99231 — Pr Hospital IP/Obs Care Subsequent Straightforward Or Low Level Per Day
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PR Hospital IP/Obs Care Subsequent Straightforward or Low Level per Day (CPT 99231) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/99231?code_type=CPT
MLA (9th ed.)
“PR Hospital IP/Obs Care Subsequent Straightforward or Low Level per Day (CPT 99231) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/99231?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“PR Hospital IP/Obs Care Subsequent Straightforward or Low Level per Day (CPT 99231) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/99231?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $44–$131 (25th–75th percentile) across 1,927 hospitals · 4,985 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 99231 — 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
$44
$68 typical
$131
The middle 50% of negotiated facility rates for this procedure, measured across 1,927 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. | $68 |
| Physician fee Estimate national typical Medicare $44 × 1.22 commercial. | $54 |
| Likely subtotal | $122 |
Complete-episode estimate (typical)
~$122
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 $44–$131.
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 |
|---|---|---|---|---|---|---|---|
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Womans Hospital Employees | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Excellus BCBS | Managed Medicaid _CHP_SP | — | $137.00 | — | 2025-05-02 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | HMO | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | HS Technology | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Peoples Health | Medicare Enrollees | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Aetna | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Humana | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Louisiana Healthcare Connection | Medicaid | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Aetna | Better Health | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | Community Plan | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | Community Coffee Group | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Amerihealth Caritas | Medicaid | — | — | — | 2026-03-17 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Fidelis | Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP | — | $137.00 | — | 2025-05-02 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | — | — | — | 2026-03-17 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Health Benefit Exchange | — | $137.00 | — | 2025-05-02 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | First Health | Aetna Medical Rental Network | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | VA CCN | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | USA Managed Care Organization | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Managed Medicaid_Aliessa and QHP | — | $137.00 | — | 2025-05-02 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Three Rivers Provider Network | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Medical Cost Containment Professionals | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Gilsbar 360 | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | Exchange Compass | — | — | — | 2026-03-17 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | AmeriHealth Mercy LA LaCare | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Amerigroup | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Humana | MGMCD | — | — | — | 2026-03-01 | MRF ↗ |
| HARDTNER MEDICAL CENTER Both | United Healthcare | Default | — | $119.00 | $23.80 | 2025-01-02 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Louisiana Healthcare Connections, Inc. | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | United | CHIP | — | — | — | 2026-03-01 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | United | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Aetna Better Health | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| SABINE MEDICAL CENTER Both | BLUE CROSS OF LOUISIANA | BLUE CROSS IP | $0.03 | $132.00 | $39.60 | 2025-12-16 | MRF ↗ |
| SABINE MEDICAL CENTER Both | BLUE CROSS OF LOUISIANA | BLUE CROSS OP | $0.03 | $132.00 | $39.60 | 2025-12-16 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.19 | $103.00 | — | 2024-12-31 | 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 ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN 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 ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $0.38 | $121.00 | $90.75 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $0.38 | $121.00 | $90.75 | 2026-07-01 | 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 ↗ |
| PEAK BEHAVIORAL HEALTH SERVICES, LLC Inpatient | MOLINA HEALTHCARE OF TX MEDICARE | MOLINA HEALTHCARE OF TX MEDICARE | $0.65 | $140.00 | — | 2026-05-20 | MRF ↗ |
| PEAK BEHAVIORAL HEALTH SERVICES, LLC Inpatient | TEXAS MEDICAID HEALTHCARE | TEXAS MEDICAID HEALTHCARE | $0.65 | $140.00 | — | 2026-05-20 | MRF ↗ |
| PEAK BEHAVIORAL HEALTH SERVICES, LLC Inpatient | UBH TX MEDICAID | UBH TX MEDICAID | $0.65 | $140.00 | — | 2026-05-20 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-02 | 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 | BLUECHOICE HEALTHPLAN OF SC | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $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 ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $1.10 | — | — | 2026-07-15 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $1.11 | $74.00 | $14.06 | 2026-01-25 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $1.11 | $119.00 | $22.61 | 2026-05-20 | MRF ↗ |
| WALLOWA MEMORIAL HOSPITAL Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $1.11 | $126.00 | $126.00 | 2026-07-09 | MRF ↗ |
| CHEYENNE COUNTY HOSPITAL Outpatient | AETNA COVENTRY - ALL OTHER PLANS | AETNA COVENTRY - ALL OTHER PLANS | $1.33 | $53.00 | — | 2026-03-02 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $1.66 | $92.06 | $55.24 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $1.66 | $92.06 | $55.24 | 2025-08-11 | MRF ↗ |
| MOBRIDGE REGIONAL HOSPITAL - CAH Outpatient | SANFORD HEALTHPLAN-ALL PLANS | SANFORD HEALTHPLAN-ALL PLANS | $1.67 | $172.00 | $172.00 | 2026-07-16 | MRF ↗ |
| RURAL WELLNESS FAIRFAX HOSPITAL Both | Medicaid | Traditional | — | $246.84 | $148.10 | 2026-03-23 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $2.17 | $108.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $2.17 | $108.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $2.17 | $108.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $2.17 | $108.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $2.17 | $108.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $2.17 | $108.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $2.17 | $108.50 | — | 2026-03-31 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $2.22 | $193.00 | $193.00 | 2026-02-13 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $2.22 | $193.00 | $193.00 | 2026-06-03 | MRF ↗ |
| NORTHWEST FLORIDA COMMUNITY HOSPITAL Outpatient | Humana | Medicare | $2.30 | $12.00 | $9.60 | 2026-07-15 | MRF ↗ |
| RURAL WELLNESS STROUD HOSPITAL Both | Medicaid | Traditional | — | $246.84 | $148.10 | 2026-03-23 | MRF ↗ |
| NORTH SUNFLOWER MEDICAL CENTER CAH Outpatient | UHC-ALL PLANS | UHC-ALL PLANS | $2.57 | $72.00 | $36.00 | 2026-10-19 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | IRON CLAD INSURANCE [10026304] | $2.75 | $39.41 | $27.59 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP GIC NAVIGATOR POS [10026312] | $2.75 | $39.41 | $27.59 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP SELECT [10026309] | $2.75 | $39.41 | $27.59 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP HMO OUT IPA [10026302] | $2.75 | $39.41 | $27.59 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP POS/EPO [10026306] | $2.75 | $39.41 | $27.59 | 2025-01-01 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $3.03 | $151.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $3.03 | $151.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $3.03 | $151.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $3.03 | $151.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $3.03 | $151.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $3.03 | $151.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $3.03 | $151.50 | — | 2026-03-31 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $3.30 | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLCARE BEHAVIORAL HEALTH [5335] | NMC WELLCARE/FEDELIS MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CHAMPVA [5354] | NMC TRICARE CONTRACT | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CIGNA MEDICARE IP SPLITS [5478] | NMC CIGNA MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $3.30 | $49.17 | $49.17 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $3.30 | $49.17 | $49.17 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA MEDICARE [5003] | NMC AETNA MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON BCBS OUT OF STATE MEDICARE [5325] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | LUMINARE HEALTH AHS RETIREE [5013] | NMC AETNA AHS EMPLOYEE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | SPECIALTY IMAGING [5433] | NMC SELF PAY | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CLAIM WATCHER/HOMESTEAD [5488] | NMC CLAIM WATCHER TIER 1 | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CLAIM WATCHER/HOMESTEAD [5488] | NMC CLAIM WATCHER TIER 1 | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UPMC MEDICARE [5454] | NMC UPMCHP CONTRACT | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HIGHMARK WHOLECARE HEALTH PLAN IP SPLITS [5464] | NMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON BCBSNJ BRAVEN HEALTH [5416] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICARE IP SPLITS [5476] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA CENTRASTATE EMPLOYEE [5425] | NMC AETNA HTC | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AMERIHEALTH CARITAS VIP CARE IP SPLITS [5460] | NMC AMERIHEALTH CARITAS | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA MCARE SUPPLEMENTAL [5041] | NMC AETNA MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA AHS EMPLOYEE [5306] | NMC AETNA AHS EMPLOYEE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | LUMINARE HEALTH AHS RETIREE [5013] | NMC AETNA AHS EMPLOYEE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | VA COMMUNITY CARE NETWORK [5403] | NMC VETERAN AFFAIR COMMUNITY CARE NETWORK | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | US FAMILY HEALTH PLAN [5258] | NMC TRICARE CONTRACT | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA MEDICARE [5003] | NMC AETNA NNJ PRIME | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA MEDICARE [5003] | NMC AETNA NNJ PRIME | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AMBETTER [5432] | NMC AMBETTER WELLCARE OF NJ | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON BCBS OUT OF STATE MEDICARE [5325] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | KINDRED GIRALDA HOSPITAL [5341] | NMC KINDRED | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLCARE MEDICARE BY ALLWELL [5506] | NMC WELLCARE PHW | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICARE IP SPLITS [5453] | NMC WELLPOINT MEDICARE ADVANTAGE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH MEDICARE [5035] | NMC UNITED MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UPMC MEDICARE [5454] | NMC UPMCHP CONTRACT | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CIGNA TOTALCARE (HMO D-SNP) [5419] | NMC CIGNA MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA MEDICARE IP SPLITS [5470] | NMC AETNA MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AMERIHEALTH MEDIGAP [5049] | NMC AMERIHEALTH MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UPMC [5455] | NMC UPMCHP CONTRACT | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HIGHMARK COMMUNITY BLUE MEDICARE [5534] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FAIROS [5491] | NMC FAIROS | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | KAREN ANN QUINLAN [5285] | NMC KAREN ANN QUINLAN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA MEDICARE [5003] | NMC AETNA MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FAIROS [5491] | NMC FAIROS | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | SEDGWICK WTC HEALTH PROGRAM WC [5514] | NMC PRIME HEALTH SERVICES | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AARP MEDICARE COMP [5039] | NMC UNITED MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | COSMETIC SURGERY/LAP BAND/GASTRIC BYPASS [5289] | NMC SELF PAY | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | SEDGWICK WTC HEALTH PROGRAM WC [5514] | NMC PRIME HEALTH SERVICES | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM MEDICARE PFFS [5052] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICARE [5007] | NMC WELLPOINT MEDICARE ADVANTAGE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM MEDICARE PFFS IP SPLITS [5474] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AMERIHEALTH CARITAS VIP CARE IP SPLITS [5460] | NMC AMERIHEALTH CARITAS | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON BCBS OUT OF STATE MEDICARE IP SPLITS [5461] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON BCBSNJ BRAVEN HEALTH IP SPLITS [5477] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID PENDING [5302] | NMC SELF PAY | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICARE IP SPLITS [5476] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON BCBSNJ BRAVEN HEALTH IP SPLITS [5477] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH MEDICARE IP SPLITS [5471] | NMC UNITED MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CIGNA TOTALCARE (HMO D-SNP) IP SPLITS [5465] | NMC CIGNA MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AMERIHEALTH ADMINISTRATORS SUPPLEMENTAL [5512] | NMC AMERIHEALTH MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $3.30 | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLCARE HEALTH PLANS IP SPLITS [5475] | NMC WELLCARE/FEDELIS MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICARE [5312] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA MEDICARE IP SPLITS [5470] | NMC AETNA MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CLAIMDOC [5434] | NMC CLAIMDOC PLAN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO IP SPLITS [5467] | NMC LONGEVITY | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UPMC MEDICARE IP SPLITS [5484] | NMC UPMCHP CONTRACT | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | COSMETIC SURGERY/LAP BAND/GASTRIC BYPASS [5289] | NMC SELF PAY | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH MEDICARE BEHAVIORAL [5409] | NMC UNITED MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA CENTRASTATE EMPLOYEE [5425] | NMC AETNA HTC | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON BCBS OUT OF STATE MEDICARE IP SPLITS [5461] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CIGNA TOTALCARE (HMO D-SNP) [5419] | NMC CIGNA MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CIGNA MEDICARE [5440] | NMC CIGNA MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CIGNA TOTALCARE (HMO D-SNP) IP SPLITS [5465] | NMC CIGNA MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLCARE HEALTH PLANS [5269] | NMC WELLCARE/FEDELIS MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON MEDICARE BLUE IP SPLITS [5456] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON MEDICARE BLUE IP SPLITS [5456] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AMERIHEALTH MEDIGAP [5049] | NMC AMERIHEALTH MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA [5002] | NMC AETNA HTC | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO [5428] | NMC LONGEVITY | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLCARE HEALTH PLANS [5269] | NMC WELLCARE/FEDELIS MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | TRICARE [5251] | NMC TRICARE CONTRACT | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID PENDING [5302] | NMC SELF PAY | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON BCBSNJ BRAVEN HEALTH [5416] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | KAREN ANN QUINLAN [5285] | NMC KAREN ANN QUINLAN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | SPECIALTY IMAGING [5433] | NMC SELF PAY | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HIGHMARK COMMUNITY BLUE MEDICARE [5534] | NMC HORIZON BRAVEN | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLCARE BEHAVIORAL HEALTH [5335] | NMC WELLCARE/FEDELIS MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HIGHMARK WHOLECARE HEALTH PLAN IP SPLITS [5464] | NMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $3.30 | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH MEDICARE BEHAVIORAL [5409] | NMC UNITED MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH MEDICARE [5035] | NMC UNITED MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CHAMPVA [5354] | NMC TRICARE CONTRACT | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH MEDICARE IP SPLITS [5471] | NMC UNITED MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | US FAMILY HEALTH PLAN [5258] | NMC TRICARE CONTRACT | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA [5002] | NMC AETNA HTC | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $3.30 | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AMERIHEALTH CARITAS VIP CARE [5313] | NMC AMERIHEALTH CARITAS | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CIGNA MEDICARE [5440] | NMC CIGNA MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UPMC [5455] | NMC UPMCHP CONTRACT | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UPMC MEDICARE IP SPLITS [5484] | NMC UPMCHP CONTRACT | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HIGHMARK WHOLECARE HEALTH PLAN [5413] | NMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AMERIHEALTH ADMINISTRATORS SUPPLEMENTAL [5512] | NMC AMERIHEALTH MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CIGNA MEDICARE IP SPLITS [5478] | NMC CIGNA MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AARP MEDICARE COMP [5039] | NMC UNITED MEDICARE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICARE [5007] | NMC WELLPOINT MEDICARE ADVANTAGE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA AHS EMPLOYEE [5306] | NMC AETNA AHS EMPLOYEE | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO [5428] | NMC LONGEVITY | — | $49.17 | $49.17 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AMBETTER [5432] | NMC AMBETTER WELLCARE OF NJ | — | $49.17 | $49.17 | 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.