97168 — Ot Re-eval Est Plan Care
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). OT RE-EVAL EST PLAN CARE (CPT 97168) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/97168?code_type=CPT
MLA (9th ed.)
“OT RE-EVAL EST PLAN CARE (CPT 97168) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/97168?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“OT RE-EVAL EST PLAN CARE (CPT 97168) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/97168?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $80–$246 (25th–75th percentile) across 2,981 hospitals · 10,182 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 97168 — 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
$80
$148 typical
$246
The middle 50% of negotiated facility rates for this procedure, measured across 2,981 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. | $148 |
| Physician fee Estimate national typical Medicare $68 × 1.22 commercial. | $84 |
| Likely subtotal | $231 |
Complete-episode estimate (typical)
~$231
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 | — | — | $289.82 | $144.91 | 2024-12-15 | MRF ↗ |
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | None | — | — | $289.82 | $144.91 | 2024-12-15 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | UHC_MCRADV | UNITED HEALTHCARE MEDICARE ADVANTAGE | $0.46 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | TRICARE | TRICARE | $0.46 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | MEDICARE | MEDICARE | $0.46 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | PRESBYTERIAN_SRCARE | PRESBYTERIAN SENIOR CARE | $0.46 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | HUMANA_MCRADV | HUMANA MEDICARE ADVANTAGE | $0.47 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | CORE_CIVIC | CORE CIVIC | $0.47 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Blue Shield | Blue Shield - Promise | $0.71 | $256.00 | $192.00 | 2026-04-01 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | BCBSNM_COMMUNITY_HMO | BCBS NEW MEXICO COMMUNITY HMO | $0.75 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.81 | $169.00 | $160.55 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.81 | $169.00 | $160.55 | 2026-02-20 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | SELFPAY | SELF PAY | $0.82 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $0.83 | $169.00 | $160.55 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $0.83 | $169.00 | $160.55 | 2026-02-20 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | ZELIS | ZELIS | $0.88 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | BCBSNM_BAV | BCBS NEW MEXICO BLUE ADVANTAGE HMO | $0.88 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | PRESBYTERIAN_HEALTH | PRESBYTERIAN HEALTH COMMERCIAL | $0.88 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | CIGNA | CIGNA | $0.88 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | BCBS_NM | BLUE CROSS BLUE SHIELD NEW MEXICO | $0.88 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | FIRST_HEALTH | AETNA - COVENTRY - FIRST HEALTH | $0.91 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | UHC | UNITED HEALTHCARE COMMERCIAL | $0.93 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | HUMANA | HUMANA | $0.93 | $1.03 | $0.82 | 2026-03-11 | 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 | SCAN Health Plan | Medicare Advantage | — | $1,836.45 | $1,193.69 | 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 | United Healthcare | HMO | — | $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 ↗ |
| ST MARY'S HOSPITAL OutpatientFacility | Amerigroup | Medicaid/Peachcare | $1.00 | $205.00 | $133.25 | 2025-01-01 | 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 ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | 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 | Covered | — | $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 | — | $1,836.45 | $1,193.69 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | 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 Both | SCAN | Medicare Advantage | — | $1,598.00 | $1,310.36 | 2025-11-26 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | MOLINA_TURQUOISE | MOLINA TURQUOISE CARE | $1.03 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | UHC_TURQUOISE | UHC TURQUOISE CARE | $1.03 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| CIBOLA GENERAL HOSPITAL Outpatient | PRESBY_TURQUOISE | PRESBYTERIAN TURQUOISE CARE | $1.03 | $1.03 | $0.82 | 2026-03-11 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.13 | $231.00 | $219.45 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.13 | $231.00 | $219.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $1.14 | $307.00 | $291.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.14 | $307.00 | $291.65 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.14 | $307.00 | $291.65 | 2026-02-20 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $1.16 | $102.00 | $76.50 | 2025-03-07 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.16 | $231.00 | $219.45 | 2026-02-20 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $1.19 | $117.00 | $76.05 | 2026-03-14 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.20 | $231.00 | $219.45 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $1.23 | $307.00 | $291.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $1.25 | $231.00 | $219.45 | 2026-02-20 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $1.39 | $366.08 | $366.08 | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $1.39 | $261.32 | $261.32 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $1.39 | $366.08 | $366.08 | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $1.60 | $261.32 | $261.32 | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $1.60 | $366.08 | $366.08 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $1.60 | $366.08 | $366.08 | 2026-03-18 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $1.64 | $282.41 | $169.45 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $1.64 | $282.41 | $169.45 | 2025-08-11 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $1.64 | $161.00 | $104.65 | 2026-03-14 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $1.72 | $165.40 | $165.40 | 2026-04-24 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $1.74 | $261.32 | $261.32 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $1.74 | $366.08 | $366.08 | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $1.74 | $366.08 | $366.08 | 2026-03-18 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | Self Insured | $2.05 | $154.00 | — | 2025-06-28 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $2.07 | $203.00 | $131.95 | 2026-03-14 | MRF ↗ |
| SAVOY MEDICAL CENTER OutpatientFacility | United Healthcare | PPO | $2.10 | $231.84 | $139.10 | 2026-03-15 | MRF ↗ |
| SAVOY MEDICAL CENTER OutpatientFacility | United Healthcare | HMO Other | $2.10 | $231.84 | $139.10 | 2026-03-15 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $2.11 | $311.00 | $115.07 | 2026-03-31 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.48 | $282.41 | $169.45 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.48 | $282.41 | $169.45 | 2025-08-11 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $2.50 | $245.00 | $159.25 | 2026-03-14 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $2.93 | $287.00 | $186.55 | 2026-03-14 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | First Carolina Care | Medicare Advantage | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Wellcare | Medicare Advantage | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Troy | Medicare Advantage | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana Choicecare | Medicare Advantage | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Tricare | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna | Medicare Advantage | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Medcost | Commercial | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Liberty Advantage | Medicare Advantage | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Wellcare | Managed Medicaid | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Carolina Complete Health | Managed Medicaid | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Compass | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana Choicecare | Commercial | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Cigna | Commercial | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Healthy Blue | Managed Medicaid | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna Nc State Health Plan | Commercial | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Longevity | Medicare Advantage | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Multiplan | Commercial | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Blue Medicare Partner Health Plan | Medicare | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Managed Medicaid | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | New Hanover | Medicare Advantage | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Medicare Advantage | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Onenet Ppo | $3.15 | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna | Commercial | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Commercial | — | $234.00 | $140.40 | 2026-05-23 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $3.37 | $330.00 | $214.50 | 2026-03-14 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $3.49 | $261.32 | $261.32 | 2026-03-18 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $3.51 | $135.00 | $54.00 | 2026-05-22 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $3.51 | $135.00 | $54.00 | 2026-05-13 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | HMO, Non-City of LA, Vivity | — | $362.88 | $235.87 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | HMO, City of LA, Vivity | — | $362.88 | $235.87 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | HMO | — | $362.88 | $235.87 | 2025-11-26 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $3.80 | $373.00 | $242.45 | 2026-03-14 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $3.98 | $199.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $3.98 | $199.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $3.98 | $199.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $3.98 | $199.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $3.98 | $199.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $3.98 | $199.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $3.98 | $199.00 | — | 2026-03-31 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $4.23 | $415.00 | $269.75 | 2026-03-14 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | HealthNet of California, Inc. | HMO | — | $1,836.45 | $1,193.69 | 2025-11-26 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $4.66 | $457.00 | $297.05 | 2026-03-14 | 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 ↗ |
| DINI-TOWNSEND HOSPITAL AT NNMH Outpatient | None | — | — | $95.62 | $4.78 | 2026-03-30 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $5.10 | $500.00 | $325.00 | 2026-03-14 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL OutpatientFacility | MagnaCare | All Products | $5.13 | — | — | 2025-12-31 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $5.53 | $542.00 | $352.30 | 2026-03-14 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER OutpatientFacility | Aetna Best Choice | HMO Employee Plan | $5.55 | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $5.85 | $90.00 | $58.50 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $5.85 | $90.00 | $58.50 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL JEFFERSON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $5.85 | $90.00 | $58.50 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $5.97 | $585.00 | $380.25 | 2026-03-14 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $6.40 | $627.00 | $407.55 | 2026-03-14 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $6.57 | $101.00 | $65.65 | 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 | $6.57 | $101.00 | $65.65 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $6.57 | $101.00 | $65.65 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $6.83 | $670.00 | $435.50 | 2026-03-14 | MRF ↗ |
| HCA FLORIDA NORTHSIDE HOSPITAL Outpatient | Access 2 Healthcare Physicians Freedom Optimum Group Members | MGMCR | $6.83 | $145.34 | $145.34 | 2026-03-01 | MRF ↗ |
| LIBERTY REGIONAL MEDICAL CENTER Both | Medicaid Georgia | Default | $6.95 | $43.00 | $32.25 | 2026-04-01 | MRF ↗ |
| LIBERTY REGIONAL MEDICAL CENTER Both | Amerigroup NM, GA, DC | Default | $6.97 | $43.00 | $32.25 | 2026-04-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $6.98 | $232.00 | $139.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $6.98 | $232.00 | $139.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $6.98 | $191.00 | $114.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $6.98 | $290.00 | $174.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $6.98 | $290.00 | $174.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $6.98 | $232.00 | $139.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $6.98 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $6.98 | $150.00 | $90.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $6.98 | $182.00 | $109.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $6.98 | $216.00 | $129.60 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $6.98 | $191.00 | $114.60 | 2026-01-01 | MRF ↗ |
| LIBERTY REGIONAL MEDICAL CENTER Both | WellCare of Georgia | Default | $7.11 | $43.00 | $32.25 | 2026-04-01 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $7.26 | $712.00 | $462.80 | 2026-03-14 | MRF ↗ |
| LIBERTY REGIONAL MEDICAL CENTER Both | CareSource GA | Default | $7.30 | $43.00 | $32.25 | 2026-04-01 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $7.69 | $754.00 | $490.10 | 2026-03-14 | MRF ↗ |
| LIBERTY REGIONAL MEDICAL CENTER Both | United Healthcare | Default | $7.74 | $43.00 | $32.25 | 2026-04-01 | MRF ↗ |
| HCA FLORIDA PASADENA HOSPITAL A PART OF HCA FLORID Outpatient | Access 2 Healthcare Physicians Freedom Optimum Group Members | MGMCR | $7.96 | $169.40 | $169.40 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA PASADENA HOSPITAL A PART OF HCA FLORID Outpatient | BCBS | MGMCRHMO | $8.13 | $169.40 | $169.40 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | CHIP | $8.15 | $163.00 | $163.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | CHPFC | $8.15 | $163.00 | $163.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | STARPLUS | $8.15 | $163.00 | $163.00 | 2026-03-01 | MRF ↗ |
| ST DAVID'S SOUTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | STAR | $8.15 | $163.00 | $163.00 | 2026-03-01 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Aetna Best Choice | HMO Employee Plan | $8.49 | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | United | Select HMO/Options PPO/Cruise Lines | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Simply Healthcare | Medicare Advantage | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Aetna Healthcare of Florida/Vista Health Plan/Aetna Better Health | HMO | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Aetna Health/Aetna Summit | Medicare Advantage | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | WellCare | Medicare Advantage | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Medica Healthcare | Medicare Advantage | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | WellCare/Stay Well | Managed Medicaid | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Humana/Choice Care | Medicare Advantage | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Clear Springs Healthcare | HMO | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Humana | Managed Medicaid | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Cigna Healthcare/SureFit | HMO/PPO/POS | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Doctor's Healthcare | Medicare Advantage | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | CarePlus Health Plan | Medicare Advantage | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Simply Healthcare/Clear Health Alliance | Managed Medicaid | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Aetna Health | HMO/PPO/Exchange | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Sunshine State Health Plan Healthy Kids | HMO | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | HealthSun Health Plan | Medicare Advantage | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Preferred Care Partners | Medicare Advantage | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Avmed | Exchange | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Florida Pace Center | Medicare Advantage | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Sunshine State Health Plan | Managed Medicaid | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Amerihealth Caritas | Medicare Advantage | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Avmed | HMO | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Community Care Plan | PPO | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Community Care Plan | HMO | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | WellCare Healthy Kids | HMO | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Freedom Health | Medicare Advantage | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Humana Gold | HMO | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Neighborhood Health Partnership | HMO | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | United AARP | Medicare Complete | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Florida Pace Center | Managed Medicaid | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Community Care Plan | Managed Medicaid | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Amerihealth Caritas | Managed Medicaid | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | United/WellMed | Medicare Advantage | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | United Healthcare Community Plan/Healthy Kids | HMO | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| BROWARD HEALTH MEDICAL CENTER InpatientFacility | Avmed | JHS Select/Select HMO | — | $81.59 | $81.59 | 2026-04-17 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $8.91 | $137.00 | $89.05 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $8.91 | $137.00 | $89.05 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL WASHINGTON OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $8.91 | $137.00 | $89.05 | 2026-03-12 | MRF ↗ |
| SAINT PETER'S UNIVERSITY HOSPITAL Both | Horizon Mercy | HORIZON NJ HEALTH MANAGED MD | $9.00 | $854.00 | $845.00 | 2025-11-19 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Aetna | MCR | $9.04 | — | — | 2026-03-01 | MRF ↗ |
| SUNRISE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna | MCR | $9.04 | — | — | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Aetna | MCR | $9.04 | — | — | 2026-03-01 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $9.05 | — | — | 2026-03-18 | 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.