98975 — Rem Ther Mntr 1st Setup&edu
Cite this view
APA (7th ed.)
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
MLA (9th ed.)
“REM THER MNTR 1ST SETUP&EDU (CPT 98975) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/98975?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“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 $66–$190 (25th–75th percentile) across 1,396 hospitals · 2,490 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.
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
$66
$128 typical
$190
The middle 50% of negotiated facility rates for this procedure, measured across 1,396 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 | $154 |
Complete-episode estimate (typical)
~$154
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 |
|---|---|---|---|---|---|---|---|
| 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 ↗ |
| 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 ↗ |
| SUNRISE HOSPITAL AND MEDICAL CENTER OutpatientFacility | 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 Culver City OutpatientFacility | Blue Shield of California | HMO | $3.54 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD 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 HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $3.85 | — | — | 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 ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Devoted Health | 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 | Optum Care Network | 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 ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Aetna | 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 | Medicare | Managed Medicare | $6.36 | $42.40 | $16.96 | 2026-02-04 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | Kaiser | 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 | Anthem Blue Cross Blue Shield | Managed Medicare | $6.36 | $42.40 | $16.96 | 2026-02-04 | MRF ↗ |
| ST THOMAS MORE HOSPITAL OutpatientFacility | United Healthcare | Managed Medicare | $6.78 | $42.40 | $16.96 | 2026-02-04 | 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 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 ↗ |
| LAKEWOOD HEALTH SYSTEM Outpatient | UHC VA CCN | UHC VA CCN | $8.00 | $20.00 | $12.40 | 2026-04-22 | 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 ILLINOIS [1210] | 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 [1014] | BC/BS OF ILLINOIS HMO-SSCD | $9.43 | $49.00 | $10.88 | 2026-01-01 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Priority Health | 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 | HAP CareSource | MEDICAID | $9.72 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD ALLEGIANCE HEALTH OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $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 ↗ |
| 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 | Priority 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 | Aetna Better Health | MEDICAID | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | HAP | HAP Caresource Medicaid | $10.68 | $200.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | HAP Caresource Medicaid | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Aetna Better Health | MEDICAID | $10.68 | $200.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $10.68 | $200.00 | — | 2025-06-28 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $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 | McLaren | MEDICAID | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Blue Cross Complete | MEDICAID | $10.68 | $200.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Meridian Health Plan of MI | MEDICAID HMO | $10.68 | $200.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | McLaren | MEDICAID | $10.68 | $200.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | McLaren | MEDICAID | $10.68 | $200.00 | — | 2025-06-28 | MRF ↗ |
| Henry Ford Hospital OutpatientFacility | Priority Health | MEDICAID | $10.68 | $200.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Aetna Better Health | MEDICAID | $10.68 | $200.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Priority Health | MEDICAID | $10.68 | $200.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | McLaren | MEDICAID | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | HAP Caresource Medicaid | $10.68 | $200.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Blue Cross Complete | MEDICAID | $10.68 | — | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | HAP | HAP Caresource Medicaid | $10.68 | — | — | 2025-06-28 | 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 | 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 ILLINOIS [1210] | 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 ↗ |
| 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 ↗ |
| 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 ↗ |
| MONMOUTH 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 ↗ |
| Henry Ford Hospital OutpatientFacility | Blue Cross Complete | MEDICAID | $11.64 | $200.00 | — | 2025-06-28 | MRF ↗ |
| TRISTAR SOUTHERN HILLS MEDICAL CENTER Outpatient | Wellpoint | MGMCD | $11.83 | — | — | 2024-10-01 | 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 REPLACEMENT [2003] | MEDICARE-WIR-RENSSELAER | $12.25 | $49.00 | $17.54 | 2026-01-01 | MRF ↗ |
| FRANCISCAN HEALTH RENSSELAER, INC Both | MEDICARE [1099] | 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 ↗ |
| 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 MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $12.47 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE 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 ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE 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 ENID HOSPITAL 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 ↗ |
| INTEGRIS MIAMI HOSPITAL 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 ↗ |
| CLAY COUNTY MEDICAL CENTER Outpatient | MULTIPLAN- ALL PLANS | MULTIPLAN- ALL PLANS | $12.70 | $21.17 | $21.17 | 2026-04-24 | 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 | UHC MCR ADV | UHC MCR ADV | $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 ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | HUMANA MCR ADV | HUMANA MCR ADV | $12.84 | $41.00 | $30.75 | 2026-04-27 | MRF ↗ |
| RUSH MEMORIAL HOSPITAL Outpatient | AETNA MCR ADV | AETNA MCR ADV | $12.84 | $41.00 | $30.75 | 2026-04-27 | MRF ↗ |
| VANDERBILT TULLAHOMA-HARTON HOSPITAL Both | UHC | UHC Medicare | $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 UNIVERSITY MEDICAL CENTER Both | Humana | Humana Military East | $13.03 | $354.00 | $191.16 | 2025-10-01 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | UHC | UHC Medicare | $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 BEDFORD HOSPITAL Both | Humana | Humana Military East | $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 ↗ |
| DAVIS MEDICAL CENTER 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 ↗ |
| 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 ↗ |
| 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 ↗ |
| 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 ↗ |
| 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 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $13.15 | — | — | 2026-03-18 | MRF ↗ |
| CENTURA HEALTH-ST ANTHONY HOSPITAL OutpatientFacility | Archdiocese of Denver | Direct to Employer | $13.19 | $39.98 | $15.99 | 2024-12-02 | MRF ↗ |
| CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES OutpatientFacility | Archdiocese of Denver | Direct to Employer | $13.19 | $39.98 | $15.99 | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Rocky Mountain Health Plan | Managed 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 ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Colorado Access | Managed Behavioral Medicaid | — | $39.98 | $15.99 | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Denver Health | 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 | Health Colorado Behavioral Health | Managed Behavioral Medicaid | — | $39.98 | $15.99 | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Northeast Health Partners | Managed Behavioral Medicaid | — | $39.98 | $15.99 | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Archdiocese of Denver | Direct to Employer | $13.19 | $39.98 | $15.99 | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Kaiser | Managed Medicaid | — | $39.98 | $15.99 | 2024-12-02 | MRF ↗ |
| ORTHOCOLORADO HOSP AT ST ANTHONY MED CAMPUS OutpatientFacility | Archdiocese of Denver | Direct to Employer | $13.19 | $39.98 | $15.99 | 2024-12-02 | MRF ↗ |
| ST FRANCIS HOSPITAL - INTERQUEST OutpatientFacility | Naphcare | Managed Medicaid | — | $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 ↗ |
| LONGMONT UNITED HOSPITAL OutpatientFacility | Archdiocese of Denver | Direct to Employer | $13.19 | $39.98 | $15.99 | 2024-12-02 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Unicare | Wv Medicaid | $13.24 | — | — | 2026-05-06 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | The Healthplan | Wv Medicaid | $13.24 | — | — | 2026-05-06 | MRF ↗ |
| Roswell Park Cancer Institute OutpatientFacility | Univera | Special Programs Medicaid Managed Care Plan | $13.28 | — | — | 2026-04-01 | MRF ↗ |
| CAREWELL HEALTH MEDICAL CENTER OutpatientFacility | Horizon New Jersey Health | Managed Medicaid | $13.39 | — | — | 2025-06-17 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | UHC | UHC Community Plan/DSNP | $13.42 | $354.00 | $191.16 | 2025-10-01 | MRF ↗ |
| VANDERBILT WILSON COUNTY HOSPITAL Both | UHC | UHC Community Plan/DSNP | $13.42 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT TULLAHOMA-HARTON HOSPITAL Both | UHC | UHC Community Plan/DSNP | $13.42 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT BEDFORD HOSPITAL Both | UHC | UHC Community Plan/DSNP | $13.42 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | Wellpoint | Wellpoint Medicare | $13.68 | $354.00 | $191.16 | 2025-10-01 | MRF ↗ |
| VANDERBILT WILSON COUNTY HOSPITAL Both | Wellpoint | Wellpoint Medicare | $13.68 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT BEDFORD HOSPITAL Both | Wellpoint | Wellpoint Medicare | $13.68 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT TULLAHOMA-HARTON HOSPITAL Both | Wellpoint | Wellpoint Medicare | $13.68 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| DAVIS MEDICAL CENTER OutpatientFacility | Unicare | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| DAVIS MEDICAL CENTER OutpatientFacility | The Health Plan | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| DAVIS MEDICAL CENTER OutpatientFacility | Aetna Better Health | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| WEBSTER MEMORIAL HOSPITAL OutpatientFacility | Unicare | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| WEBSTER MEMORIAL HOSPITAL OutpatientFacility | Aetna Better Health | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| DAVIS MEDICAL CENTER OutpatientFacility | Aetna Better Health | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| DAVIS MEDICAL CENTER OutpatientFacility | Unicare | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| DAVIS MEDICAL CENTER OutpatientFacility | The Health Plan | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| BROADDUS HOSPITAL ASSOCIATION, INC OutpatientFacility | The Health Plan | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| BROADDUS HOSPITAL ASSOCIATION, INC OutpatientFacility | Aetna Better Health | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| BROADDUS HOSPITAL ASSOCIATION, INC OutpatientFacility | Unicare | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| WEBSTER MEMORIAL HOSPITAL OutpatientFacility | Unicare | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| WEBSTER MEMORIAL HOSPITAL OutpatientFacility | The Health Plan | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| WEBSTER MEMORIAL HOSPITAL OutpatientFacility | Aetna Better Health | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| WEBSTER MEMORIAL HOSPITAL OutpatientFacility | The Health Plan | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| BROADDUS HOSPITAL ASSOCIATION, INC OutpatientFacility | Aetna Better Health | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| BROADDUS HOSPITAL ASSOCIATION, INC OutpatientFacility | The Health Plan | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| BROADDUS HOSPITAL ASSOCIATION, INC OutpatientFacility | Unicare | Managed Medicaid | $13.69 | — | — | 2025-08-07 | MRF ↗ |
| JERSEY CITY MEDICAL CENTER OutpatientFacility | Wellpoint | NJ Family Care | $13.79 | — | — | 2026-03-04 | MRF ↗ |
| STOUGHTON HOSPITAL Outpatient | TRICARE-ALL PLANS | TRICARE-ALL PLANS | $13.89 | $63.15 | $34.73 | 2026-01-19 | MRF ↗ |
| MOUNTAIN VIEW HOSPITAL Outpatient | Vista Hospice | COMM | $13.97 | — | — | 2024-10-01 | MRF ↗ |
| MOUNTRAIL COUNTY MEDICAL CENTER INC Outpatient | United Healthcare | Medicare Advantage | $14.00 | $30.00 | $27.00 | 2025-08-27 | MRF ↗ |
| MOUNTRAIL COUNTY MEDICAL CENTER INC Outpatient | NextBlue | Medicare Advantage | $14.00 | $30.00 | $27.00 | 2025-08-27 | MRF ↗ |
| TRISTAR SOUTHERN HILLS MEDICAL CENTER Outpatient | Wellpoint | MGMCD | $14.03 | — | — | 2026-03-12 | MRF ↗ |
| TRISTAR SKYLINE MEDICAL CENTER Outpatient | Wellpoint | MGMCD | $14.03 | — | — | 2026-03-12 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | Aetna | Aetna Medicare | $14.07 | $354.00 | $191.16 | 2025-10-01 | MRF ↗ |
| VANDERBILT BEDFORD HOSPITAL Both | Cigna | Cigna Medicare | $14.07 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | Cigna | Cigna Medicare | $14.07 | $354.00 | $191.16 | 2025-10-01 | MRF ↗ |
| VANDERBILT WILSON COUNTY HOSPITAL Both | Cigna | Cigna Medicare | $14.07 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT BEDFORD HOSPITAL Both | Aetna | Aetna Medicare | $14.07 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT TULLAHOMA-HARTON HOSPITAL Both | Aetna | Aetna Medicare | $14.07 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT TULLAHOMA-HARTON HOSPITAL Both | Cigna | Cigna Medicare | $14.07 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT WILSON COUNTY HOSPITAL Both | Aetna | Aetna Medicare | $14.07 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Peach State Ambetter | MCR | $14.24 | — | — | 2024-10-01 | MRF ↗ |
| VANDERBILT UNIVERSITY MEDICAL CENTER Both | WellCare of TN | WellCare of TN | $14.33 | $354.00 | $191.16 | 2025-10-01 | MRF ↗ |
| VANDERBILT BEDFORD HOSPITAL Both | WellCare of TN | WellCare of TN | $14.33 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT TULLAHOMA-HARTON HOSPITAL Both | WellCare of TN | WellCare of TN | $14.33 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| VANDERBILT WILSON COUNTY HOSPITAL Both | WellCare of TN | WellCare of TN | $14.33 | $354.00 | $102.66 | 2025-10-01 | MRF ↗ |
| T J SAMSON COMMUNITY HOSPITAL Outpatient | AETNA BETTER HEALTH MCAID - ALL PLANS | AETNA BETTER HEALTH MCAID - ALL PLANS | $14.41 | $218.00 | $141.70 | 2026-04-23 | MRF ↗ |
| T J SAMSON COMMUNITY HOSPITAL Outpatient | HUMANA MCAID | HUMANA MCAID | $14.41 | $218.00 | $141.70 | 2026-04-23 | MRF ↗ |
| T J SAMSON COMMUNITY HOSPITAL Outpatient | HUMANA MCAID | HUMANA MCAID | $14.41 | $218.00 | $141.70 | 2026-04-23 | MRF ↗ |
| T J SAMSON COMMUNITY HOSPITAL Outpatient | AETNA BETTER HEALTH MCAID - ALL PLANS | AETNA BETTER HEALTH MCAID - ALL PLANS | $14.41 | $218.00 | $141.70 | 2026-04-23 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - CANNON FALLS BothFacility | HEALTHPARTNERS [91200021] | MEDICAID CAH HEALTHPARTNERS [1174] | $14.56 | $70.00 | $61.60 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN BothFacility | UCARE [91200044] | PPS ALBERT LEA MEDICAID UCARE [1185] | $14.56 | $70.00 | $61.60 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN BothFacility | HEALTHPARTNERS [91210021] | MEDICAID CAH HEALTHPARTNERS [1174] | $14.56 | $70.00 | $61.60 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - CANNON FALLS BothFacility | HEALTHPARTNERS [91210021] | MEDICAID CAH HEALTHPARTNERS [1174] | $14.56 | $70.00 | $61.60 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - WASECA BothFacility | HEALTHPARTNERS [91200021] | MEDICAID CAH HEALTHPARTNERS [1174] | $14.56 | $70.00 | $61.60 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM NEW PRAGUE BothFacility | UCARE [91200044] | UCARE CONNECT MEDICAID CAH [1181] | $14.56 | $70.00 | $52.50 | 2026-03-31 | MRF ↗ |
| MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN BothFacility | HEALTHPARTNERS [91200021] | MEDICAID CAH HEALTHPARTNERS [1174] | $14.56 | $70.00 | $61.60 | 2026-03-31 | 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.