99204 — Pr Visit Office Outpatient New Moderate Level
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PR Visit Office Outpatient New Moderate Level (CPT 99204) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/99204?code_type=CPT
MLA (9th ed.)
“PR Visit Office Outpatient New Moderate Level (CPT 99204) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/99204?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“PR Visit Office Outpatient New Moderate Level (CPT 99204) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/99204?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $135–$400 (25th–75th percentile) across 2,477 hospitals · 8,530 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 99204 — 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 surgeon and anesthesia figures are estimates from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$135
$217 typical
$400
The middle 50% of negotiated facility rates for this procedure, measured across 2,477 hospitals. Surgeon & anesthesia 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. | $217 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $117 × 1.22 commercial. | $143 |
| Likely subtotal | $359 |
Surgical episode (typical)
~$359
Your recovery plan — adjust to what your surgeon told you
After surgery, recovery care is billed separately. We pre-fill the typical plan; change it to your situation.
Recovery cost modeled
~$3,785
With your recovery plan (typical)
~$4,144
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Surgeon (professional 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 |
|---|---|---|---|---|---|---|---|
| WEST JERSEY HOSPITAL Outpatient | None | — | — | $1,152.00 | $115.20 | 2026-04-01 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Fidelis | Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP | — | $321.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Excellus BCBS | Managed Medicaid _CHP_SP | — | $321.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Managed Medicaid_Aliessa and QHP | — | $321.00 | — | 2025-05-02 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | None | — | — | $1,152.00 | $115.20 | 2026-06-01 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Health Benefit Exchange | — | $321.00 | — | 2025-05-02 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | None | — | — | $1,152.00 | $115.20 | 2026-04-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | HealthNet of California, Inc. | HMO | — | $1,037.19 | $674.17 | 2025-11-26 | MRF ↗ |
| GROSSMONT HOSPITAL Outpatient | Health Net | Health Net - HMO/POS/EPO | $0.06 | $635.00 | $476.25 | 2026-04-01 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL MIDTOWN Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.51 | $512.72 | $153.82 | 2026-04-01 | MRF ↗ |
| UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross HMO | $0.51 | $512.00 | $153.60 | 2026-04-01 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL NORTHSIDE Both | BLUE CROSS [10001] | Blue Cross PPO | $0.51 | $512.72 | $153.82 | 2026-04-01 | MRF ↗ |
| UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross PPO | $0.51 | $512.72 | $153.82 | 2026-04-01 | MRF ↗ |
| UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.51 | $512.72 | $153.82 | 2026-04-01 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL MIDTOWN Both | BLUE CROSS [10001] | Blue Cross HMO | $0.51 | $512.72 | $153.82 | 2026-04-01 | MRF ↗ |
| PIEDMONT AUGUSTA HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.51 | $512.00 | $153.60 | 2026-04-01 | MRF ↗ |
| PIEDMONT AUGUSTA HOSPITAL Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.51 | $512.00 | $153.60 | 2026-04-01 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL NORTHSIDE Both | BLUE CROSS [10001] | Blue Cross HMO | $0.51 | $512.72 | $153.82 | 2026-04-01 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL MIDTOWN Both | BLUE CROSS [10001] | Blue Cross PPO | $0.51 | $512.72 | $153.82 | 2026-04-01 | MRF ↗ |
| PIEDMONT AUGUSTA HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.51 | $512.00 | $153.60 | 2026-04-01 | MRF ↗ |
| PIEDMONT AUGUSTA HOSPITAL Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.51 | $512.00 | $153.60 | 2026-04-01 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL MIDTOWN Both | BLUE CROSS [10001] | Blue Cross PPO | $0.51 | $512.72 | $153.82 | 2026-04-01 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL NORTHSIDE Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.51 | $512.72 | $153.82 | 2026-04-01 | MRF ↗ |
| PIEDMONT AUGUSTA HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.51 | $512.00 | $153.60 | 2026-04-01 | MRF ↗ |
| PIEDMONT AUGUSTA HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.51 | $512.00 | $153.60 | 2026-04-01 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL MIDTOWN Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.51 | $512.72 | $153.82 | 2026-04-01 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL MIDTOWN Both | BLUE CROSS [10001] | Blue Cross HMO | $0.51 | $512.72 | $153.82 | 2026-04-01 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.58 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.58 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.58 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.58 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $0.61 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $0.61 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $0.62 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $0.62 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Aetna | Default | $0.63 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Meritain | Default | $0.63 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| PIEDMONT HOSPITAL, INC Both | BLUE CROSS [10001] | Blue Cross HMO | $0.64 | $638.00 | $191.40 | 2026-04-01 | MRF ↗ |
| PIEDMONT HOSPITAL, INC Both | BLUE CROSS [10001] | Blue Cross PPO | $0.64 | $638.00 | $191.40 | 2026-04-01 | MRF ↗ |
| PIEDMONT ROCKDALE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT CARTERSVILLE MEDICAL CENTER Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT EASTSIDE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT EASTSIDE MEDICAL CENTER Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWNAN HOSPITAL, INC Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT EASTSIDE MEDICAL CENTER Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT HOSPITAL, INC Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| COLISEUM MEDICAL CENTERS, LLC, DBA Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| COLISEUM MEDICAL CENTERS, LLC, DBA Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT FAYETTE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT CARTERSVILLE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT ROCKDALE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT ROCKDALE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT MOUNTAINSIDE HOSPITAL INC Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| COLISEUM MEDICAL CENTERS, LLC, DBA Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT HOSPITAL, INC Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT HENRY HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT EASTSIDE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT ATHENS REGIONAL MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT EASTSIDE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT ATHENS REGIONAL MEDICAL CENTER Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT MACON NORTH HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| COLISEUM MEDICAL CENTERS, LLC, DBA Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT FAYETTE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT ATHENS REGIONAL MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT WALTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT FAYETTE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| COLISEUM MEDICAL CENTERS, LLC, DBA Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT ROCKDALE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT HENRY HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| COLISEUM MEDICAL CENTERS, LLC, DBA Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT MACON NORTH HOSPITAL Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT HENRY HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT CARTERSVILLE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT MACON NORTH HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT HENRY HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWNAN HOSPITAL, INC Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT CARTERSVILLE MEDICAL CENTER Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT CARTERSVILLE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT WALTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT FAYETTE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT MOUNTAINSIDE HOSPITAL INC Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT CARTERSVILLE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross HMO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT EASTSIDE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross PPO | $0.67 | $665.00 | $199.50 | 2026-04-01 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.75 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.75 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.75 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.75 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.76 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.76 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $0.76 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.76 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.76 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $0.76 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $0.84 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $0.84 | $156.00 | $148.20 | 2026-02-20 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Medicare B LA JH | Default | $0.98 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Aetna | Medicare Advantage | $0.98 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Verity National Group | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | UHC Definity Services | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | UMR United Medical Resources | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | PPO Plus LLC | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | UHC Community Plan LA MCD Rep | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | PHCS GEHA Govt Employee Health Assc | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Multiplan Inc. for American Family | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Louisiana Healthcare Connections MCD Rep | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Humana Healthy Horizons MCD Rep | Medicaid Replacement | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Peoples Health Network DOS lt 01012024 | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| MEDICAL ARTS HOSPITAL Both | UNITED HEALTHCARE | UNITED HEALTHCARE | $1.00 | $252.00 | — | 2025-06-09 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Blue Cross Blue Shield of LA | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | GEHA Multiplan Network | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| MEDICAL ARTS HOSPITAL Both | ALL SAVERS | ALL SAVERS | $1.00 | $252.00 | — | 2025-06-09 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Gilsbar Inc | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Healthy Blue Community Care of LA MCD | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Golden Rule Insurance Company | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Aetna | Medicaid Replacement | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | First Health | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | United Healthcare | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| MEDICAL ARTS HOSPITAL Both | GOLDEN RULE | GOLDEN RULE | $1.00 | $252.00 | — | 2025-06-09 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $958.91 | $623.29 | 2025-11-26 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | WebTPA | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | SCAN Health Plan | Medicare Advantage | — | $958.91 | $623.29 | 2025-11-26 | MRF ↗ |
| MEDICAL ARTS HOSPITAL Both | UMR | UMR | $1.00 | $252.00 | — | 2025-06-09 | MRF ↗ |
| MEDICAL ARTS HOSPITAL Both | UHC ONE | UHC ONE | $1.00 | $252.00 | — | 2025-06-09 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $1.15 | $319.00 | $239.25 | 2025-03-07 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.39 | $377.00 | $358.15 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $1.39 | $377.00 | $358.15 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.39 | $377.00 | $358.15 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.43 | $377.00 | $358.15 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.47 | $377.00 | $358.15 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $1.51 | $377.00 | $358.15 | 2026-02-20 | MRF ↗ |
| OKEENE MUNICIPAL HOSPITAL Outpatient | PREF COMMUNITY CHOICE PPO-ALL PLANS | PREF COMMUNITY CHOICE PPO-ALL PLANS | $1.75 | $11.67 | $9.34 | 2026-03-18 | MRF ↗ |
| OKEENE MUNICIPAL HOSPITAL Outpatient | PREF COMMUNITY CHOICE PPO-ALL PLANS | PREF COMMUNITY CHOICE PPO-ALL PLANS | $1.75 | $11.67 | $9.34 | 2026-03-18 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.85 | $377.00 | $358.15 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.85 | $377.00 | $358.15 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.89 | $377.00 | $358.15 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.89 | $394.00 | $374.30 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.89 | $394.00 | $374.30 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $1.93 | $394.00 | $374.30 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.93 | $394.00 | $374.30 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.96 | $377.00 | $358.15 | 2026-02-20 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $1.98 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $1.98 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| ROSELAND COMMUNITY HOSPITAL Outpatient | BCBS HMO | BCBS HMO | $2.00 | $4.00 | — | 2026-04-16 | MRF ↗ |
| ROSELAND COMMUNITY HOSPITAL Outpatient | BCBS PPO - ALL OTHER PLANS | BCBS PPO - ALL OTHER PLANS | $2.00 | $4.00 | — | 2026-04-16 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $2.01 | $394.00 | $374.30 | 2026-02-20 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.02 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.02 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $2.04 | $377.00 | $358.15 | 2026-02-20 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.52 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.52 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.52 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.52 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.75 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.75 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $2.89 | $380.00 | $152.00 | 2026-05-13 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $2.89 | $380.00 | $152.00 | 2026-05-22 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.96 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $2.96 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| ROSELAND COMMUNITY HOSPITAL Outpatient | CHOICECARE - ALL PLANS | CHOICECARE - ALL PLANS | $3.00 | $4.00 | — | 2026-04-16 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.21 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.21 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.27 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.27 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $3.36 | $329.00 | $213.85 | 2026-03-14 | MRF ↗ |
| OHIO COUNTY HOSPITAL BothFacility | HUMANA INC. - Medicare-HMO | Medicare Advantage | $3.57 | $323.00 | $161.50 | 2026-01-12 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $3.66 | $200.00 | $38.00 | 2026-01-25 | MRF ↗ |
| Ventura County Medical Center - Santa Paula Hospital Outpatient | UHC MCR ADV | UHC MCR ADV | $3.66 | $450.00 | $225.00 | 2026-03-23 | MRF ↗ |
| OTTAWA COUNTY HEALTH CENTER Outpatient | CHOICECARE MCR ADV - ALL PLANS | CHOICECARE MCR ADV - ALL PLANS | $3.66 | $190.00 | $190.00 | 2026-03-09 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $3.66 | $200.00 | $38.00 | 2026-01-25 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.85 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.85 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Humana | Medicare Advantage | — | — | — | 2026-03-21 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $4.02 | $430.25 | $258.15 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $4.02 | $430.25 | $258.15 | 2025-08-11 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $4.18 | $402.00 | $402.00 | 2026-04-24 | MRF ↗ |
| CENTRAL VALLEY MEDICAL CENTER - CAH OutpatientFacility | Select Health | Care | — | — | — | 2026-03-30 | MRF ↗ |
| CENTRAL VALLEY MEDICAL CENTER - CAH OutpatientFacility | Select Health | Choice | — | — | — | 2026-03-30 | MRF ↗ |
| CENTRAL VALLEY MEDICAL CENTER - CAH OutpatientFacility | Select Health | Value | — | — | — | 2026-03-30 | MRF ↗ |
| CENTRAL VALLEY MEDICAL CENTER - CAH OutpatientFacility | Select Health | Med | — | — | — | 2026-03-30 | MRF ↗ |
| CHEYENNE COUNTY HOSPITAL Outpatient | AETNA COVENTRY - ALL OTHER PLANS | AETNA COVENTRY - ALL OTHER PLANS | $4.39 | $170.00 | — | 2026-03-02 | MRF ↗ |
| ROSELAND COMMUNITY HOSPITAL Outpatient | HUMANA - ALL PLANS | HUMANA - ALL PLANS | $4.40 | $4.00 | — | 2026-04-16 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Aetna | MCR Advantage | $4.50 | $10.00 | $9.00 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Martins Point | MCR Advantage | $4.50 | $10.00 | $9.00 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Cigna | MCR Advantage | $4.50 | $10.00 | $9.00 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | United Healthcare | MCR Advantage | $4.50 | $10.00 | $9.00 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Wellcare | MCR Advantage | $4.50 | $10.00 | $9.00 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Anthem | MCR Advantage | $4.50 | $10.00 | $9.00 | 2026-04-05 | MRF ↗ |
| CENTRAL VALLEY MEDICAL CENTER - CAH OutpatientFacility | Blue Cross | PPO | — | — | — | 2026-03-30 | MRF ↗ |
| CENTRAL VALLEY MEDICAL CENTER - CAH OutpatientFacility | Blue Cross | HMO | — | — | — | 2026-03-30 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $4.90 | $213.00 | $78.81 | 2026-03-31 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $4.98 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $4.98 | $270.67 | $162.40 | 2025-08-11 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | ARKANSAS DEPARTMENT OF HEALTH [20036] | HB FTSM ARK MEDICAID | $5.00 | $178.00 | $115.70 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | MEDICAID [20240] | HB FTSM ARK MEDICAID | $5.00 | $178.00 | $115.70 | 2026-03-13 | 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.