97004 — Pr Occupational Therapy Re-evaluation
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PR OCCUPATIONAL THERAPY RE-EVALUATION (CPT 97004) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/97004?code_type=CPT
MLA (9th ed.)
“PR OCCUPATIONAL THERAPY RE-EVALUATION (CPT 97004) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/97004?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“PR OCCUPATIONAL THERAPY RE-EVALUATION (CPT 97004) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/97004?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $58–$207 (25th–75th percentile) across 273 hospitals · 723 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 97004 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
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 |
|---|---|---|---|---|---|---|---|
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $1.64 | $156.45 | $93.87 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $1.64 | $156.45 | $93.87 | 2025-08-11 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED CHICAGO TEACHER FUND-ALL PLANS | UNITED CHICAGO TEACHER FUND-ALL PLANS | $7.16 | $53.00 | $39.75 | 2026-01-16 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | UNITED AT&T-ALL PLANS | UNITED AT&T-ALL PLANS | $11.00 | $53.00 | $39.75 | 2026-01-16 | MRF ↗ |
| HCA FLORIDA LARGO HOSPITAL Outpatient | Access 2 Healthcare Physicians Freedom Optimum Group Members | MGMCR | $11.48 | $244.17 | $244.17 | 2026-03-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | MEDICARE BLUE CHOICE [1306] | MEDICARE BLUE CHOICE [130601] | $11.50 | — | — | 2026-04-01 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Care 1St Medi Cal Hmo Cap Exceptional Care | Care 1St Medi Cal Hmo Cap Exceptional Care | $12.30 | $123.00 | $123.00 | 2026-11-03 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Care First Health Plan | Blue Shield Promise Healthplan Mcal | $12.30 | $123.00 | $123.00 | 2026-11-03 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Simply Healthcare MCD Rep DOS lt 2/1/19 | Medicaid Replacement | — | $51.99 | $36.39 | 2026-08-12 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Medicaid Florida | Medicaid Replacement | — | $51.99 | $36.39 | 2026-08-12 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Sunshine State Health Plan MCD Rep | Default | — | $51.99 | $36.39 | 2026-08-12 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Medicaid Florida | Default | — | $51.99 | $36.39 | 2026-08-12 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Tricare East Region DOS lt 01012025 | Default | $12.32 | $51.99 | $36.39 | 2026-08-12 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | WellCare Health Plan MCD Rep | Medicaid Replacement | — | $51.99 | $36.39 | 2026-08-12 | MRF ↗ |
| Hca Florida Largo Hospital Outpatient | Access 2 Healthcare Physicians | MGMCR | $12.45 | $244.17 | $244.17 | 2024-10-01 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Tricare East Region Dos Lt 01012025 | Default | $12.59 | $51.99 | $36.39 | 2026-05-08 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Sunshine State Health Plan Mcd Rep | Default | — | $51.99 | $36.39 | 2026-05-08 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Medicare B Fl Jn | Default | — | $51.99 | $36.39 | 2026-05-08 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Simply Healthcare Mcd Rep Dos Lt 2/1/19 | Medicaid Replacement | — | $51.99 | $36.39 | 2026-05-08 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Magellan Health Services | Medicaid Replacement | — | $51.99 | $36.39 | 2026-05-08 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Wellcare Health Plan Mcd Rep | Medicaid Replacement | — | $51.99 | $36.39 | 2026-05-08 | MRF ↗ |
| HILL REGIONAL HOSPITAL Outpatient | Great-West Healthcare | HMO | $14.00 | $140.00 | $140.00 | 2025-11-06 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | MEDICARE BLUE CHOICE BLUE CROSS BLUE SHIELD [1306] | MEDICARE BLUE CHOICE [130601] | $14.02 | — | — | 2026-04-01 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | NovaSys Health Inc | Network Access | $14.39 | $100.80 | $37.30 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | NovaSys Health Inc | NovaSys Exchange | $14.39 | $100.80 | $37.30 | 2024-12-26 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | NovaSys Health Inc | NovaSys All Payor | $14.39 | $100.80 | $37.30 | 2024-12-26 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Clinica Medica Familiar | Clinica Medica Familiar Medi Cal | $14.76 | $123.00 | $123.00 | 2026-11-03 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | UNITED HEALTHCARE MEDICARE [1309] | UNITED HEALTHCARE MEDICARE [130901] | $14.99 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | MVP MEDICARE [1307] | MVP MEDICARE [130701] | $14.99 | — | — | 2026-04-01 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Care 1St Medi Cal Hmo Cap Exceptional Care | Care 1St Medi Cal Hmo Cap Exceptional Care | $15.00 | $150.00 | $150.00 | 2026-11-03 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Care First Health Plan | Blue Shield Promise Healthplan Mcal | $15.00 | $150.00 | $150.00 | 2026-11-03 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Blue Cross Blue Shield Of Fl Florida Blue | Medicare Advantage | $15.08 | $51.99 | $36.39 | 2026-05-08 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Medicare A Fl Jn | Default | $15.80 | $51.99 | $36.39 | 2026-05-08 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Wellcare Health Plan Inc Mcr Adv | Medicare Advantage | $15.80 | $51.99 | $36.39 | 2026-05-08 | MRF ↗ |
| ARBUCKLE MEMORIAL HOSPITAL Outpatient | Medica | Commercial | $16.00 | $30.00 | $24.00 | 2025-06-25 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | United Healthcare | Medicare Advantage | $16.31 | $51.99 | $36.39 | 2026-08-12 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Wellcare Health Plan Inc MCR Adv | Medicare Advantage | $16.31 | $51.99 | $36.39 | 2026-08-12 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Humana | Medicare Advantage | $16.31 | $51.99 | $36.39 | 2026-08-12 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Medicare A FL JN | Default | $16.31 | $51.99 | $36.39 | 2026-08-12 | MRF ↗ |
| WHITTIER HOSPITAL MEDICAL CENTER InpatientFacility | — | — | — | $165.00 | $29.70 | 2026-03-17 | MRF ↗ |
| HCA FLORIDA LARGO HOSPITAL Outpatient | Aetna | MCR | $16.85 | $244.17 | $244.17 | 2026-03-01 | MRF ↗ |
| RIVERSIDE UNIVERSITY HEALTH SYSTEM-MEDICAL CENTER Outpatient | LA CARE HEALTH PLAN | MCAL HMO | $17.04 | $165.20 | $165.20 | 2026-03-30 | MRF ↗ |
| RIVERSIDE UNIVERSITY HEALTH SYSTEM-MEDICAL CENTER Outpatient | INLAND EMPIRE HEALTH PLAN MCAL HMO | MCAL HMO | $17.04 | $165.20 | $165.20 | 2026-03-30 | MRF ↗ |
| RIVERSIDE UNIVERSITY HEALTH SYSTEM-MEDICAL CENTER Outpatient | MEDI-CAL | Government | $17.04 | $165.20 | $165.20 | 2026-03-30 | MRF ↗ |
| Penn Medicine Lancaster General Health Outpatient | Medicaid | Medicaid | $17.18 | $167.00 | $167.00 | 2026-07-15 | MRF ↗ |
| Penn Medicine Lancaster General Health Outpatient | Medicaid | Medicaid | $17.18 | $167.00 | $167.00 | 2026-10-30 | MRF ↗ |
| Penn Medicine Lancaster General Health Outpatient | Medicaid Managed Generic | Medicaid Managed Generic | $17.18 | $167.00 | $167.00 | 2026-10-30 | MRF ↗ |
| Penn Medicine Lancaster General Health Outpatient | Medicaid Managed Generic | Medicaid Managed Generic | $17.18 | $167.00 | $167.00 | 2026-07-15 | MRF ↗ |
| HCA FLORIDA LARGO HOSPITAL Outpatient | Access 2 Healthcare Physicians Freedom Health | MGMCR | $17.58 | $244.17 | $244.17 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LARGO HOSPITAL Outpatient | Access 2 Healthcare Physicians Optimum | MGMCR | $17.58 | $244.17 | $244.17 | 2026-03-01 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Clinica Medica Familiar | Clinica Medica Familiar Medi Cal | $18.00 | $150.00 | $150.00 | 2026-11-03 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | IN MEDICAID MGD CARE 20140101 (ST. MARY) | 1753_IN MEDICAID MGD CARE 20140101 (ST. MARY) | $18.01 | — | — | 2026-01-01 | MRF ↗ |
| KUAKINI MEDICAL CENTER OutpatientFacility | HMAA | ALL PRODUCTS | $18.38 | — | — | 2026-01-25 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | MVP MEDICARE [1307] | MVP MEDICARE [130701] | $18.69 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICARE [1301] | HIGHMARK BCBS MEDICARE [130101] | $18.69 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | CAPITAL DISTRICT PHP MEDICARE [1320] | CDPHP MEDICARE [132001] | $18.69 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | FIDELIS MEDICARE [1311] | FIDELIS MEDICARE [131101] | $18.69 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | EXCELLUS [2201] | EXCELLUS METAL TIERS [220102] | $18.74 | — | — | 2026-04-01 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | EXCELLUS [2201] | EXCELLUS BLUE CHOICE [220107], EXCELLUS HEALTHY NY [220110], EXCELLUS HIGH PERFORMANCE [220103], EXCELLUS SIMPLY BLUE [220106] | $18.74 | — | — | 2026-04-01 | MRF ↗ |
| HCA FLORIDA LARGO HOSPITAL Outpatient | Freedom Health Care | MGMGR | $19.05 | $244.17 | $244.17 | 2026-03-01 | MRF ↗ |
| Hca Florida Largo Hospital Outpatient | Optimum Healthcare | PFFS | $19.05 | $244.17 | $244.17 | 2024-10-01 | MRF ↗ |
| Hca Florida Largo Hospital Outpatient | Optimum Healthcare | MCRHMO | $19.05 | $244.17 | $244.17 | 2024-10-01 | MRF ↗ |
| Hca Florida Largo Hospital Outpatient | Optimum Healthcare | PPO | $19.05 | $244.17 | $244.17 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA LARGO HOSPITAL Outpatient | Optimum Healthcare | MCRPPO | $19.05 | $244.17 | $244.17 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LARGO HOSPITAL Outpatient | Optimum Healthcare | PFFS | $19.05 | $244.17 | $244.17 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LARGO HOSPITAL Outpatient | Optimum Healthcare | MCRHMO | $19.05 | $244.17 | $244.17 | 2026-03-01 | MRF ↗ |
| Hca Florida Largo Hospital Outpatient | Freedom Health Care | MCR | $19.05 | $244.17 | $244.17 | 2024-10-01 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Tustin Unified School District | Tustin Unified School District | $19.50 | $376.00 | $376.00 | 2026-11-02 | MRF ↗ |
| Hca Florida Largo Hospital Outpatient | Aetna | MCR | $19.78 | $244.17 | $244.17 | 2024-10-01 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | In Custody-Ca Highway Patrol | In Custody-Ca Highway Patrol | $20.00 | $150.00 | $150.00 | 2026-11-03 | MRF ↗ |
| RIVERSIDE MEDICAL CENTER Both | Blue Cross Blue Shield | Medicare | $20.09 | $49.00 | $19.60 | 2026-07-01 | MRF ↗ |
| RIVERSIDE MEDICAL CENTER Both | Blue Cross Blue Shield | HMO | $20.09 | $49.00 | $19.60 | 2026-07-01 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Amerigroup | Medicaid | $20.09 | $51.00 | $25.50 | 2026-10-17 | MRF ↗ |
| RIVERSIDE MEDICAL CENTER Both | Humana | Medicare | $20.09 | $49.00 | $19.60 | 2026-07-01 | MRF ↗ |
| RIVERSIDE MEDICAL CENTER Both | Aetna | Medicare | $20.09 | $49.00 | $19.60 | 2026-07-01 | MRF ↗ |
| RIVERSIDE MEDICAL CENTER Both | Wellcare | Medicare | $20.09 | $49.00 | $19.60 | 2026-07-01 | MRF ↗ |
| Penn Medicine Lancaster General Health Outpatient | Keystone First Medicaid | Keystone First Medicaid | $20.44 | $167.00 | $167.00 | 2026-07-15 | MRF ↗ |
| Penn Medicine Lancaster General Health Outpatient | Amerihealth Caritas | Amerihealth Caritas Medicaid Hmo | $20.44 | $167.00 | $167.00 | 2026-07-15 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Peachstate | Medicaid | $20.50 | $51.00 | $25.50 | 2026-10-17 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICARE [1309] | UNITED HEALTHCARE MEDICARE [130901] | $20.56 | — | — | 2026-04-01 | MRF ↗ |
| BENSON HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $20.80 | $65.00 | $31.20 | 2025-03-27 | MRF ↗ |
| BENSON HOSPITAL OutpatientFacility | Arizona Complete (Allwell) | Medicare Advantage | $20.80 | $65.00 | $31.20 | 2025-03-27 | MRF ↗ |
| BENSON HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | $20.80 | $65.00 | $31.20 | 2025-03-27 | MRF ↗ |
| BENSON HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $20.80 | $65.00 | $31.20 | 2025-03-27 | MRF ↗ |
| BENSON HOSPITAL OutpatientFacility | United Healthcare | Medicare Advantage | $20.80 | $65.00 | $31.20 | 2025-03-27 | MRF ↗ |
| BENSON HOSPITAL OutpatientFacility | Banner | Medicare Advantage | $20.80 | $65.00 | $31.20 | 2025-03-27 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Humana | Medicare Advantage | $20.96 | $51.99 | $36.39 | 2026-05-08 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Humana | Default | $20.96 | $51.99 | $36.39 | 2026-05-08 | MRF ↗ |
| HILL REGIONAL HOSPITAL Outpatient | The First Health Network | Commercial | $21.00 | $140.00 | $140.00 | 2025-11-06 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Caresource | Medicaid | $21.10 | $51.00 | $25.50 | 2026-10-17 | MRF ↗ |
| RIVERSIDE UNIVERSITY HEALTH SYSTEM-MEDICAL CENTER Outpatient | MEDICAL GROUPS COMMERCIAL CONTRACTED | MCAL HMO | $21.16 | $165.20 | $165.20 | 2026-03-30 | MRF ↗ |
| KAPIOLANI MEDICAL CENTER FOR WOMEN & CHILDREN OutpatientFacility | OHANA | QUEST - ABD | $21.23 | — | — | 2026-02-12 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Humana | Default | $21.63 | $51.99 | $36.39 | 2026-08-12 | MRF ↗ |
| RIVERSIDE MEDICAL CENTER Both | Aetna | PPO | $21.80 | $49.00 | $19.60 | 2026-07-01 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELIS_1400 | FIDELIS CLINIC | $22.22 | $87.94 | $88.60 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | NYSDOH_1400 | NY MEDICAID CLINIC EPISODE | $22.22 | $87.94 | $88.60 | 2025-01-19 | MRF ↗ |
| Penn Medicine Lancaster General Health Outpatient | Keystone First Medicaid | Keystone First Medicaid | $22.68 | $167.00 | $167.00 | 2026-10-30 | MRF ↗ |
| Penn Medicine Lancaster General Health Outpatient | Amerihealth Caritas | Amerihealth Caritas Medicaid Hmo | $22.68 | $167.00 | $167.00 | 2026-10-30 | MRF ↗ |
| ARBUCKLE MEMORIAL HOSPITAL Outpatient | Aetna | Commercial | $23.00 | $30.00 | $24.00 | 2025-06-25 | MRF ↗ |
| LEVI HOSPITAL OutpatientFacility | Aetna Behavioral Health Medicare Advantage | Medicare Advantage | $23.18 | $100.80 | $37.30 | 2024-12-26 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD [2201], OUT AREA BLUE CROSS BLUE SHIELD, UNIVERA | EXCELLUS [220101], EXCELLUS SIMPLY BLUE [220106], EXCELLUS BLUE CHOICE [220107], EXCELLUS HIGH PERFORMANCE [220103] | $23.29 | — | — | 2026-04-01 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | UNITED_1400 | UNITED COMMUNITY CLINIC | $23.33 | $87.94 | $88.60 | 2025-01-19 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Humana | Medicare | $23.46 | $51.00 | $25.50 | 2026-10-17 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Uhc | Medicare | $23.46 | $51.00 | $25.50 | 2026-10-17 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Wellcare | Medicare | $23.46 | $51.00 | $25.50 | 2026-10-17 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Aetna | Medicare | $23.46 | $51.00 | $25.50 | 2026-10-17 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Bcbs | Medicare | $23.46 | $51.00 | $25.50 | 2026-10-17 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Newport Mesa Unified School District | Newport Mesa Unified School District | $23.75 | $376.00 | $376.00 | 2026-11-02 | MRF ↗ |
| EAST CARROLL PARISH HOSPITAL Outpatient | CIGNA-ALL PLANS | CIGNA-ALL PLANS | $23.85 | $53.00 | $39.75 | 2026-01-16 | MRF ↗ |
| PIGGOTT COMMUNITY HOSPITAL Outpatient | BCBS AR - ALL PLANS | BCBS AR - ALL PLANS | $24.00 | $60.00 | $42.00 | 2026-04-02 | MRF ↗ |
| ARBUCKLE MEMORIAL HOSPITAL Outpatient | MultiPlan | Commercial | $24.00 | $30.00 | $24.00 | 2025-06-25 | MRF ↗ |
| RIVERSIDE MEDICAL CENTER Both | Blue Cross Blue Shield | PPO | $24.01 | $49.00 | $19.60 | 2026-07-01 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Care 1St Medi Cal Hmo Cap Exceptional Care | Care 1St Medi Cal Hmo Cap Exceptional Care | $24.60 | $246.00 | $246.00 | 2026-11-03 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Bella Vista Medical Group Ipa | Bella Vista Med Grp Medi Cal | $24.60 | $123.00 | $123.00 | 2026-11-03 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Care First Health Plan | Blue Shield Promise Healthplan Mcal | $24.60 | $246.00 | $246.00 | 2026-11-03 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Employee Health Systems Medical Group | Employee Health Systems Ppo | $24.60 | $123.00 | $123.00 | 2026-11-03 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Global Care Medical Group Ipa | Global Care Med Grp Medi Cal | $24.60 | $123.00 | $123.00 | 2026-11-03 | MRF ↗ |
| PIGGOTT COMMUNITY HOSPITAL Outpatient | HARMONY HP MCARE - ALL PLANS | HARMONY HP MCARE - ALL PLANS | $25.20 | $60.00 | $42.00 | 2026-04-02 | MRF ↗ |
| PIGGOTT COMMUNITY HOSPITAL Outpatient | VACCN - ALL PLANS | VACCN - ALL PLANS | $25.20 | $60.00 | $42.00 | 2026-04-02 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Anthem Blue Cross | Anthem Bx Covered Calif Exchange | $25.29 | $123.00 | $123.00 | 2026-11-03 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | FIDELIS_1402 | FIDELIS EMERGENCY ROOM | $25.44 | $87.94 | $88.60 | 2025-01-19 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | NYSDOH_1402 | NY MEDICAID EMERGENCY ROOM | $25.44 | $87.94 | $88.60 | 2025-01-19 | MRF ↗ |
| NORTHWEST FLORIDA COMMUNITY HOSPITAL Outpatient | Humana | Medicare | $25.52 | $133.00 | $106.40 | 2026-07-15 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Chinatown Service Center Pace | Chinatown Service Center Pace | $25.83 | $123.00 | $123.00 | 2026-11-03 | MRF ↗ |
| CUBA MEMORIAL HOSPITAL, INC OutpatientFacility | Magnacare | All Commercial Plans | $25.89 | — | — | 2026-04-01 | MRF ↗ |
| PIGGOTT COMMUNITY HOSPITAL Outpatient | ALLWELL MEDICARE - ALL PLANS | ALLWELL MEDICARE - ALL PLANS | $25.96 | $60.00 | $42.00 | 2026-04-02 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Cigna | Default | $26.00 | $51.99 | $36.39 | 2026-05-08 | MRF ↗ |
| CALHOUN-LIBERTY HOSPITAL Both | Cigna | Default | $26.00 | $51.99 | $36.39 | 2026-08-12 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | MEDICARE BLUE CHOICE [1306] | MEDICARE BLUE CHOICE [130601] | $26.03 | — | — | 2026-04-01 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Peachstate | Medicaid | $26.65 | $51.00 | $25.50 | 2026-07-18 | MRF ↗ |
| AUBURN COMMUNITY HOSPITAL Outpatient | UNITED_1402 | UNITED COMMUNITY EMERGENCY ROOM | $26.71 | $87.94 | $88.60 | 2025-01-19 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Anthem Blue Cross | Anthem Blue Cross Select Hmo | $26.88 | $123.00 | $123.00 | 2026-11-03 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Anthem Blue Cross | Anthem Blue Cross Priority Select Hmo | $26.88 | $123.00 | $123.00 | 2026-11-03 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Wellcare | Medicare | $27.00 | $51.00 | $25.00 | 2026-07-18 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Humana | Medicare | $27.00 | $51.00 | $25.00 | 2026-07-18 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Uhc | Medicare | $27.00 | $51.00 | $25.00 | 2026-07-18 | MRF ↗ |
| ARBUCKLE MEMORIAL HOSPITAL Outpatient | OK Health Network | Commercial | $27.00 | $30.00 | $24.00 | 2025-06-25 | MRF ↗ |
| ENGLEWOOD HOSPITAL AND MEDICAL CENTER OutpatientFacility | Emblem_762 | GHI | $27.00 | — | — | 2026-02-02 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Bcbs | Commercial | $27.00 | $51.00 | $25.00 | 2026-07-18 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Cigna | Medicare | $27.00 | $51.00 | $25.00 | 2026-07-18 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Aetna | Medicare | $27.03 | $51.00 | $25.50 | 2026-07-18 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Wellcare | Medicare | $27.03 | $51.00 | $25.50 | 2026-07-18 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Bcbs | Commercial | $27.03 | $51.00 | $25.50 | 2026-10-17 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Humana | Medicare | $27.03 | $51.00 | $25.50 | 2026-07-18 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Cigna | Medicare | $27.03 | $51.00 | $25.50 | 2026-07-18 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Bcbs | Commercial | $27.03 | $51.00 | $25.50 | 2026-07-18 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Uhc | Medicare | $27.03 | $51.00 | $25.50 | 2026-07-18 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Bcbs | Medicare | $27.03 | $51.00 | $25.50 | 2026-07-18 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $27.08 | — | — | 2026-05-06 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $27.08 | — | — | 2026-09-21 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Amerigroup | Medicaid | $27.13 | $51.00 | $25.50 | 2026-07-18 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | AETNA MEDICARE [1300] | AETNA MEDICARE [130001] | $27.79 | — | — | 2026-04-01 | MRF ↗ |
| CRESCENT MEDICAL CENTER LANCASTER OutpatientFacility | Oscar | Commercial | $28.00 | $140.00 | $91.00 | 2026-10-27 | MRF ↗ |
| WARM SPRINGS MEDICAL CENTER Outpatient | Caresource | Medicaid | $28.48 | $51.00 | $25.50 | 2026-07-18 | MRF ↗ |
| HIGHLAND HOSPITAL Outpatient | CDPHP MEDICARE [1320] | CAPITAL DISTRICT PHYSICIANS MEDICARE [132001] | $28.80 | — | — | 2026-04-01 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Health Net Foundation | Health Net Latino | $29.40 | $123.00 | $123.00 | 2026-11-03 | MRF ↗ |
| PIGGOTT COMMUNITY HOSPITAL Outpatient | UHC MCR ADVANTAGE | UHC MCR ADVANTAGE | $29.40 | $60.00 | $42.00 | 2026-04-02 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Clinica Medica Familiar | Clinica Medica Familiar Medi Cal | $29.52 | $246.00 | $246.00 | 2026-11-03 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Care 1St Medi Cal Hmo Cap Exceptional Care | Care 1St Medi Cal Hmo Cap Exceptional Care | $29.90 | $299.00 | $299.00 | 2026-11-03 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Care First Health Plan | Blue Shield Promise Healthplan Mcal | $29.90 | $299.00 | $299.00 | 2026-11-03 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Employee Health Systems Medical Group | Employee Health Systems Ppo | $30.00 | $150.00 | $150.00 | 2026-11-03 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Bella Vista Medical Group Ipa | Bella Vista Med Grp Medi Cal | $30.00 | $150.00 | $150.00 | 2026-11-03 | MRF ↗ |
| ARBUCKLE MEMORIAL HOSPITAL Outpatient | Health Choice Network | Commercial | $30.00 | $30.00 | $24.00 | 2025-06-25 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Global Care Medical Group Ipa | Global Care Med Grp Medi Cal | $30.00 | $150.00 | $150.00 | 2026-11-03 | MRF ↗ |
| CHILDREN'S HOSPITAL OF ORANGE COUNTY Outpatient | Irvine Unified School District | Irvine Unified School District | $30.00 | $376.00 | $376.00 | 2026-11-02 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Anthem Blue Cross | Anthem Blue Cross Commercial/Hmo/Ppo/Epo | $30.23 | $123.00 | $123.00 | 2026-11-03 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Anthem Blue Cross | Anthem Blue Cross Workers Compensation | $30.23 | $123.00 | $123.00 | 2026-11-03 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Health Net Inc | Health Net Community Care Commercial | $30.26 | $123.00 | $123.00 | 2026-11-03 | MRF ↗ |
| CASS REGIONAL MEDICAL CENTER InpatientFacility | United Healthcare National Hospital | PPO | — | $236.00 | $165.20 | 2026-04-07 | MRF ↗ |
| CASS REGIONAL MEDICAL CENTER InpatientFacility | Celtic/Ambetter | Commercial | — | $236.00 | $165.20 | 2026-04-07 | MRF ↗ |
| CASS REGIONAL MEDICAL CENTER InpatientFacility | Aetna I-35 NN | Commercial | — | $236.00 | $165.20 | 2026-04-07 | MRF ↗ |
| CASS REGIONAL MEDICAL CENTER InpatientFacility | Blue Cross Blue Shield PHP | Commercial | — | $236.00 | $165.20 | 2026-04-07 | MRF ↗ |
| CASS REGIONAL MEDICAL CENTER InpatientFacility | Cigna All Programs | Commercial | $30.68 | $236.00 | $165.20 | 2026-04-07 | MRF ↗ |
| CASS REGIONAL MEDICAL CENTER InpatientFacility | United Healthcare National Hospital | Commercial | — | $236.00 | $165.20 | 2026-04-07 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Alta Med Health Services Med Grp | Alta Med Health Services Hmo/Sr/Medi Cal | $30.75 | $123.00 | $123.00 | 2026-11-03 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Anthem Blue Cross | Anthem Bx Covered Calif Exchange | $30.84 | $150.00 | $150.00 | 2026-11-03 | MRF ↗ |
| HCA FLORIDA LARGO HOSPITAL Outpatient | Simply Healthcare | HIX | $31.01 | $244.17 | $244.17 | 2026-03-01 | MRF ↗ |
| KELL WEST REGIONAL HOSPITAL Outpatient | MEDICAID_SUPERIOR | MEDICAID SUPERIOR | $31.17 | $138.00 | $25.60 | 2025-01-21 | MRF ↗ |
| KELL WEST REGIONAL HOSPITAL Outpatient | MEDICAID_TEXAS | MEDICAID TEXAS | $31.17 | $138.00 | $25.60 | 2025-01-21 | MRF ↗ |
| KELL WEST REGIONAL HOSPITAL Outpatient | MEDICAID_FIRST-CARE | MEDICAID FIRST CARE | $31.17 | $138.00 | $25.60 | 2025-01-21 | MRF ↗ |
| KELL WEST REGIONAL HOSPITAL Outpatient | UHC_COMMUNITY_PLAN | UNITED HEALTHCARE MEDICAID | $31.17 | $138.00 | $25.60 | 2025-01-21 | MRF ↗ |
| PIGGOTT COMMUNITY HOSPITAL Outpatient | CENTENE COMM EXCHANGE - ALL PLANS | CENTENE COMM EXCHANGE - ALL PLANS | $31.50 | $60.00 | $42.00 | 2026-04-02 | MRF ↗ |
| MONROE HOSPITAL Outpatient | Keenan | Keenan | $31.50 | $105.00 | — | 2024-12-19 | MRF ↗ |
| GREATER EL MONTE COMMUNITY HOSPITAL Outpatient | Chinatown Service Center Pace | Chinatown Service Center Pace | $31.50 | $150.00 | $150.00 | 2026-11-03 | MRF ↗ |
| KANSAS MEDICAL CENTER LLC Outpatient | WPPA | WPPA PROVIDER CARE OPEN NETWORK | $31.60 | $79.00 | $47.40 | 2026-03-31 | MRF ↗ |
| Penn Medicine Lancaster General Health Outpatient | Hospice And Community Care | Hospice And Community Care | $31.73 | $167.00 | $167.00 | 2026-10-30 | MRF ↗ |
| Penn Medicine Lancaster General Health Outpatient | Hospice And Community Care | Hospice And Community Care | $31.73 | $167.00 | $167.00 | 2026-07-15 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | MEDICARE BLUE CHOICE BLUE CROSS BLUE SHIELD [1306] | MEDICARE BLUE CHOICE [130601] | $31.74 | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE [5158] | UNITED HEALTHCARE (ATLANTA,GA) [515803] | — | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD [5143] | HIGHMARK BCBS [514301] | — | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | INDEPENDENT HEALTH [5156] | INDEPENDENT HEALTH (BUFFALO NY) [515601] | — | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | CAPITAL DISTRICT PHYSICIANS HEALTH PLAN (CDPHP) [51490] | CAPITAL DISTRICT PHYSICIANS HEALTH PLAN (CDPHP) [514901] | — | — | — | 2026-04-01 | MRF ↗ |
| Hca Florida Largo Hospital Outpatient | Oscar | HIX | $31.74 | $244.17 | $244.17 | 2024-10-01 | MRF ↗ |
| Hca Florida Largo Hospital Outpatient | Bright Health | HIX | $31.74 | $244.17 | $244.17 | 2024-10-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | INDEPENDENT HEALTH ASSOC MEDICAID [1710] | INDEPENDENT HEALTH ASSOC MEDICAID [171001] | — | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | INDEPENDENT HEALTH MEDICARE [1305] | INDEPENDENT HEALTH MEDICARE [130501] | — | — | — | 2026-04-01 | MRF ↗ |
| STRONG MEMORIAL HOSPITAL Outpatient | AETNA [2700] | AETNA [270002] | — | — | — | 2026-04-01 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Cigna Healthcare | Managed Medicare | $32.22 | $214.78 | $85.92 | 2026-02-04 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Kaiser | Managed Medicare | $32.22 | $214.78 | $85.92 | 2026-02-04 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Aetna | Managed Medicare | $32.22 | $214.78 | $85.92 | 2026-02-04 | 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.