98975 — Rem Ther Mntr 1st Setup&edu
Cite this view
HANK Price Transparency. (n.d.). REM THER MNTR 1ST SETUP&EDU (CPT 98975) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/98975?code_type=CPT
“REM THER MNTR 1ST SETUP&EDU (CPT 98975) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/98975?code_type=CPT. Accessed .
“REM THER MNTR 1ST SETUP&EDU (CPT 98975) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/98975?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $64–$194 (25th–75th percentile) across 1,611 hospitals · 2,309 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 98975 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
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.
The middle 50% of negotiated facility rates for this procedure, measured across 1,611 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. | $128 |
| Physician fee Estimate national typical Medicare $22 × 1.22 commercial. | $26 |
| Likely subtotal | $155 |
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge
- Complications, revisions, or readmissions
- Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)
The biggest swing: which insurer's rate applies — negotiated prices here run $64–$194.
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Physician fee (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $0.29 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $0.29 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.49 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $0.60 | — | — | 2026-09-01 | MRF ↗ |
| James Cancer Hospital & Solove Research Institute Outpatient | Cigna | Cigna - Transplant | $0.62 | $307.00 | — | 2026-07-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.07 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.09 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.09 | — | — | 2026-03-18 | MRF ↗ |
| SUNRISE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna | MCR | $3.24 | — | — | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Aetna | MCR | $3.24 | — | — | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Aetna | MCR | $3.24 | — | — | 2026-03-01 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $3.52 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $3.54 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $3.54 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $3.83 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $3.85 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $3.85 | — | — | 2026-03-18 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Group Health Coop (Ghc) | Ghc Commercial (Kaiser) | $4.20 | $42.00 | $42.00 | 2026-07-15 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Kaiser | Managed Medicare | $6.36 | $42.40 | $16.96 | 2026-02-04 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Humana | Managed Medicare | $6.36 | $42.40 | $16.96 | 2026-02-04 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Anthem Blue Cross Blue Shield | Managed Medicare | $6.36 | $42.40 | $16.96 | 2026-02-04 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Optum Care Network | Managed Medicare | $6.36 | $42.40 | $16.96 | 2026-02-04 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Managed Medicare | Managed Medicare | $6.36 | $42.40 | $16.96 | 2026-02-04 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Aetna | Managed Medicare | $6.36 | $42.40 | $16.96 | 2026-02-04 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Medicare | Managed Medicare | $6.36 | $42.40 | $16.96 | 2026-02-04 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Devoted Health | Managed Medicare | $6.36 | $42.40 | $16.96 | 2026-02-04 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Cigna Healthcare | Managed Medicare | $6.36 | $42.40 | $16.96 | 2026-02-04 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Innovage | Managed Medicare | $6.36 | $42.40 | $16.96 | 2026-02-04 | MRF ↗ |
| ABBOTT NORTHWESTERN HOSPITAL Outpatient | Blue Cross Blue Shield Of Minnesota | Bc Pmap (Amu) | $6.42 | $36.20 | $17.38 | 2026-07-15 | MRF ↗ |
| UNITED MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Minnesota | Bc Pmap (Amu) | $6.42 | $36.20 | $17.38 | 2026-07-15 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | United Healthcare | Managed Medicare | $6.78 | $42.40 | $16.96 | 2026-02-04 | MRF ↗ |
| UNITED MEDICAL CENTER Outpatient | Ucare Pmap (A B C D E G N O S U R H) | Ucare Pmap (Abdmnorsuv) | $7.28 | $36.20 | $17.38 | 2026-07-15 | MRF ↗ |
| ABBOTT NORTHWESTERN HOSPITAL Outpatient | Ucare Pmap (A B C D E G N O S U R H) | Ucare Pmap (Abdmnorsuv) | $7.28 | $36.20 | $17.38 | 2026-07-15 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $7.44 | — | — | 2026-03-18 | MRF ↗ |
| LAKEWOOD HEALTH SYSTEM Outpatient | BCBS MN MHCP | BCBS MN MHCP | $7.77 | $20.00 | $12.40 | 2026-04-22 | MRF ↗ |
| LAKEWOOD HEALTH SYSTEM Outpatient | UHC VA CCN | UHC VA CCN | $8.00 | $20.00 | $12.40 | 2026-04-22 | MRF ↗ |
| LAKEWOOD HEALTH SYSTEM Outpatient | UHC MCR ADV | UHC MCR ADV | $8.00 | $20.00 | $12.40 | 2026-04-22 | MRF ↗ |
| LAKEWOOD HEALTH SYSTEM Outpatient | BCBS MN MCR ADV | BCBS MN MCR ADV | $8.00 | $20.00 | $12.40 | 2026-04-22 | MRF ↗ |
| ABBOTT NORTHWESTERN HOSPITAL Outpatient | Medica Health System | Medica Pmap (A) | $8.04 | $36.20 | $17.38 | 2026-07-15 | MRF ↗ |
| UNITED MEDICAL CENTER Outpatient | Medica Pmap (Um) | Medica Pmap (Um) | $8.04 | $36.20 | $17.38 | 2026-07-15 | MRF ↗ |
| LAKEWOOD HEALTH SYSTEM Outpatient | HUMANA MCR ADV-ALL PLANS | HUMANA MCR ADV-ALL PLANS | $8.08 | $20.00 | $12.40 | 2026-04-22 | MRF ↗ |
| LAKEWOOD HEALTH SYSTEM Outpatient | UHC MEDICAID | UHC MEDICAID | $8.20 | $20.00 | $12.40 | 2026-04-22 | MRF ↗ |
| LAKEWOOD HEALTH SYSTEM Outpatient | UCARE MSHO/SPECIAL NEEDS | UCARE MSHO/SPECIAL NEEDS | $8.24 | $20.00 | $12.40 | 2026-04-22 | MRF ↗ |
| LAKEWOOD HEALTH SYSTEM Outpatient | UCARE MCR ADV | UCARE MCR ADV | $8.24 | $20.00 | $12.40 | 2026-04-22 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Horizon | Managed Medicaid | $8.42 | — | $129.13 | 2024-12-31 | MRF ↗ |
| LAKEWOOD HEALTH SYSTEM Outpatient | UCARE INDIVIDUAL/FAMILY - ALL OTHER PLANS | UCARE INDIVIDUAL/FAMILY - ALL OTHER PLANS | $9.20 | $20.00 | $12.40 | 2026-04-22 | MRF ↗ |
| FRANCISCAN HEALTH OLYMPIA & CHICAGO HEIGHTS Both | BLUE CROSS [1014] | BC/BS OF ILLINOIS HMO-SSCD | $9.43 | $49.00 | $10.88 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH OLYMPIA & CHICAGO HEIGHTS Both | BLUE CROSS BLUE SHIELD IL [1030] | BC/BS OF ILLINOIS HMO-SSCD | $9.43 | $49.00 | $10.88 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH OLYMPIA & CHICAGO HEIGHTS Both | BLUE CROSS ILLINOIS [1210] | BC/BS OF ILLINOIS HMO-SSCD | $9.43 | $49.00 | $10.88 | 2026-01-01 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $9.72 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | HAP CareSource | MEDICAID | $9.72 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | McLaren | MEDICAID | $9.72 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Blue Cross Complete | MEDICAID | $9.72 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Priority Health | MEDICAID | $9.72 | — | — | 2025-06-28 | MRF ↗ |
| LAKEWOOD HEALTH SYSTEM Outpatient | MEDICA CHOICE CARE | MEDICA CHOICE CARE | $9.76 | $20.00 | $12.40 | 2026-04-22 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Horizon | Managed Medicaid | $9.77 | — | $130.82 | 2024-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | Horizon | Managed Medicaid | $10.12 | — | $130.82 | 2024-12-31 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Aetna Better Health | MEDICAID | $10.21 | — | — | 2025-06-28 | MRF ↗ |
| SCOTT COUNTY HOSPITAL OutpatientFacility | UnitedHealthcare | Medicaid | $10.40 | $26.00 | — | 2026-03-26 | MRF ↗ |
| SCOTT COUNTY HOSPITAL OutpatientFacility | UnitedHealthcare | Medicaid | $10.40 | $26.00 | — | 2026-03-26 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | Horizon | Managed Medicaid | $10.50 | — | $130.82 | 2024-12-31 | MRF ↗ |
| TRINITAS REGIONAL MEDICAL CENTER OutpatientFacility | Wellpoint | NJ Family Care | $10.66 | — | — | 2026-03-04 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | HAP | HAP Caresource Medicaid | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Aetna Better Health | MEDICAID | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Priority Health | MEDICAID | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna Better Health | MEDICAID | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | HAP Caresource Medicaid | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | McLaren | MEDICAID | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Blue Cross Complete | MEDICAID | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | McLaren | MEDICAID | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Priority Health | MEDICAID | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| FRANCISCAN HEALTH OLYMPIA & CHICAGO HEIGHTS Both | BLUE CROSS ILLINOIS [1210] | BC/BS OF ILLINOIS PPO-SSCD | $10.87 | $49.00 | $10.88 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH OLYMPIA & CHICAGO HEIGHTS Both | BLUE CROSS [1014] | BC/BS OF ILLINOIS PPO-SSCD | $10.87 | $49.00 | $10.88 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH OLYMPIA & CHICAGO HEIGHTS Both | ALT PAYER ILLINOIS BLUE CROSS [121002] | BC/BS OF ILLINOIS PPO-SSCD | $10.87 | $49.00 | $10.88 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH OLYMPIA & CHICAGO HEIGHTS Both | BLUE CROSS OUT OF STATE [1211] | BC/BS OF ILLINOIS PPO-SSCD | $10.87 | $49.00 | $10.88 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH OLYMPIA & CHICAGO HEIGHTS Both | BLUE CROSS BLUE SHIELD IL [1030] | BC/BS OF ILLINOIS PPO-SSCD | $10.87 | $49.00 | $10.88 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH OLYMPIA & CHICAGO HEIGHTS Both | ALT PAYER INDIANA BLUE CROSS [121003] | BC/BS OF ILLINOIS PPO-SSCD | $10.87 | $49.00 | $10.88 | 2026-01-01 | MRF ↗ |
| SCOTT COUNTY HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $10.92 | $26.00 | — | 2026-03-26 | MRF ↗ |
| SCOTT COUNTY HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $10.92 | $26.00 | — | 2026-03-26 | MRF ↗ |
| NEWARK BETH ISRAEL MEDICAL CENTER OutpatientFacility | United Healthcare | Community Plan | $10.97 | — | — | 2026-03-04 | MRF ↗ |
| ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL - SOMERSET OutpatientFacility | Wellpoint | NJ Family Care | $11.29 | — | — | 2026-03-04 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Horizon | Managed Medicaid | $11.54 | — | $132.69 | 2024-12-31 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Peach State Ambetter | HIX | $11.57 | — | — | 2024-10-01 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Cigna | Cigna Medicare Advantage | $11.76 | $42.00 | $42.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Umvs | Umvs | $11.76 | $42.00 | $42.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Group Health Coop (Ghc) | Ghc Medicare | $11.76 | $42.00 | $42.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Care First Health Plan | Care 1St Medicare Advantage | $11.76 | $42.00 | $42.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Managed Medicare Plans | Managed Medicare Plans | $11.76 | $42.00 | $42.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Tricare | Tricare For Life | $11.76 | $42.00 | $42.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Veterans Administrations | Veterans Administration | $11.76 | $42.00 | $42.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Champva | Champva/Health Net | $11.76 | $42.00 | $42.00 | 2026-07-15 | MRF ↗ |
| UNITED MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Minnesota | Bc Premier (M U) | $11.77 | $36.20 | $17.38 | 2026-07-15 | MRF ↗ |
| ABBOTT NORTHWESTERN HOSPITAL Outpatient | Blue Cross Blue Shield Of Minnesota | Bc Premier (A) | $11.77 | $36.20 | $17.38 | 2026-07-15 | MRF ↗ |
| TRISTAR SOUTHERN HILLS MEDICAL CENTER Outpatient | Wellpoint | MGMCD | $11.83 | — | — | 2024-10-01 | MRF ↗ |
| UNITED MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Minnesota | Bc State Health Plan (Mu) | $11.86 | $36.20 | $17.38 | 2026-07-15 | MRF ↗ |
| ABBOTT NORTHWESTERN HOSPITAL Outpatient | Blue Cross Blue Shield Of Minnesota | Bc State Health Plan (A) | $11.86 | $36.20 | $17.38 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Chpw | Chpw | $11.94 | $42.00 | $42.00 | 2026-07-15 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | HEALTH NET | HEALTH NET | $12.07 | $41.00 | $30.75 | 2026-04-27 | MRF ↗ |
| FRANCISCAN HEALTH RENSSELAER, INC Both | MEDICARE [1099] | MEDICARE-WIR-RENSSELAER | $12.25 | $49.00 | $17.54 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH RENSSELAER, INC Both | MEDICARE REPLACEMENT [2003] | MEDICARE-WIR-RENSSELAER | $12.25 | $49.00 | $17.54 | 2026-01-01 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | MOLINA MCR ADV | MOLINA MCR ADV | $12.30 | $41.00 | $24.60 | 2025-11-18 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Managed Medicare Plans | Managed Medicare Plans | — | $44.00 | $44.00 | 2026-10-02 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Champva | Champva/Health Net | — | $44.00 | $44.00 | 2026-10-02 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Regence | Regence Medicare | $12.35 | $42.00 | $42.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Bcbs | Blue Cross Medicare Advanatage | $12.35 | $42.00 | $42.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Uhc | Uhc Medicare Advantage | $12.35 | $42.00 | $42.00 | 2026-07-15 | MRF ↗ |
| TRISTAR SKYLINE MEDICAL CENTER Outpatient | Wellpoint | MGMCD | $12.36 | — | — | 2024-10-01 | MRF ↗ |
| O'CONNOR HOSPITAL Outpatient | Bcbs | Excellus Hmo Blue Option Managed Medicaid | $12.40 | $40.00 | $10.80 | 2026-07-15 | MRF ↗ |
| COBLESKILL REGIONAL HOSPITAL Outpatient | Bcbs | Excellus Hmo Option | $12.40 | $40.00 | $10.80 | 2026-07-15 | MRF ↗ |
| COBLESKILL REGIONAL HOSPITAL Outpatient | Bcbs | Excellus Hmo Blue Option Managed Medicaid | $12.40 | $40.00 | $10.80 | 2026-07-15 | MRF ↗ |
| COBLESKILL REGIONAL HOSPITAL Outpatient | Bcbs | Excellus Healthy Ny Managed Medicaid | $12.40 | $40.00 | $10.80 | 2026-07-15 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan | $12.43 | — | — | 2026-03-01 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan – Hmo | $12.43 | — | — | 2026-03-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $12.47 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $12.47 | — | — | 2026-04-01 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $12.47 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $12.47 | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $12.47 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $12.47 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $12.47 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $12.47 | — | — | 2026-04-01 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Cdphp | Medicaid | $12.49 | — | — | 2026-07-18 | MRF ↗ |
| CLAY COUNTY MEDICAL CENTER Outpatient | MULTIPLAN- ALL PLANS | MULTIPLAN- ALL PLANS | $12.70 | $21.17 | $21.17 | 2026-04-24 | MRF ↗ |
| CLAY COUNTY MEDICAL CENTER Outpatient | MULTIPLAN- ALL PLANS | MULTIPLAN- ALL PLANS | $12.70 | $21.17 | $21.17 | 2026-07-22 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | UHC MCR ADV | UHC MCR ADV | $12.71 | $41.00 | $30.75 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | MY TRUE ADVANTAGE - ALL PLANS | MY TRUE ADVANTAGE - ALL PLANS | $12.71 | $41.00 | $30.75 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | CARESOURCE MCR ADV | CARESOURCE MCR ADV | $12.71 | $41.00 | $30.75 | 2026-04-27 | MRF ↗ |
| ABBOTT NORTHWESTERN HOSPITAL Outpatient | Aetna | Aetna Elevate (Amu) | $12.76 | $36.20 | $17.38 | 2026-07-15 | MRF ↗ |
| UNITED MEDICAL CENTER Outpatient | Aetna | Aetna Elevate (Amu) | $12.76 | $36.20 | $17.38 | 2026-07-15 | MRF ↗ |
| COBLESKILL REGIONAL HOSPITAL Outpatient | United Healthcare | Madicare Advantage | $12.80 | $40.00 | $10.80 | 2026-07-15 | MRF ↗ |
| COBLESKILL REGIONAL HOSPITAL Outpatient | Champva | — | $12.80 | $40.00 | $10.80 | 2026-07-15 | MRF ↗ |
| COBLESKILL REGIONAL HOSPITAL Outpatient | Bcbs | Excellus Blue Medicare Advantage | $12.80 | $40.00 | $10.80 | 2026-07-15 | MRF ↗ |
| COBLESKILL REGIONAL HOSPITAL Outpatient | Bcbs | Anthem Medicare Advantage | $12.80 | $40.00 | $10.80 | 2026-07-15 | MRF ↗ |
| COBLESKILL REGIONAL HOSPITAL Outpatient | Tricare | — | $12.80 | $40.00 | $10.80 | 2026-07-15 | MRF ↗ |
| COBLESKILL REGIONAL HOSPITAL Outpatient | Emblem | Medicare Advantage | $12.80 | $40.00 | $10.80 | 2026-07-15 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | AETNA MCR ADV | AETNA MCR ADV | $12.84 | $41.00 | $30.75 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | HUMANA MCR ADV | HUMANA MCR ADV | $12.84 | $41.00 | $30.75 | 2026-04-27 | MRF ↗ |
| COBLESKILL REGIONAL HOSPITAL Outpatient | Martins Point | — | $12.93 | $40.00 | $10.80 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Regence | Regence Medicare | — | $44.00 | $44.00 | 2026-10-02 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Bcbs | Medicare Advantage | — | $44.00 | $44.00 | 2026-10-02 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | UHC | UHC Medicare | $13.03 | $354.00 | $191.16 | 2025-10-01 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | Humana | Humana Military East | $13.03 | $354.00 | $191.16 | 2025-10-01 | MRF ↗ |
| VANDERBILT WILSON COUNTY HOSPITAL Both | UHC | UHC Medicare | $13.03 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT WILSON COUNTY HOSPITAL Both | Humana | Humana Military East | $13.03 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT TULLAHOMA-HARTON HOSPITAL Both | Humana | Humana Military East | $13.03 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT BEDFORD HOSPITAL Both | UHC | UHC Medicare | $13.03 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT BEDFORD HOSPITAL Both | Humana | Humana Military East | $13.03 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT TULLAHOMA-HARTON HOSPITAL Both | UHC | UHC Medicare | $13.03 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| DAVIS MEDICAL CENTER OutpatientFacility | Correctional Medical Systems | Commercial | $13.04 | — | — | 2025-08-07 | MRF ↗ |
| BROADDUS HOSPITAL ASSOCIATION, INC OutpatientFacility | Correctional Medical Systems | Commercial | $13.04 | — | — | 2025-08-07 | MRF ↗ |
| BROADDUS HOSPITAL ASSOCIATION, INC OutpatientFacility | Correctional Medical Systems | Commercial | $13.04 | — | — | 2025-08-07 | MRF ↗ |
| DAVIS MEDICAL CENTER OutpatientFacility | Correctional Medical Systems | Commercial | $13.04 | — | — | 2025-08-07 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Humana | Humana Medicare Advantage | $13.04 | $42.00 | $42.00 | 2026-07-15 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | TODAY'S OPTION MCR ADV-ALL PLANS | TODAY'S OPTION MCR ADV-ALL PLANS | $13.09 | $41.00 | $30.75 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | ANTHEM MCR ADV | ANTHEM MCR ADV | $13.09 | $41.00 | $30.75 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | VIANT BEECH ST MCR ADV | VIANT BEECH ST MCR ADV | $13.09 | $41.00 | $30.75 | 2026-04-27 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $13.15 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $13.15 | — | — | 2026-09-15 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Mvp | Commercial | $13.17 | — | — | 2026-07-18 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Mvp | Medicare Advantage | $13.17 | — | — | 2026-07-18 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Mvp | Medicaid | $13.17 | — | — | 2026-07-18 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Mvp | Child Health Plus | $13.17 | — | — | 2026-07-18 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Mvp | Individual | $13.17 | — | — | 2026-07-18 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Mvp | Essential Plans | $13.17 | — | — | 2026-07-18 | MRF ↗ |
| COBLESKILL REGIONAL HOSPITAL Outpatient | Cdphp | Medicare Advantage | $13.18 | $40.00 | $10.80 | 2026-07-15 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Kaiser | Managed Medicaid | — | $39.98 | $15.99 | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Naphcare | Managed Medicaid | — | $39.98 | $15.99 | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-ST ANTHONY NORTH HEALTH CAMPUS OutpatientFacility | Archdiocese of Denver | Direct to Employer | $13.19 | $39.98 | $15.99 | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Colorado Access | Managed Medicaid | — | $39.98 | $15.99 | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Colorado Access | Managed Behavioral Medicaid | — | $39.98 | $15.99 | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Colorado Community Health Alliance | Managed Behavioral Medicaid | — | $39.98 | $15.99 | 2024-12-02 | 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.