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 $136–$404 (25th–75th percentile) across 2,982 hospitals · 7,719 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 physician fees are estimated from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$136
$220 typical
$404
The middle 50% of negotiated facility rates for this procedure, measured across 2,982 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. | $220 |
| Physician fee Estimate national typical Medicare $117 × 1.22 commercial. | $143 |
| Likely subtotal | $363 |
Complete-episode estimate (typical)
~$363
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 $136–$404.
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 |
|---|---|---|---|---|---|---|---|
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Prime Health | Ppo | — | $1,152.00 | $115.20 | 2026-08-01 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Amerihealth | Casualty | — | $1,152.00 | $115.20 | 2026-08-01 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Aetna | Better Health | — | $1,152.00 | $115.20 | 2026-08-01 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Chn | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Praxis Health | Workers Comp | — | $1,152.00 | $115.20 | 2026-08-01 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Aetna | Medicare | — | $1,152.00 | $115.20 | 2026-08-01 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Galaxy | Commercial | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Chn | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | First Mco | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Chn | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Three Rivers | Commercial | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Pnoa | Commercial | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Brighton | Commercial | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Aetna | Medicare | — | $1,152.00 | $115.20 | 2026-08-01 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Occunet | Commercial | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Wellcare | Medicare | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Hst | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | First Mco | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty State Of Nj | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Praxis Health | Workers Comp | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellpoint | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Aetna | Workers Comp | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Naphcare | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | HealthNet of California, Inc. | HMO | — | $1,037.19 | $674.17 | 2025-11-26 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Phcs | Commercial | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Wellpoint | Medicaid | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Multiplan | Commercial | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Fidelis | Medicaid | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Hst | Commercial | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | United Community | Medicaid | — | $1,152.00 | $115.20 | 2026-08-01 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Hst | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Contigo Health | Commercial | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Chn | Commercial | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Naphcare | Commercial | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Fidelis | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Chn | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellpoint | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellpoint | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | United Community | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Horizon Bcbs | Casualty | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Aetna | First Health | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | First Mco | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Multiplan | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Occunet | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Amerihealth | Casualty | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Prime Health | Ppo | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Prime Health | Ppo | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Chn | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Prime Health | Ppo | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Workers Comp | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Casualty | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Prime Health | Ppo | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Workers Comp | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Aetna | Medicare | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Amerihealth | Casualty | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Qualcare | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Horizon Bcbs | Casualty | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Horizon Bcbs | Casualty State Of Nj | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Longevity Health | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty State Of Nj | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty State Of Nj | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Qualcare | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Hst | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Prime Health | Ppo | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Qualcare | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Longevity Health | Medicare | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | United Community | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | First Mco | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Naphcare | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Longevity Health | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Three Rivers | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellpoint | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Occunet | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Hst | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Horizon Bcbs | Casualty State Of Nj | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | United Community | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Praxis Health | Workers Comp | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Hst | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Better Health | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Praxis Health | Workers Comp | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Galaxy | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | First Health | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Phcs | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Three Rivers | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Aetna | First Health | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | First Mco | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Qualcare | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Fidelis | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Naphcare | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Wellcare | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Horizon Bcbs | Casualty | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Contigo Health | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Multiplan | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Pnoa | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | First Health | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Three Rivers | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty State Of Nj | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Phcs | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Galaxy | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Multiplan | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Phcs | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Contigo Health | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Phcs | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Casualty | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellcare | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Three Rivers | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Brighton | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Galaxy | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Fidelis | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | First Health | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Aetna | Workers Comp | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Workers Comp | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Aetna | First Health | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Brighton | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Naphcare | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | Praxis Health | Workers Comp | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Naphcare | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Multiplan | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Pnoa | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Pnoa | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Occunet | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Galaxy | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Longevity Health | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Horizon Bcbs | Casualty | — | $1,152.00 | $115.20 | 2026-07-15 | 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 | Health Benefit Exchange | — | $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 | Aetna | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Pnoa | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Galaxy | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Occunet | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Aetna | Better Health | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Casualty | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Contigo Health | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | First Mco | Commercial | — | $1,152.00 | $115.20 | 2026-07-18 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Aetna | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Hst | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Brighton | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Better Health | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | — | — | — | $1,152.00 | $115.20 | 2026-04-01 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Contigo Health | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Aetna | Better Health | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Brighton | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Wellpoint | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Aetna | Workers Comp | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Three Rivers | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | United Community | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Contigo Health | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Phcs | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Brighton | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Pnoa | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Brighton | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Amerihealth | Casualty | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | United Community | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Aetna | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | Horizon Bcbs | Casualty State Of Nj | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA WILLINGBORO HOSPITAL Outpatient | First Mco | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | United Community | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Praxis Health | Workers Comp | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Galaxy | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Amerihealth | Casualty | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Qualcare | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Praxis Health | Workers Comp | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Occunet | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Fidelis | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Naphcare | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Better Health | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Three Rivers | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | First Health | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Occunet | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Longevity Health | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Fidelis | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Better Health | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Aetna | Workers Comp | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Contigo Health | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Multiplan | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Fidelis | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Multiplan | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Longevity Health | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellcare | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellcare | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Wellcare | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Wellcare | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Pnoa | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Praxis Health | Workers Comp | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Phcs | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Chn | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Longevity Health | Medicare | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Wellpoint | Medicaid | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Prime Health | Ppo | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | Prime Health | Ppo | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Qualcare | Commercial | — | $1,152.00 | $115.20 | 2026-07-15 | MRF ↗ |
| VIRTUA MOUNT HOLLY HOSPITAL Outpatient | Phcs | Commercial | — | $1,152.00 | $115.20 | 2026-08-01 | 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.