97161 — Pt Eval Low Complex 20 Min
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PT EVAL LOW COMPLEX 20 MIN (CPT 97161) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/97161?code_type=CPT
MLA (9th ed.)
“PT EVAL LOW COMPLEX 20 MIN (CPT 97161) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/97161?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“PT EVAL LOW COMPLEX 20 MIN (CPT 97161) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/97161?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $104–$275 (25th–75th percentile) across 3,236 hospitals · 11,051 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 97161 — 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
$104
$174 typical
$275
The middle 50% of negotiated facility rates for this procedure, measured across 3,236 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. | $174 |
| Physician fee Estimate national typical Medicare $98 × 1.22 commercial. | $119 |
| Likely subtotal | $293 |
Complete-episode estimate (typical)
~$293
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Physician fee (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | None | — | — | $478.87 | $239.44 | 2024-12-15 | MRF ↗ |
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | None | — | — | $478.87 | $239.44 | 2024-12-15 | MRF ↗ |
| HANCOCK COUNTY HEALTH SYSTEM Outpatient | WELLMARK HMO-ALL OTHER PLANS | WELLMARK HMO-ALL OTHER PLANS | $0.31 | $214.00 | $160.50 | 2026-03-26 | MRF ↗ |
| MAHASKA HEALTH PARTNERSHIP Outpatient | MOLINA MCAID - ALL PLANS | MOLINA MCAID - ALL PLANS | $0.62 | $1.50 | $1.28 | 2026-02-04 | MRF ↗ |
| MAHASKA HEALTH PARTNERSHIP Outpatient | IOWA TOTAL CARE MEDICAID | IOWA TOTAL CARE MEDICAID | $0.62 | $1.50 | $1.28 | 2026-02-04 | MRF ↗ |
| MAHASKA HEALTH PARTNERSHIP Outpatient | AMERIGROUP MEDICAID-ALL OTHER PLANS | AMERIGROUP MEDICAID-ALL OTHER PLANS | $0.62 | $1.50 | $1.28 | 2026-02-04 | MRF ↗ |
| MAHASKA HEALTH PARTNERSHIP Outpatient | AETNA MCR ADV | AETNA MCR ADV | $0.83 | $1.50 | $1.28 | 2026-02-04 | MRF ↗ |
| MAHASKA HEALTH PARTNERSHIP Outpatient | AMERIGROUP MCR ADV | AMERIGROUP MCR ADV | $0.83 | $1.50 | $1.28 | 2026-02-04 | MRF ↗ |
| MAHASKA HEALTH PARTNERSHIP Outpatient | UHC MCR ADV | UHC MCR ADV | $0.83 | $1.50 | $1.28 | 2026-02-04 | MRF ↗ |
| MAHASKA HEALTH PARTNERSHIP Outpatient | HUMANA MCR ADV - ALL PLANS | HUMANA MCR ADV - ALL PLANS | $0.83 | $1.50 | $1.28 | 2026-02-04 | MRF ↗ |
| MAHASKA HEALTH PARTNERSHIP Outpatient | IOWA TOTAL CARE MCR | IOWA TOTAL CARE MCR | $0.83 | $1.50 | $1.28 | 2026-02-04 | MRF ↗ |
| MAHASKA HEALTH PARTNERSHIP Outpatient | IOWA TOTAL CARE COMM - ALL OTHER PLANS | IOWA TOTAL CARE COMM - ALL OTHER PLANS | $0.83 | $1.50 | $1.28 | 2026-02-04 | MRF ↗ |
| MAHASKA HEALTH PARTNERSHIP Outpatient | UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $0.97 | $1.50 | $1.28 | 2026-02-04 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | Covered | — | $768.00 | $629.76 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | HMO | — | $768.00 | $629.76 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | SCAN Health Plan | Medicare Advantage | — | $1,465.50 | $952.58 | 2025-11-26 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net Individual - HMO | $1.00 | $329.00 | $246.75 | 2026-04-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | United Healthcare | POS | — | $768.00 | $629.76 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $768.00 | $629.76 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $768.00 | $629.76 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $768.00 | $629.76 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | United Healthcare | HMO | — | $768.00 | $629.76 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $768.00 | $629.76 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $1,131.36 | $735.38 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $768.00 | $629.76 | 2025-11-26 | MRF ↗ |
| ST MARY'S HOSPITAL OutpatientFacility | Amerigroup | Medicaid/Peachcare | $1.00 | $410.00 | $266.50 | 2025-01-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | HMO | — | $768.00 | $629.76 | 2025-11-26 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Inpatient | United Healthcare | United Healthcare - Medicare | $1.03 | $329.00 | $246.75 | 2026-04-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Blue Cross | Blue Cross - MCS | $1.25 | $329.00 | $246.75 | 2026-04-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Cigna | Cigna - PPO | $1.30 | $329.00 | $246.75 | 2026-04-01 | MRF ↗ |
| MAHASKA HEALTH PARTNERSHIP Outpatient | AETNA HMO | AETNA HMO | $1.38 | $1.50 | $1.28 | 2026-02-04 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $1.42 | $139.00 | $90.35 | 2026-03-14 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $1.45 | $102.00 | $76.50 | 2025-03-07 | MRF ↗ |
| MAHASKA HEALTH PARTNERSHIP Outpatient | AETNA PPO - ALL OTHER PLANS | AETNA PPO - ALL OTHER PLANS | $1.46 | $1.50 | $1.28 | 2026-02-04 | MRF ↗ |
| MAHASKA HEALTH PARTNERSHIP Outpatient | MIDLANDS CHOICE - ALL PLANS | MIDLANDS CHOICE - ALL PLANS | $1.46 | $1.50 | $1.28 | 2026-02-04 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $1.85 | $181.00 | $117.65 | 2026-03-14 | MRF ↗ |
| NATIONAL PARK MEDICAL CENTER Inpatient | QCA HEALTH PLAN INC | Indemnity | $1.90 | $502.00 | $150.60 | 2025-07-01 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | Self Insured | $2.05 | $283.00 | — | 2025-06-28 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $2.16 | $207.30 | $207.30 | 2026-04-24 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.17 | $427.10 | $427.10 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.17 | $597.47 | $597.47 | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.17 | $597.47 | $597.47 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $2.28 | $224.00 | $145.60 | 2026-03-14 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.39 | $341.15 | $204.69 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.39 | $341.15 | $204.69 | 2025-08-11 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $2.48 | $427.10 | $427.10 | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $2.48 | $597.47 | $597.47 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $2.48 | $597.47 | $597.47 | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $2.70 | $427.10 | $427.10 | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $2.70 | $597.47 | $597.47 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $2.70 | $597.47 | $597.47 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $2.72 | $267.00 | $173.55 | 2026-03-14 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL BothFacility | Tricare | All | $2.91 | $247.00 | $247.00 | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL BothFacility | Blue Cross Blue Shield | Medicare Advantage | $2.91 | $247.00 | $247.00 | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL BothFacility | VA Health | All | $2.91 | $247.00 | $247.00 | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL BothFacility | Humana | Medicare Advantage | $2.91 | $247.00 | $247.00 | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL BothFacility | UHC | Medicare Advantage | $2.91 | $247.00 | $247.00 | 2026-03-28 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Community Health Group | Community Health Group - Cal Mediconnect | $2.94 | $329.00 | $246.75 | 2026-04-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Blue Shield | Blue Shield - Promise | $2.94 | $329.00 | $246.75 | 2026-04-01 | MRF ↗ |
| SAVOY MEDICAL CENTER OutpatientFacility | United Healthcare | PPO | $3.01 | $464.31 | $278.59 | 2026-03-15 | MRF ↗ |
| SAVOY MEDICAL CENTER OutpatientFacility | United Healthcare | HMO Other | $3.01 | $464.31 | $278.59 | 2026-03-15 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $3.02 | $418.00 | $154.66 | 2026-03-31 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $3.15 | $309.00 | $200.85 | 2026-03-14 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $3.58 | $351.00 | $228.15 | 2026-03-14 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.85 | $341.15 | $204.69 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.85 | $341.15 | $204.69 | 2025-08-11 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $4.01 | $393.00 | $255.45 | 2026-03-14 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $4.45 | $436.00 | $283.40 | 2026-03-14 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $4.75 | $427.10 | $427.10 | 2026-03-18 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of El Paso OutpatientFacility | Aetna | Medicare Advantage | $4.76 | $23.82 | $23.82 | 2025-09-11 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of El Paso OutpatientFacility | Aetna | Medicare Advantage | $4.76 | $23.82 | $23.82 | 2025-09-11 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $4.89 | $479.00 | $311.35 | 2026-03-14 | MRF ↗ |
| GROSSMONT HOSPITAL Outpatient | Community Health Group | Community Health Group - Cal Mediconnect | $4.95 | $329.00 | $246.75 | 2026-04-01 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $5.31 | $521.00 | $338.65 | 2026-03-14 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $5.49 | $316.00 | $126.40 | 2026-05-13 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $5.49 | $316.00 | $126.40 | 2026-05-22 | MRF ↗ |
| WASHINGTON COUNTY HOSPITAL Both | Alabama Medicaid | PPO | $5.76 | $5.76 | $2.30 | 2025-05-21 | MRF ↗ |
| WASHINGTON COUNTY HOSPITAL Both | United Health Care | PPO | $6.10 | $5.76 | $2.30 | 2025-05-21 | MRF ↗ |
| WASHINGTON COUNTY HOSPITAL Both | Humana | PPO | $6.10 | $5.76 | $2.30 | 2025-05-21 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $6.47 | $323.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $6.47 | $323.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $6.47 | $323.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $6.47 | $323.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $6.47 | $323.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $6.47 | $323.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $6.47 | $323.50 | — | 2026-03-31 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of Surprise OutpatientFacility | Arizona Care Network | Commercial | — | $47.64 | $47.64 | 2025-09-11 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of Surprise OutpatientFacility | Arizona Priority Care | PPO | — | $47.64 | $47.64 | 2025-09-11 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of Surprise OutpatientFacility | Arizona HealthNet (Centene) | Managed Medicaid | $6.72 | $47.64 | $47.64 | 2025-09-11 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of Surprise OutpatientFacility | Blue Cross Blue Shield of Arizona | Medicare Advantage | — | $47.64 | $47.64 | 2025-09-11 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of Surprise OutpatientFacility | Blue Cross Blue Shield of Arizona | PPO/HMO/Indemnity/Neighborhood | — | $47.64 | $47.64 | 2025-09-11 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of Surprise OutpatientFacility | Blue Cross and Blue Shield of Arizona HealthChoice | Managed Medicaid and Exchange Plan | $6.72 | $47.64 | $47.64 | 2025-09-11 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of Surprise OutpatientFacility | Mercy Care | Managed Medicaid | $6.72 | $47.64 | $47.64 | 2025-09-11 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of Surprise OutpatientFacility | Molina | Managed Medicaid | $6.72 | $47.64 | $47.64 | 2025-09-11 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of El Paso OutpatientFacility | Alignment Health Plan | All Plans | $7.15 | $23.82 | $23.82 | 2025-09-11 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of El Paso OutpatientFacility | Alignment Health Plan | All Plans | $7.15 | $23.82 | $23.82 | 2025-09-11 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $7.15 | — | — | 2025-12-31 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Health Net of California, Inc. | HMO | — | $434.62 | $282.50 | 2025-11-26 | MRF ↗ |
| RURAL WELLNESS STROUD HOSPITAL Both | Medicaid | Traditional | — | $259.59 | $155.75 | 2026-03-23 | MRF ↗ |
| THE PHYSICIANS' HOSPITAL IN ANADARKO Both | Medicaid | Traditional | — | $259.59 | $155.75 | 2026-03-23 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $8.06 | $124.00 | $80.60 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $8.06 | $124.00 | $80.60 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $8.06 | $124.00 | $80.60 | 2026-03-12 | MRF ↗ |
| NATCHITOCHES REGIONAL MEDICAL CENTER BothFacility | Aetna | Community | $8.34 | $28.00 | $11.20 | 2026-03-18 | MRF ↗ |
| NATCHITOCHES REGIONAL MEDICAL CENTER BothFacility | Blue Cross Blue Shield Of Louisiana | Healthy Blue Medicaid | $8.34 | $28.00 | $11.20 | 2026-03-18 | MRF ↗ |
| NATCHITOCHES REGIONAL MEDICAL CENTER BothFacility | Aetna | Medicaid | $8.34 | $28.00 | $11.20 | 2026-03-18 | MRF ↗ |
| NATCHITOCHES REGIONAL MEDICAL CENTER BothFacility | Centene | Louisiana Healthcare Connections Medicaid | $8.34 | $28.00 | $11.20 | 2026-03-18 | MRF ↗ |
| NATCHITOCHES REGIONAL MEDICAL CENTER BothFacility | United Healthcare | Medicaid | $8.34 | $28.00 | $11.20 | 2026-03-18 | MRF ↗ |
| NATCHITOCHES REGIONAL MEDICAL CENTER BothFacility | Amerihealth | Medicaid | $8.34 | $28.00 | $11.20 | 2026-03-18 | MRF ↗ |
| NATCHITOCHES REGIONAL MEDICAL CENTER BothFacility | Humana | Medicaid | $8.51 | $28.00 | $11.20 | 2026-03-18 | MRF ↗ |
| EAST LOS ANGELES DOCTORS HOSPITAL InpatientFacility | LA Care | Covered California | — | $495.60 | $495.60 | 2026-02-04 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior Health Plan | CHPFC | $9.14 | $152.36 | $152.36 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior Health Plan | STARKids | $9.14 | $152.36 | $152.36 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior Health Plan | STARPLUS | $9.14 | $152.36 | $152.36 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior Health Plan | CHIP | $9.14 | $152.36 | $152.36 | 2026-03-01 | MRF ↗ |
| WOMANS HOSPITAL OF TEXAS,THE Outpatient | Superior Health Plan | STAR | $9.14 | $152.36 | $152.36 | 2026-03-01 | MRF ↗ |
| NORTHERN REGIONAL HOSPITAL BothFacility | UMR - Commercial-PPO | UMR | $9.21 | $861.00 | $585.48 | 2025-11-12 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of El Paso OutpatientFacility | Curative | PPO/EPO/Self-Funded | $9.53 | $23.82 | $23.82 | 2025-09-11 | MRF ↗ |
| Cobalt Rehabilitation Hospital Clarksville OutpatientFacility | CareSource Kentucky | Exchange | — | $47.64 | $47.64 | 2025-09-11 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of El Paso OutpatientFacility | Curative | PPO/EPO/Self-Funded | $9.53 | $23.82 | $23.82 | 2025-09-11 | MRF ↗ |
| Cobalt Rehabilitation Hospital Clarksville OutpatientFacility | Aetna | Medicare Advantage | $9.53 | $47.64 | $47.64 | 2025-09-11 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $9.69 | $149.00 | $96.85 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $9.69 | $149.00 | $96.85 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $9.69 | $149.00 | $96.85 | 2026-03-12 | MRF ↗ |
| VISTA MEDICAL CENTER EAST Outpatient | Medicaid | Medicaid | $10.27 | $810.90 | $810.90 | 2025-03-31 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Both | United HC | Medicare Advantage - Outpatient | $10.37 | $54.00 | $27.00 | 2025-10-24 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Both | BlueCross | Medicare Advantage - Outpatient | $10.37 | $54.00 | $27.00 | 2025-10-24 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Both | Health First | Medicare Advantage - Outpatient | $10.37 | $54.00 | $27.00 | 2025-10-24 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | STARPLUS | $10.45 | $209.00 | $209.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | CHPFC | $10.45 | $209.00 | $209.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | CHIP | $10.45 | $209.00 | $209.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | STAR | $10.45 | $209.00 | $209.00 | 2026-03-01 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Both | Molina | Medicare Advantage - Outpatient | $10.58 | $54.00 | $27.00 | 2025-10-24 | MRF ↗ |
| MERCY HOSPITAL LINCOLN OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $10.73 | $165.00 | $107.25 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL LINCOLN OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $10.73 | $165.00 | $107.25 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL LINCOLN OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $10.73 | $165.00 | $107.25 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL LINCOLN OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $10.73 | $165.00 | $107.25 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL LINCOLN OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $10.73 | $165.00 | $107.25 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL LINCOLN OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $10.73 | $165.00 | $107.25 | 2026-03-12 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Both | Baycare | Medicare Advantage - Outpatient | $10.89 | $54.00 | $27.00 | 2025-10-24 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Both | Devoted | Medicare Advantage - Outpatient | $10.89 | $54.00 | $27.00 | 2025-10-24 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Both | CarePlus | Medicare Advantage - Outpatient | $10.89 | $54.00 | $27.00 | 2025-10-24 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $10.90 | $254.00 | $152.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $10.90 | $319.00 | $191.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $10.90 | $185.00 | $111.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $10.90 | $185.00 | $111.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $10.90 | $185.00 | $111.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $10.90 | $235.00 | $141.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $10.90 | $234.00 | $140.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $10.90 | $319.00 | $191.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $10.90 | $224.00 | $134.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $10.90 | $253.00 | $151.80 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $10.90 | $224.00 | $134.40 | 2026-01-01 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $11.18 | $172.00 | $111.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $11.18 | $172.00 | $111.80 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $11.18 | $172.00 | $111.80 | 2026-03-12 | MRF ↗ |
| BROWARD HEALTH NORTH OutpatientFacility | Aetna Healthcare of Florida/Vista Health Plan/Aetna Better Health | HMO | — | $283.83 | $283.83 | 2026-04-17 | MRF ↗ |
| H Lee Moffitt Cancer Center & Research Institute I Both | Devoted | Medicare Advantage OON (MMG) - Outpatient | $11.40 | $54.00 | $27.00 | 2025-10-24 | MRF ↗ |
| ATRIUM HEALTH PINEVILLE OutpatientFacility | United Healthcare | IEX Commercial | — | $404.15 | $202.08 | 2025-12-04 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | Wellcare | Managed Medicaid | $11.87 | $278.00 | $278.00 | 2026-04-30 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | Wellcare | Managed Medicaid | $11.87 | $278.00 | $278.00 | 2026-04-30 | MRF ↗ |
| THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC BothFacility | ARISE HEALTH PLAN - WPS HEALTH PLAN INC - Commercial-Indemnity | Other Commercial | $11.90 | $225.90 | $126.50 | 2025-01-01 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of El Paso OutpatientFacility | Ninety Degree Benefits | All Plans | $11.91 | $23.82 | $23.82 | 2025-09-11 | MRF ↗ |
| Pam Health Rehabilitation Hospital Of El Paso OutpatientFacility | Ninety Degree Benefits | All Plans | $11.91 | $23.82 | $23.82 | 2025-09-11 | MRF ↗ |
| Taylor Regional Hospital OutpatientFacility | PEACH STATE HEALTHPLAN | Medicaid | $11.96 | $116.20 | $116.20 | 2026-01-01 | MRF ↗ |
| Taylor Regional Hospital OutpatientFacility | AMGP GEORGIA MANAGED CARE CO INC | Medicaid | $11.96 | $116.20 | $116.20 | 2026-01-01 | MRF ↗ |
| Taylor Regional Hospital OutpatientFacility | BCBS HEALTHCARE PLAN OF GA | Medicaid | $11.96 | $116.20 | $116.20 | 2026-01-01 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL BothFacility | Aetna | Medicare Advantage | $11.97 | $95.00 | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL BothFacility | Aetna | All Plans | $11.97 | $95.00 | — | 2026-03-17 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB STLO CAPE MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $12.03 | $185.00 | $120.25 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | AETNA MEDICAID CONTRACTED [320009] | HB STLO CAPE AETNA BETTER HEALTH OF IL MEDICAID NEW 040125 | $12.03 | $185.00 | $120.25 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $12.03 | $185.00 | $120.25 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL ST LOUIS OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB STLO CAPE MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $12.03 | $185.00 | $120.25 | 2026-03-12 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | Wellpoint (Amerigroup) | Managed Medicaid/CHIP | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | Wellpoint (Amerigroup) | Medicare Advantage/Texas Essential Exchange | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | Memorial Hermann Health Plan | Medicare Advantage | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| PAM Rehabilitation Hospital of Humble OutpatientFacility | Aetna | Medicare Advantage | $12.04 | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | Wellpoint (Amerigroup) | MMP Plan | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| PAM Health Rehabilitation Hospital of Henderson OutpatientFacility | Aetna | Medicare Advantage | $12.04 | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | IntegraNet Health | Medicare Advantage/Dual Health | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | Superior Health Ambetter | Marketplace HMO/EPO | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | Sana Benefits | Commercial | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Warm Springs Rehab Hospital Of San Antonio Llc OutpatientFacility | Community First Health Plans | STAR/STAR Plus/CHIP | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Warm Springs Rehab Hospital Of San Antonio Llc OutpatientFacility | Community First Health Plans | Medicare Advantage | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | Superior Health | Managed Medicaid/CHIP | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | Christus Health Plan | Managed Medicaid | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | WellCare Complete | Medicare Advantage/Dual Health | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Warm Springs Rehab Hospital Of San Antonio Llc OutpatientFacility | Wellpoint (Amerigroup) | Managed Medicaid/CHIP | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Warm Springs Rehab Hospital Of San Antonio Llc OutpatientFacility | Aetna | Medicare Advantage | $12.04 | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Warm Springs Rehab Hospital Of San Antonio Llc OutpatientFacility | Superior Health | Managed Medicaid/CHIP | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Warm Springs Rehab Hospital Of San Antonio Llc OutpatientFacility | Sana Benefits | Commercial | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Warm Springs Rehab Hospital Of San Antonio Llc OutpatientFacility | WellCare Complete | Medicare Advantage/Dual Health | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | Texas Independence Health Plan | Medicare Advantage | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | Prime Health Services | Personal Injury | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Warm Springs Rehab Hospital Of San Antonio Llc OutpatientFacility | Molina Healthcare | Managed Medicaid | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | Molina Healthcare | Fed Exchange/Medicare Advantage/Options/Options Plus | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | WellMed | Medicare Advantage | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | Aetna | Medicare Advantage | $12.04 | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Pam Rehabilitation Hospital Of Beaumont OutpatientFacility | Molina Healthcare | Managed Medicaid | — | $120.35 | $120.35 | 2025-09-11 | MRF ↗ |
| Warm Springs Rehab Hospital Of San Antonio Llc OutpatientFacility | Oscar | Exchange | — | $120.35 | $120.35 | 2025-09-11 | 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.