99221 — Pr Hospital IP/Obs Care Initial Straightforward Or Low Level Per Day
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PR Hospital IP/Obs Care Initial Straightforward or Low Level per Day (CPT 99221) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/99221?code_type=CPT
MLA (9th ed.)
“PR Hospital IP/Obs Care Initial Straightforward or Low Level per Day (CPT 99221) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/99221?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“PR Hospital IP/Obs Care Initial Straightforward or Low Level per Day (CPT 99221) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/99221?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $80–$268 (25th–75th percentile) across 1,918 hospitals · 4,764 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 99221 — 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
$80
$134 typical
$268
The middle 50% of negotiated facility rates for this procedure, measured across 1,918 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. | $134 |
| Physician fee Estimate national typical Medicare $74 × 1.22 commercial. | $91 |
| Likely subtotal | $225 |
Complete-episode estimate (typical)
~$225
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 $80–$268.
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 | — | $338.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Excellus BCBS | Managed Medicaid _CHP_SP | — | $338.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Fidelis | Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP | — | $338.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Health Benefit Exchange | — | $338.00 | — | 2025-05-02 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $0.29 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $0.29 | — | — | 2026-09-01 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.30 | $164.00 | — | 2024-12-31 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.49 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $0.60 | — | — | 2026-09-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $0.66 | $166.00 | $124.50 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $0.66 | $166.00 | $124.50 | 2025-03-07 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW MEXICO MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS STATE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW MEXICO MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| COMANCHE COUNTY MEDICAL CENTER Outpatient | MPI - ALL PLANS | MPI - ALL PLANS | $2.68 | $319.00 | $207.35 | 2026-05-07 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP HMO OUT IPA [10026302] | $2.75 | $103.49 | $72.44 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP GIC NAVIGATOR POS [10026312] | $2.75 | $103.49 | $72.44 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP SELECT [10026309] | $2.75 | $103.49 | $72.44 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP POS/EPO [10026306] | $2.75 | $103.49 | $72.44 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | IRON CLAD INSURANCE [10026304] | $2.75 | $103.49 | $72.44 | 2025-01-01 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $2.88 | $123.00 | $23.37 | 2026-01-25 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $2.88 | $200.00 | $38.00 | 2026-05-20 | MRF ↗ |
| WALLOWA MEMORIAL HOSPITAL Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $2.88 | $294.00 | $294.00 | 2026-07-09 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $2.90 | — | — | 2026-07-15 | MRF ↗ |
| RURAL WELLNESS FAIRFAX HOSPITAL Both | Medicaid | Traditional | — | $412.08 | $247.25 | 2026-03-23 | MRF ↗ |
| THE PHYSICIANS' HOSPITAL IN ANADARKO Both | Medicaid | Traditional | — | $412.08 | $247.25 | 2026-03-23 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | UnitedHealthcare | Community & State | $3.49 | $145.00 | — | 2026-08-17 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | Wellpoint | Medicaid Managed Care | $3.84 | $145.00 | — | 2026-08-17 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $4.02 | $201.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $4.02 | $201.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $4.02 | $201.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $4.02 | $201.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $4.02 | $201.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $4.02 | $201.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $4.02 | $201.00 | — | 2026-03-31 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | Wellpoint | Medicaid Managed Care | $4.12 | $145.00 | — | 2026-08-17 | MRF ↗ |
| MOBRIDGE REGIONAL HOSPITAL - CAH Outpatient | SANFORD HEALTHPLAN-ALL PLANS | SANFORD HEALTHPLAN-ALL PLANS | $4.29 | $341.00 | $341.00 | 2026-07-16 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $4.40 | $310.39 | $186.23 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $4.40 | $310.39 | $186.23 | 2025-08-11 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | UnitedHealthcare | Community & State | $4.58 | $145.00 | — | 2026-08-17 | MRF ↗ |
| NORTHWEST FLORIDA COMMUNITY HOSPITAL Outpatient | Humana | Medicare | $4.99 | $26.00 | $20.80 | 2026-07-15 | MRF ↗ |
| MCGEHEE HOSPITAL Both | Medicaid Arkansas | Default | $5.00 | $210.00 | $140.70 | 2026-04-09 | MRF ↗ |
| BAXTER HEALTH FULTON COUNTY HOSPITAL Inpatient | Medicaid Arkansas | Default | $5.00 | $262.00 | $183.40 | 2026-07-15 | MRF ↗ |
| MCGEHEE HOSPITAL Both | Arkansas Total Care | Medicaid Replacement | $5.00 | $210.00 | $140.70 | 2026-04-09 | MRF ↗ |
| RURAL WELLNESS STROUD HOSPITAL Both | Medicaid | Traditional | — | $412.08 | $247.25 | 2026-03-23 | MRF ↗ |
| STOUGHTON HOSPITAL Outpatient | WPS - ALL PLANS | WPS - ALL PLANS | $5.52 | $461.25 | $253.69 | 2026-01-19 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $5.76 | $363.00 | $363.00 | 2026-02-13 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Life Trac National | Transplant (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Interlink National | Transplant Commercial (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Blue Cross Blue Shield Association BDCT | Transplant (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | CCHA Behavioral Health | Medicaid (All Contracted Plans) | $6.50 | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Humana National | Transplant (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Interlink National | Transplant Medicaid (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Kaiser National | Transplant (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Anthem Centers for Medical Excellence | Transplant (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Optum Health | Transplant Commercial (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Optum Health | Transplant Government (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Inpatient | United Healthcare Medicare | Medicare Advantage | $7.48 | $203.00 | $121.80 | 2026-02-12 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Inpatient | United Healthcare Medicare | Medicare Advantage | $7.48 | $203.00 | $121.80 | 2026-02-12 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $7.51 | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $7.51 | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $7.51 | $111.99 | $111.99 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $7.51 | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $7.51 | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $7.51 | $111.99 | $111.99 | 2026-04-01 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $7.65 | $382.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $7.65 | $382.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $7.65 | $382.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $7.65 | $382.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $7.65 | $382.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $7.65 | $382.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $7.65 | $382.50 | — | 2026-03-31 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Vaccn | Medicare | $7.71 | $366.00 | $274.50 | 2026-10-01 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Bcbs Medicare | Medicare | $7.71 | $366.00 | $274.50 | 2026-10-01 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Medicare | Medicare | $7.71 | $366.00 | $274.50 | 2026-10-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN [5034] | NMC UNITED HEALTH COMMUNITY | $8.26 | $111.99 | $111.99 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN BEHAVIORAL HEALTH [5293] | NMC UNITED HEALTH COMMUNITY | $8.26 | $111.99 | $111.99 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN BEHAVIORAL HEALTH [5293] | NMC UNITED HEALTH COMMUNITY | $8.26 | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN [5034] | NMC UNITED HEALTH COMMUNITY | $8.26 | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN BEHAVIORAL HEALTH [5293] | NMC UNITED HEALTH COMMUNITY | $8.26 | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN [5034] | NMC UNITED HEALTH COMMUNITY | $8.26 | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | UnitedHealthcare | Community & State | $8.44 | $350.00 | — | 2026-08-17 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FIDELIS CARE MEDICAID [5509] | NMC FEDELIS CARE MANAGED MEDICAID | $8.65 | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICAID [5006] | NMC WELLPOINT MANAGED MEDICAID | $8.65 | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FIDELIS CARE MEDICAID [5509] | NMC FEDELIS CARE MANAGED MEDICAID | $8.65 | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FIDELIS CARE MEDICAID [5509] | NMC FEDELIS CARE MANAGED MEDICAID | $8.65 | $111.99 | $111.99 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICAID [5006] | NMC WELLPOINT MANAGED MEDICAID | $8.65 | $111.99 | $111.99 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICAID [5006] | NMC WELLPOINT MANAGED MEDICAID | $8.65 | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA BETTER HEALTH [5005] | NMC AETNA BETTER HEALTH | $9.02 | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA BETTER HEALTH [5005] | NMC AETNA BETTER HEALTH | $9.02 | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA BETTER HEALTH [5005] | NMC AETNA BETTER HEALTH | $9.02 | $111.99 | $111.99 | 2026-04-01 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | Wellpoint | Medicaid Managed Care | $9.28 | $350.00 | — | 2026-08-17 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Aetna | Medicare Advantage | — | $93.00 | $93.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Cigna | PPO | — | $93.00 | $93.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Blue Cross Blue Shield | Medicare Advantage | — | $93.00 | $93.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Wellcare | Medicare Advantage HMO | — | $93.00 | $93.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Multiplan/PHCS | PPO | — | $93.00 | $93.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Community Partners Health Plan (CPHP) | PPO | — | $93.00 | $93.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | United Healthcare (UHC) | Medicare Advantage | — | $93.00 | $93.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | United Healthcare (UHC) | VA CCN/Optum | — | $93.00 | $93.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Blue Cross Blue Shield | HMO | — | $93.00 | $93.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Meridian | Medicare-Medicaid (D-SNP) | $9.30 | $93.00 | $93.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Humana | Medicare Advantage | — | $93.00 | $93.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Blue Cross Blue Shield | Blue Choice/Options/PPO | — | $93.00 | $93.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | Aetna | Commercial | — | $93.00 | $93.00 | 2026-04-15 | MRF ↗ |
| CARLE BROMENN MEDICAL CENTER InpatientFacility | United Healthcare (UHC) | PPO | — | $93.00 | $93.00 | 2026-04-15 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | AETNA | MEDICARE | $9.61 | $85.00 | $12.75 | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | AETNA | MEDICARE | $9.61 | $85.00 | $12.75 | 2025-12-23 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | Aetna Institute of Excellence | Transplant (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | MotivHealth/Denver Public Schools | Commercial (PPO) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | Select Health | Commercial (EPO/HMO/POS/PPO) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | Colorado Access Behavioral Health | Medicaid (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | Department of Corrections | Commercial (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | Colorado Medicaid | FFS (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | Colorado Access | CHP+ | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | Rocky Mountain Health Plan | Medicaid Prime | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | United Behavioral Health/Optum | Commercial (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Integrated Health Plan | Commercial (PPO) | $9.75 | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | Cigna | Commercial (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | United Healthcare | Commercial (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | United Healthcare | Commercial (Select CO) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | ValueOptions Colorado | Medicaid (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | Cigna Lifesource | Transplant (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | CCHA Behavioral Health | Medicaid (All Contracted Plans) | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO InpatientFacility | Denver Health Medical Plan | Medicaid Choice | — | $65.00 | $42.25 | 2026-04-17 | MRF ↗ |
| CARLE EUREKA HOSPITAL InpatientFacility | Meridian | Medicare-Medicaid (D-SNP) | $9.80 | $98.00 | $98.00 | 2026-04-15 | MRF ↗ |
| LAWRENCE & MEMORIAL HOSPITAL Outpatient | Medicaid Managed - UHC | All Plans | $9.84 | $254.64 | $91.67 | 2026-09-19 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Inpatient | United Healthcare Medicare | Medicare Advantage | $9.89 | $287.00 | $172.20 | 2026-02-12 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Inpatient | United Healthcare Medicare | Medicare Advantage | $9.89 | $287.00 | $172.20 | 2026-02-12 | MRF ↗ |
| SCRIPPS MEMORIAL HOSPITAL - ENCINITAS Both | RADYS CPMG [803] | RADY'S CHILDREN'S MEDI-CAL HMO | $9.92 | $124.03 | $31.01 | 2026-03-30 | MRF ↗ |
| SCRIPPS MEMORIAL HOSPITAL LA JOLLA Both | RADYS CPMG [803] | RADY'S CHILDREN'S MEDI-CAL HMO | $9.92 | $124.03 | $31.01 | 2026-03-30 | MRF ↗ |
| SCRIPPS GREEN HOSPITAL Both | RADYS CPMG [803] | RADY'S CHILDREN'S MEDI-CAL HMO | $9.92 | $124.03 | $31.01 | 2026-03-30 | MRF ↗ |
| SCRIPPS MERCY HOSPITAL Both | RADYS CPMG [803] | RADY'S CHILDREN'S MEDI-CAL HMO | $9.92 | $124.03 | $31.01 | 2026-03-30 | MRF ↗ |
| Scripps Mercy Hospital - Chula Vista Both | RADYS CPMG [803] | RADY'S CHILDREN'S MEDI-CAL HMO | $9.92 | $124.03 | $31.01 | 2026-03-30 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | Wellpoint | Medicaid Managed Care | $9.94 | $350.00 | — | 2026-08-17 | MRF ↗ |
| THE PHYSICIANS' HOSPITAL IN ANADARKO Both | UnitedHealthcare | Medicare Advantage | — | $412.08 | $247.25 | 2026-03-23 | MRF ↗ |
| WHITTIER HOSPITAL MEDICAL CENTER InpatientFacility | — | — | — | $101.00 | $18.18 | 2026-03-17 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $10.43 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $10.43 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $10.43 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $10.43 | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $10.43 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $10.43 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $10.43 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $10.43 | — | — | 2026-04-01 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | AETNA | MEDICARE | $10.56 | $48.00 | $7.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | WELLCARE | MCARE HMO DUAL PLAN | $10.56 | $48.00 | $7.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | WELLCARE | MCARE HMO | $10.56 | $48.00 | $7.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | BC FL | MEDICARE HMO | $10.56 | $48.00 | $7.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | HUMANA | MCARE CHOICE PPO | $10.56 | $48.00 | $7.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC | MCARE ADV DUAL PLAN | $10.56 | $48.00 | $7.20 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | UHC | MCARE ADV PLN | $10.56 | $48.00 | $7.20 | 2025-12-23 | MRF ↗ |
| SAINT ANNE'S HOSPITAL Inpatient | Self Pay Non-Traditional | Self Pay Non-Traditional | $10.64 | $133.01 | $133.01 | 2026-07-17 | MRF ↗ |
| RANDOLPH HOSPITAL Inpatient | Mcd Amerihealth Caritas | — | $10.75 | $125.00 | $25.00 | 2026-07-15 | MRF ↗ |
| RANDOLPH HOSPITAL Inpatient | Mcd Wellcare- Centene | — | $10.75 | $125.00 | $25.00 | 2026-07-15 | MRF ↗ |
| RANDOLPH HOSPITAL Inpatient | Mcd Healthy Blue | — | $10.75 | $125.00 | $25.00 | 2026-07-15 | MRF ↗ |
| RANDOLPH HOSPITAL Inpatient | Mcd | — | $10.75 | $125.00 | $25.00 | 2026-07-15 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH MEDIGAP [5049] | HMC AMERIHEALTH MEDICARE | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA MEDICARE [5440] | HMC CIGNA MEDICARE | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH MEDIGAP [5049] | HMC AMERIHEALTH MEDICARE | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA MEDICARE [5440] | HMC CIGNA MEDICARE | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMBETTER [5432] | HMC AMBETTER WELLCARE OF NJ | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBSNJ BRAVEN HEALTH IP SPLITS [5477] | HMC HORIZON BRAVEN | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE [5035] | HMC UNITED MEDICARE | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMBETTER [5432] | HMC AMBETTER WELLCARE OF NJ | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH CARITAS VIP CARE [5313] | HMC AMERIHEALTH CARITAS | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | KINDRED GIRALDA HOSPITAL [5341] | HMC KINDRED | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE [5035] | HMC UNITED MEDICARE | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE MEDICARE BY ALLWELL [5506] | HMC WELLCARE PHW | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLPOINT MANAGED MEDICARE [5007] | HMC WELLPOINT MEDICARE ADVANTAGE | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | COSMETIC SURGERY/LAP BAND/GASTRIC BYPASS [5289] | HMC SELF PAY | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO IP SPLITS [5467] | HMC LONGEVITY | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM MEDICARE PFFS [5052] | HMC HORIZON BRAVEN | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM MEDICARE PFFS [5052] | HMC HORIZON BRAVEN | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE MEDICARE BY ALLWELL [5506] | HMC WELLCARE PHW | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO IP SPLITS [5467] | HMC LONGEVITY | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | KINDRED GIRALDA HOSPITAL [5341] | HMC KINDRED | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC [5455] | HMC UPMCHP CONTRACT | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE HEALTH PLANS [5269] | HMC WELLCARE/FEDELIS MEDICARE | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC [5455] | HMC UPMCHP CONTRACT | — | $111.99 | $111.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH CARITAS VIP CARE [5313] | HMC AMERIHEALTH CARITAS | — | $111.99 | $111.99 | 2026-01-01 | 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.