99211 — Office Or Other Outpatient Visit For The Evaluation And Management Of Established Patient That May Not Require Presence Of Healthcare Professional
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional (CPT 99211) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/99211?code_type=CPT
MLA (9th ed.)
“Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional (CPT 99211) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/99211?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional (CPT 99211) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/99211?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $41–$179 (25th–75th percentile) across 2,699 hospitals · 9,018 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 99211 — 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
$41
$95 typical
$179
The middle 50% of negotiated facility rates for this procedure, measured across 2,699 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. | $95 |
| Physician fee Estimate national typical Medicare $8 × 1.22 commercial. | $9 |
| Likely subtotal | $104 |
Complete-episode estimate (typical)
~$104
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 |
|---|---|---|---|---|---|---|---|
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Managed Medicaid_Aliessa and QHP | — | $139.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Fidelis | Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP | — | $139.00 | — | 2025-05-02 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | HealthNet of California, Inc. | HMO | — | $1,037.19 | $674.17 | 2025-11-26 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | None | — | — | $566.00 | $56.60 | 2026-06-01 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Health Benefit Exchange | — | $139.00 | — | 2025-05-02 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | None | — | — | $566.00 | $56.60 | 2026-04-01 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | None | — | — | $566.00 | $56.60 | 2026-04-01 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Excellus BCBS | Managed Medicaid _CHP_SP | — | $139.00 | — | 2025-05-02 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Aetna | First Health Medicare | $0.06 | $296.00 | $222.00 | 2026-04-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $0.07 | $311.00 | $233.25 | 2025-03-07 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.12 | $25.00 | $23.75 | 2026-02-20 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Epic Americas | AXA Assistance | $0.12 | $296.00 | $222.00 | 2026-04-01 | MRF ↗ |
| GROSSMONT HOSPITAL Outpatient | Managed Health Network | MHN - Medicare | $0.16 | $415.00 | $311.25 | 2026-04-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Health Net | Health Net - Medicare | $0.17 | $415.00 | $311.25 | 2026-04-01 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $0.20 | $51.71 | $31.03 | 2025-08-11 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.20 | $54.00 | $51.30 | 2026-02-20 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $0.20 | $51.71 | $31.03 | 2025-08-11 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $0.21 | $54.00 | $51.30 | 2026-02-20 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $0.23 | $51.71 | $31.03 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $0.23 | $51.71 | $31.03 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $0.23 | $51.71 | $31.03 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $0.23 | $51.71 | $31.03 | 2025-08-11 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL NORTHSIDE Both | BLUE CROSS [10001] | Blue Cross PPO | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL NORTHSIDE Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL MIDTOWN Both | BLUE CROSS [10001] | Blue Cross HMO | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| PIEDMONT AUGUSTA HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| PIEDMONT AUGUSTA HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| PIEDMONT AUGUSTA HOSPITAL Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL MIDTOWN Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| PIEDMONT AUGUSTA HOSPITAL Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| PIEDMONT AUGUSTA HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| PIEDMONT AUGUSTA HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.26 | $54.00 | $51.30 | 2026-02-20 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL MIDTOWN Both | BLUE CROSS [10001] | Blue Cross HMO | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| UNIVERSITY MCDUFFIE COUNTY REGIONAL MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross HMO | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL MIDTOWN Both | BLUE CROSS [10001] | Blue Cross PPO | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL MIDTOWN Both | BLUE CROSS [10001] | Blue Cross PPO | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| OTTAWA COUNTY HEALTH CENTER Outpatient | CHOICECARE MCR ADV - ALL PLANS | CHOICECARE MCR ADV - ALL PLANS | $0.26 | $45.00 | $45.00 | 2026-03-09 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.26 | $54.00 | $51.30 | 2026-02-20 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL MIDTOWN Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| PIEDMONT COLUMBUS REGIONAL NORTHSIDE Both | BLUE CROSS [10001] | Blue Cross HMO | $0.26 | $258.29 | $77.49 | 2026-04-01 | MRF ↗ |
| Ventura County Medical Center - Santa Paula Hospital Outpatient | UHC MCR ADV | UHC MCR ADV | $0.26 | $450.00 | $225.00 | 2026-03-23 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $0.28 | $54.00 | $51.30 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.30 | $61.00 | $57.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.30 | $61.00 | $57.95 | 2026-02-20 | MRF ↗ |
| CHEYENNE COUNTY HOSPITAL Outpatient | AETNA COVENTRY - ALL OTHER PLANS | AETNA COVENTRY - ALL OTHER PLANS | $0.31 | $12.50 | — | 2026-03-02 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $0.31 | $30.00 | $30.00 | 2026-04-24 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $0.32 | $61.00 | $57.95 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $0.33 | $61.00 | $57.95 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.33 | $90.00 | $85.50 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.33 | $90.00 | $85.50 | 2026-02-20 | MRF ↗ |
| COLISEUM MEDICAL CENTERS, LLC, DBA Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT WALTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| COLISEUM MEDICAL CENTERS, LLC, DBA Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT ROCKDALE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT MOUNTAINSIDE HOSPITAL INC Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT WALTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT ATHENS REGIONAL MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| COLISEUM MEDICAL CENTERS, LLC, DBA Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT MACON NORTH HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT MACON NORTH HOSPITAL Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT MOUNTAINSIDE HOSPITAL INC Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT EASTSIDE MEDICAL CENTER Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT HENRY HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT EASTSIDE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT EASTSIDE MEDICAL CENTER Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT ROCKDALE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| COLISEUM MEDICAL CENTERS, LLC, DBA Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT EASTSIDE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT ATHENS REGIONAL MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT HOSPITAL, INC Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT HOSPITAL, INC Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT EASTSIDE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT CARTERSVILLE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT HENRY HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT MACON NORTH HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWNAN HOSPITAL, INC Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| COLISEUM MEDICAL CENTERS, LLC, DBA Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT ATHENS REGIONAL MEDICAL CENTER Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT CARTERSVILLE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT FAYETTE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT HENRY HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT CARTERSVILLE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT ROCKDALE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT FAYETTE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT HENRY HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| COLISEUM MEDICAL CENTERS, LLC, DBA Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT FAYETTE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWNAN HOSPITAL, INC Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT NEWTON HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT CARTERSVILLE MEDICAL CENTER Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT CARTERSVILLE MEDICAL CENTER Both | BLUE CROSS ANTHEM PATHWAY GEORGIA [11103] | Anthem Pathway | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT CARTERSVILLE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT FAYETTE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT ROCKDALE HOSPITAL Both | BLUE CROSS [10001] | Blue Cross HMO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| PIEDMONT EASTSIDE MEDICAL CENTER Both | BLUE CROSS [10001] | Blue Cross PPO | $0.34 | $335.00 | $100.50 | 2026-04-01 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $0.35 | $90.00 | $85.50 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $0.36 | $90.00 | $85.50 | 2026-02-20 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $0.40 | $51.71 | $31.03 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $0.40 | $51.71 | $31.03 | 2025-08-11 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.43 | $90.00 | $85.50 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.43 | $90.00 | $85.50 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $0.44 | $90.00 | $85.50 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $0.44 | $90.00 | $85.50 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.50 | $102.00 | $96.90 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.50 | $102.00 | $96.90 | 2026-02-20 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $0.52 | $150.00 | $150.00 | 2026-02-13 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $0.55 | $102.00 | $96.90 | 2026-02-20 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Aetna | Coventry | $0.61 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Aetna | Medicare Advantage | $0.61 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Aetna | Coventry | $0.61 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Aetna | Medicare Advantage | $0.61 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Aetna | Medicare Advantage | $0.61 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Hospital Of The Fox Chase Cancer Center OutpatientFacility | Aetna | Coventry | $0.61 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Hospital Of The Fox Chase Cancer Center OutpatientFacility | Aetna | Medicare Advantage | $0.61 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Aetna | Coventry | $0.61 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Episcopal Campus OutpatientFacility | Aetna | Medicare Advantage | $0.61 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple Women & Families Hospital OutpatientFacility | Aetna | Coventry | $0.61 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple Women & Families Hospital OutpatientFacility | Aetna | Medicare Advantage | $0.61 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Aetna | Coventry | $0.61 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Aetna | Medicare Advantage | $0.61 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Episcopal Campus OutpatientFacility | Aetna | Coventry | $0.61 | $10.00 | — | 2026-04-13 | MRF ↗ |
| SAN ANTONIO REGIONAL HOSPITAL Outpatient | ANTHEM BLUE CROSS EXCHG | ANTHEM BLUE CROSS EXCHG | $0.65 | $298.75 | $149.38 | 2026-04-02 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $0.70 | $84.00 | $31.08 | 2026-03-31 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $0.71 | $68.40 | $68.40 | 2026-04-24 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $0.88 | $51.71 | $31.03 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $0.88 | $51.71 | $31.03 | 2025-08-11 | MRF ↗ |
| RIVERS HEALTH BothFacility | THE HEALTH PLAN - Medicaid | Medicaid Managed Care | $0.91 | $808.60 | $258.75 | 2025-11-22 | MRF ↗ |
| RIVERS HEALTH BothFacility | THE HEALTH PLAN - Medicaid | Medicaid Managed Care | $0.91 | $808.60 | $258.75 | 2025-11-22 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $0.92 | $88.20 | $88.20 | 2026-04-24 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Medicare Advantage Select 65 | $0.96 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Tiered PPACA | $0.96 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Medicare Advantage HMO/Medicare Advantage PPO | $0.96 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Medicare Advantage HMO/Medicare Advantage PPO | $0.96 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Tiered PPACA | $0.96 | $10.00 | — | 2026-04-13 | MRF ↗ |
| TEMPLE HEALTH - CHESTNUT HILL HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Medicare Advantage HMO/Medicare Advantage PPO | $0.96 | $10.00 | — | 2026-04-08 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Medicare Advantage HMO/Medicare Advantage PPO | $0.96 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple Women & Families Hospital OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Medicare Advantage Select 65 | $0.96 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Episcopal Campus OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Medicare Advantage HMO/Medicare Advantage PPO | $0.96 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Episcopal Campus OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Medicare Advantage Select 65 | $0.96 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple Women & Families Hospital OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Medicare Advantage HMO/Medicare Advantage PPO | $0.96 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Medicare Advantage HMO/Medicare Advantage PPO | $0.96 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Medicare Advantage Select 65 | $0.96 | $10.00 | — | 2026-04-13 | MRF ↗ |
| MEDICAL ARTS HOSPITAL Both | UHC ONE | UHC ONE | $1.00 | $38.00 | — | 2025-06-09 | MRF ↗ |
| MEDICAL ARTS HOSPITAL Both | ALL SAVERS | ALL SAVERS | $1.00 | $38.00 | — | 2025-06-09 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - Molina | Medicaid - Molina | $1.00 | $13.00 | $6.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - United | Medicaid - United | $1.00 | $13.00 | $6.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $1.00 | $13.00 | $6.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - Molina | Medicaid - Molina | $1.00 | $13.00 | $6.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - Meridian | Medicaid - Meridian | $1.00 | $13.00 | $6.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - Meridian | Medicaid - Meridian | $1.00 | $13.00 | $6.00 | 2025-02-03 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | SCAN Health Plan | Medicare Advantage | — | $408.32 | $265.41 | 2025-11-26 | MRF ↗ |
| WATERBURY HOSPITAL OutpatientFacility | Evernorth Behavioral Health | Commercial | $1.00 | $144.66 | $72.33 | 2026-05-13 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $1.00 | $13.00 | $6.00 | 2025-02-03 | MRF ↗ |
| MEDICAL ARTS HOSPITAL Both | UNITED HEALTHCARE | UNITED HEALTHCARE | $1.00 | $38.00 | — | 2025-06-09 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $408.32 | $265.41 | 2025-11-26 | MRF ↗ |
| GOSHEN HOSPITAL Both | Aetna Allied Benefit Systems | AETABS_1 | — | $261.00 | $182.70 | 2026-05-11 | MRF ↗ |
| GOSHEN HOSPITAL Both | Aetna Allied Benefit Systems | AETABS | — | $261.00 | $182.70 | 2026-05-11 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | California Physicians' Service dba Blue Shield of California | HMO | — | $471.00 | $386.22 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | California Physicians' Service dba Blue Shield of California | Medicare Advantage | — | $374.00 | $306.68 | 2025-11-26 | MRF ↗ |
| MEDICAL ARTS HOSPITAL Both | GOLDEN RULE | GOLDEN RULE | $1.00 | $38.00 | — | 2025-06-09 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | California Physicians' Service dba Blue Shield of California | Covered | — | $471.00 | $386.22 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $374.00 | $306.68 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $471.00 | $386.22 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $374.00 | $306.68 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | HMO | — | $374.00 | $306.68 | 2025-11-26 | MRF ↗ |
| MEDICAL ARTS HOSPITAL Both | UMR | UMR | $1.00 | $38.00 | — | 2025-06-09 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $471.00 | $386.22 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $374.00 | $306.68 | 2025-11-26 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $1.02 | $51.71 | $31.03 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $1.02 | $51.71 | $31.03 | 2025-08-11 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $1.07 | $130.00 | $52.00 | 2026-05-13 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $1.07 | $130.00 | $52.00 | 2026-05-22 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $1.08 | $104.00 | $104.00 | 2026-04-24 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Managed Health Network | MHN - Medicare | $1.08 | $296.00 | $222.00 | 2026-04-01 | MRF ↗ |
| Temple University Hospital - Episcopal Campus OutpatientFacility | Cigna | Medicare DSNP/Medicare HMO/Medicare PPO | $1.10 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Cigna | Medicare DSNP/Medicare HMO/Medicare PPO | $1.10 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Hospital Of The Fox Chase Cancer Center OutpatientFacility | Cigna | Medicare DSNP/Medicare HMO/Medicare PPO | $1.10 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Cigna | Medicare DSNP/Medicare HMO/Medicare PPO | $1.10 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple Women & Families Hospital OutpatientFacility | Cigna | Medicare DSNP/Medicare HMO/Medicare PPO | $1.10 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Cigna | Medicare DSNP/Medicare HMO/Medicare PPO | $1.10 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Cigna | Medicare DSNP/Medicare HMO/Medicare PPO | $1.10 | $10.00 | — | 2026-04-13 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $1.14 | $109.15 | $109.15 | 2026-04-24 | MRF ↗ |
| MERCY HOSPITAL COLUMBUS OutpatientFacility | CENTIVO CONTRACTED [320505] | HB MNCK CENTIVO 165% MEDICARE | $1.20 | $118.00 | $76.70 | 2026-03-14 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $1.21 | $51.71 | $31.03 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $1.21 | $51.71 | $31.03 | 2025-08-11 | MRF ↗ |
| Hospital Of The Fox Chase Cancer Center OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Medicare Advantage Select 65 | $1.26 | $10.00 | — | 2026-04-08 | MRF ↗ |
| Hospital Of The Fox Chase Cancer Center OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Medicare Advantage HMO/Medicare Advantage PPO | $1.26 | $10.00 | — | 2026-04-08 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Blue Cross | Blue Cross - MCS | $1.32 | $742.00 | $556.50 | 2026-04-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | California Physicians' Service, dba Blue Shield of California | EPO | — | $408.32 | $265.41 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | California Physicians' Service, dba Blue Shield of California | PPO | — | $408.32 | $265.41 | 2025-11-26 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Cigna | Commercial | $1.36 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Northeastern Campus OutpatientFacility | Cigna | Commercial | $1.36 | $10.00 | — | 2026-04-13 | MRF ↗ |
| Temple University Hospital - Episcopal Campus OutpatientFacility | Cigna | Commercial | $1.36 | $10.00 | — | 2026-04-13 | 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.