401] | NWR BCBS PPO | $9.83 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE MCHENRY Outpatient | ALTERNATE BLUE CROSS [1402] | NWR BCBS PPO | $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 ↗ |
| CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC Outpatient | Johns Hopkins Healthcare | All Products | $9.92 | $10.44 | $9.40 | 2026-07-18 | MRF ↗ |
| NORTHWESTERN MEDICINE MCHENRY Outpatient | AETNA HEALTH PLAN [171] | NWR AETNA APCN/SP | $9.98 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| INTERMOUNTAIN MEDICAL CENTER Inpatient | Donor Connect | Other | $10.00 | $833.01 | $624.76 | 2026-07-17 | MRF ↗ |
| VALLEY WEST COMMUNITY HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | VWH AETNA IL PREFERRED | $10.09 | $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 MCHENRY Outpatient | AETNA HEALTH PLAN [171] | NWR AETNA IL PREFERRED | $10.30 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE MCHENRY Outpatient | ALTERNATE BLUE CROSS [1402] | NWR BCBS HMO | $10.35 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE MCHENRY Outpatient | BLUE CROSS BLUE SHIELD [1401] | NWR BCBS HMO | $10.35 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | KH AETNA IL PREFERRED | $10.41 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| MCKAY-DEE HOSPITAL Inpatient | Donor Connect | Other | $10.45 | $1,044.71 | $783.53 | 2026-07-31 | 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 | 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 ↗ |
| 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 ↗ |
| LDS HOSPITAL Inpatient | Donor Connect | Other | $10.83 | $833.01 | $624.76 | 2026-08-01 | 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 ↗ |
| 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 | ALTERNATE BLUE CROSS [1402] | PH BCBS HMO | $11.35 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | BLUE CROSS BLUE SHIELD [1401] | PH BCBS HMO | $11.35 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| INTERMOUNTAIN MEDICAL CENTER Inpatient | Donor Connect | Other | $11.36 | $946.36 | $709.77 | 2026-07-17 | MRF ↗ |
| INTERMOUNTAIN HEALTH UTAH VALLEY HOSPITAL Inpatient | Donor Connect | Other | $11.66 | $833.01 | $624.76 | 2026-08-01 | MRF ↗ |
| KINGMAN REGIONAL MEDICAL CENTER Outpatient | MERCY CARE AHCCCS DDD | MERCY CARE AHCCCS DDD | $11.88 | $395.00 | $138.25 | 2026-02-25 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Outpatient | Superior Health Plan | PPO | $12.00 | $20.00 | $12.00 | 2025-12-16 | MRF ↗ |
| MULESHOE AREA MEDICAL CENTER Outpatient | Superior Health Plan | HMO | $12.00 | $20.00 | $12.00 | 2025-12-16 | 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 ↗ |
| LDS HOSPITAL Inpatient | Donor Connect | Other | $12.30 | $946.36 | $709.77 | 2026-08-01 | MRF ↗ |
| NORTHWESTERN LAKE FOREST HOSPITAL Outpatient | AETNA HEALTH PLAN [171] | NLFH AETNA | $12.47 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| INTERMOUNTAIN MEDICAL CENTER Inpatient | Donor Connect | Other | $12.54 | $1,044.80 | $783.60 | 2026-07-17 | 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 ↗ |
| INTERMOUNTAIN HEALTH UTAH VALLEY HOSPITAL Inpatient | Donor Connect | Other | $13.25 | $946.36 | $709.77 | 2026-08-01 | 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 ↗ |
| NORTHWESTERN MEDICINE MCHENRY Outpatient | BLUE CROSS BLUE SHIELD [1401] | NWR BCBS BLUECHOICE OPTIONS | $13.86 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE MCHENRY Outpatient | BLUE CROSS BLUE SHIELD [1401] | NWR BCBS BLUECHOICE PREFERRED | $13.86 | $29.00 | $20.30 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE MCHENRY Outpatient | BLUE CROSS BLUE SHIELD [1401] | NWR BCBS BLUECHOICE SELECT | $13.86 | $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 MCHENRY Outpatient | AETNA HEALTH PLAN [171] | NWR AETNA | $14.12 | $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 MCHENRY Outpatient | HEALTHLINK [125] | NWR SEIU HEALTHLINK | $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 LAKE FOREST HOSPITAL Outpatient | HEALTHLINK [125] | NLFH SEIU HEALTHLINK | $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 ↗ |
| PALOS COMMUNITY HOSPITAL Outpatient | CARELON BEHAVIORAL HEALTH [159] | PH VALUE OPTIONS BHO | $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 ↗ |
| VALLEY WEST COMMUNITY HOSPITAL Outpatient | UNITED HEALTHCARE [158] | VWH 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 ↗ |
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.