97163 — Pt Eval High Complex 45 Min
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PT EVAL HIGH COMPLEX 45 MIN (CPT 97163) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/97163?code_type=CPT
MLA (9th ed.)
“PT EVAL HIGH COMPLEX 45 MIN (CPT 97163) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/97163?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“PT EVAL HIGH COMPLEX 45 MIN (CPT 97163) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/97163?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $112–$340 (25th–75th percentile) across 3,175 hospitals · 10,846 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 97163 — 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
$112
$208 typical
$340
The middle 50% of negotiated facility rates for this procedure, measured across 3,175 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. | $208 |
| Physician fee Estimate national typical Medicare $98 × 1.22 commercial. | $119 |
| Likely subtotal | $327 |
Complete-episode estimate (typical)
~$327
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 | $312.00 | $234.00 | 2026-03-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | SCAN Health Plan | Medicare Advantage | — | $2,938.25 | $1,909.86 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | Covered | — | $1,598.00 | $1,310.36 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $1,598.00 | $1,310.36 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $1,598.00 | $1,310.36 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $1,598.00 | $1,310.36 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | California Physicians' Service dba Blue Shield of California | HMO | — | $1,598.00 | $1,310.36 | 2025-11-26 | MRF ↗ |
| ST MARY'S HOSPITAL OutpatientFacility | Amerigroup | Medicaid/Peachcare | $1.00 | $422.00 | $274.30 | 2025-01-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $1,598.00 | $1,310.36 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $2,938.25 | $1,909.86 | 2025-11-26 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Aetna | First Health - Direct | $1.00 | $577.00 | $432.75 | 2026-04-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | Health Net of California, Inc. | HMO | — | $1,598.00 | $1,310.36 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | United Healthcare | POS | — | $1,598.00 | $1,310.36 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | United Healthcare | HMO | — | $1,598.00 | $1,310.36 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $1,598.00 | $1,310.36 | 2025-11-26 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.26 | $263.00 | $249.85 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.26 | $263.00 | $249.85 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.29 | $263.00 | $249.85 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $1.29 | $263.00 | $249.85 | 2026-02-20 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | United Healthcare | United Healthcare - HMO | $1.30 | $577.00 | $432.75 | 2026-04-01 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.34 | $263.00 | $249.85 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.41 | $380.00 | $361.00 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $1.41 | $380.00 | $361.00 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.41 | $380.00 | $361.00 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.44 | $380.00 | $361.00 | 2026-02-20 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $1.45 | $194.00 | $145.50 | 2025-03-07 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.48 | $380.00 | $361.00 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $1.52 | $380.00 | $361.00 | 2026-02-20 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | Self Insured | $2.05 | $356.00 | — | 2025-06-28 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $2.06 | $103.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $2.06 | $103.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $2.06 | $103.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $2.06 | $103.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $2.06 | $103.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $2.06 | $103.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $2.06 | $103.00 | — | 2026-03-31 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.17 | $660.79 | $660.79 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.17 | $660.79 | $660.79 | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.17 | $471.99 | $471.99 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $2.22 | $218.00 | $141.70 | 2026-03-14 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $2.24 | $458.00 | $435.10 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $2.24 | $458.00 | $435.10 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $2.29 | $458.00 | $435.10 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $2.38 | $458.00 | $435.10 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $2.47 | $458.00 | $435.10 | 2026-02-20 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $2.48 | $660.79 | $660.79 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $2.48 | $660.79 | $660.79 | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $2.48 | $471.99 | $471.99 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $2.66 | $261.00 | $169.65 | 2026-03-14 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $2.70 | $660.79 | $660.79 | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $2.70 | $471.99 | $471.99 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $2.70 | $660.79 | $660.79 | 2026-03-18 | MRF ↗ |
| SAVOY MEDICAL CENTER OutpatientFacility | United Healthcare | HMO Other | $3.01 | $464.31 | $278.59 | 2026-03-15 | MRF ↗ |
| SAVOY MEDICAL CENTER OutpatientFacility | United Healthcare | PPO | $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 ↗ |
| CRAWFORD MEMORIAL HOSPITAL BothFacility | HUMANA INC. - Medicare-HMO | Medicare Advantage | $3.03 | $444.00 | $355.20 | 2025-11-12 | MRF ↗ |
| CRAWFORD MEMORIAL HOSPITAL BothFacility | HUMANA INC. - Medicare-HMO | Medicare Advantage | $3.03 | $444.00 | $355.20 | 2025-11-12 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $3.10 | $304.00 | $197.60 | 2026-03-14 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $3.39 | $326.35 | $326.35 | 2026-04-24 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $3.53 | $346.00 | $224.90 | 2026-03-14 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.58 | $374.61 | $224.77 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.58 | $374.61 | $224.77 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.58 | $374.61 | $224.77 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.58 | $374.61 | $224.77 | 2025-08-11 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $3.96 | $388.00 | $252.20 | 2026-03-14 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $4.40 | $431.00 | $280.15 | 2026-03-14 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $4.75 | $471.99 | $471.99 | 2026-03-18 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $4.82 | $473.00 | $307.45 | 2026-03-14 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $5.26 | $516.00 | $335.40 | 2026-03-14 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $5.49 | $387.00 | $154.80 | 2026-05-13 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $5.49 | $387.00 | $154.80 | 2026-05-22 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | POS | — | $1,598.00 | $1,310.36 | 2025-11-26 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $5.69 | $558.00 | $362.70 | 2026-03-14 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $6.12 | $600.00 | $390.00 | 2026-03-14 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Wellcare | Medicare Advantage | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Healthy Blue | Managed Medicaid | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Blue Medicare Partner Health Plan | Medicare | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Liberty Advantage | Medicare Advantage | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna | Commercial | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana Choicecare | Medicare Advantage | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Cigna | Commercial | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Carolina Complete Health | Managed Medicaid | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana Choicecare | Commercial | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Multiplan | Commercial | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Tricare | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Medicare Advantage | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Commercial | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Onenet Ppo | $6.70 | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Managed Medicaid | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Medcost | Commercial | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Troy | Medicare Advantage | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Compass | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna | Medicare Advantage | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Wellcare | Managed Medicaid | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Longevity | Medicare Advantage | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | New Hanover | Medicare Advantage | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna Nc State Health Plan | Commercial | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | First Carolina Care | Medicare Advantage | — | $487.00 | $292.20 | 2026-05-23 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | California PhysiciansÆ Service, dba Blue Shield of California | Medi-Cal | — | $869.25 | $565.01 | 2025-11-26 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $7.15 | — | — | 2025-12-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $8.55 | $427.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $8.55 | $427.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $8.55 | $427.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $8.55 | $427.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $8.55 | $427.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $8.55 | $427.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $8.55 | $427.50 | — | 2026-03-31 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL BothFacility | Blue Cross Blue Shield | Medicare Advantage | $8.73 | $288.00 | $288.00 | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL BothFacility | Humana | Medicare Advantage | $8.73 | $288.00 | $288.00 | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL BothFacility | Tricare | All | $8.73 | $288.00 | $288.00 | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL BothFacility | UHC | Medicare Advantage | $8.73 | $288.00 | $288.00 | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL BothFacility | VA Health | All | $8.73 | $288.00 | $288.00 | 2026-03-28 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | CIGNA | CIGNA MEDICARE | $9.04 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | CIGNA | CIGNA MEDICARE | $9.04 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| VISTA MEDICAL CENTER EAST Outpatient | Medicaid | Medicaid | $10.27 | $810.90 | $810.90 | 2025-03-31 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $10.34 | $159.00 | $103.35 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $10.34 | $159.00 | $103.35 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $10.34 | $159.00 | $103.35 | 2026-03-12 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $10.90 | $361.00 | $216.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $10.90 | $375.00 | $225.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $10.90 | $375.00 | $225.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $10.90 | $476.00 | $285.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $10.90 | $392.00 | $235.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $10.90 | $465.00 | $279.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $10.90 | $465.00 | $279.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $10.90 | $364.00 | $218.40 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $10.90 | $465.00 | $279.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $10.90 | $476.00 | $285.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $10.90 | $392.00 | $235.20 | 2026-01-01 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Outpatient | United Healthcare Medicare | Medicare Advantage | $11.22 | $469.00 | $281.40 | 2026-02-12 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Outpatient | United Healthcare Medicare | Medicare Advantage | $11.22 | $469.00 | $281.40 | 2026-02-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $11.64 | $179.00 | $116.35 | 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 | $11.64 | $179.00 | $116.35 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $11.64 | $179.00 | $116.35 | 2026-03-12 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | BLUE CROSS TN | BLUE ADVANTAGE TN | $12.05 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | BLUE CROSS OF AL | BLUE ADVANTAGE | $12.05 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | VIVA | VIVA MEDICARE | $12.05 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | MEDICARE | MEDICARE ADVANTAGE | $12.05 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | BLUE CROSS TN | BLUE ADVANTAGE TN | $12.05 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | BLUE CROSS OF AL | BLUE ADVANTAGE | $12.05 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | VIVA | VIVA MEDICARE | $12.05 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | MEDICARE | MEDICARE ADVANTAGE | $12.05 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $12.22 | $188.00 | $122.20 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $12.22 | $188.00 | $122.20 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $12.22 | $188.00 | $122.20 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $12.29 | $189.00 | $122.85 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $12.29 | $189.00 | $122.85 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $12.29 | $189.00 | $122.85 | 2026-03-12 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | HUMANA | HUMANA MEDICARE | $12.29 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $12.29 | $189.00 | $122.85 | 2026-03-12 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | AETNA | AETNA MEDICARE | $12.29 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | HUMANA | HUMANA MEDICARE | $12.29 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | AETNA | AETNA MEDICARE | $12.29 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $12.29 | $189.00 | $122.85 | 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 | $12.29 | $189.00 | $122.85 | 2026-03-12 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | UNITED HEALTHCARE | UNITED MEDICARE | $12.35 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | UNITED HEALTHCARE | UNITED MEDICARE | $12.35 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | DEVOTED | DEVOTED MEDICARE | $12.41 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | DEVOTED | DEVOTED MEDICARE | $12.41 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| IRON COUNTY MEDICAL CENTER Outpatient | Healthlink | HMO/PPO/Traditional | $12.44 | $325.00 | $292.50 | 2026-03-03 | MRF ↗ |
| NOCONA GENERAL HOSPITAL Both | United Healthcare | All | $12.50 | $369.00 | $27.85 | 2026-05-06 | MRF ↗ |
| NOCONA GENERAL HOSPITAL Both | United Healthcare | All | $12.50 | $369.00 | $27.85 | 2026-05-09 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Aetna | MCR | $12.92 | — | — | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Aetna | MCR | $12.92 | — | — | 2026-03-01 | MRF ↗ |
| SUNRISE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna | MCR | $12.92 | — | — | 2026-03-01 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | WELLCARE | WELLCARE MEDICARE | $13.26 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | WELLCARE | WELLCARE MEDICARE | $13.26 | $117.90 | $117.90 | 2026-03-27 | MRF ↗ |
| SAINT PETER'S UNIVERSITY HOSPITAL Both | Horizon Mercy | HORIZON NJ HEALTH MANAGED MD | $14.00 | $1,029.00 | $1,015.00 | 2025-11-19 | MRF ↗ |
| SAINT PETER'S UNIVERSITY HOSPITAL Both | Horizon Mercy | HORIZON NJ HEALTH MANAGED MD | $14.00 | $1,094.00 | $1,080.00 | 2025-11-19 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $14.12 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $14.12 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $14.12 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | UHC MCR ADV | UHC MCR ADV | $14.62 | $43.00 | $25.80 | 2025-11-18 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | United | MGMCD | — | — | — | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Aetna | MCR | $14.68 | — | — | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Aetna | MCR | $14.68 | — | — | 2026-03-01 | MRF ↗ |
| SUNRISE HOSPITAL AND MEDICAL CENTER OutpatientFacility | United | MGMCD | — | — | — | 2026-03-01 | MRF ↗ |
| SUNRISE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna | MCR | $14.68 | — | — | 2026-03-01 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $14.76 | $227.00 | $147.55 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $14.76 | $227.00 | $147.55 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $14.76 | $227.00 | $147.55 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $14.76 | $227.00 | $147.55 | 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 | $14.76 | $227.00 | $147.55 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL SOUTH OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $14.76 | $227.00 | $147.55 | 2026-03-12 | MRF ↗ |
| LANE REGIONAL MEDICAL CENTER Outpatient | Humana Inc. | Commercial | $15.00 | $86.00 | $30.00 | 2026-05-27 | MRF ↗ |
| BAYAMON MEDICAL CENTER Outpatient | None | — | — | $45.00 | $45.00 | 2026-03-31 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $15.34 | $236.00 | $153.40 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $15.34 | $236.00 | $153.40 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $15.34 | $236.00 | $153.40 | 2026-03-12 | MRF ↗ |
| HCA FLORIDA PASADENA HOSPITAL A PART OF HCA FLORID Outpatient | Access 2 Healthcare Physicians Freedom Optimum Group Members | MGMCR | $15.47 | $329.12 | $329.12 | 2026-03-01 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $15.47 | $238.00 | $154.70 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $15.47 | $238.00 | $154.70 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $15.47 | $238.00 | $154.70 | 2026-03-12 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | Memorial Health Partners/GHP | MemorialHealthPartnersGHP | — | $764.00 | $573.00 | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | Clover Insurance Co | CloverMgdMCare | — | $764.00 | $573.00 | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | Eon Health Medicare | EONHealthMedicare | — | $764.00 | $573.00 | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | Employers Choice Network | EmployersChoiceNetwork | — | $764.00 | $573.00 | 2024-12-08 | 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.