99238 — Pr Discharge Day Management Hospital IP/Obs <=30 Min On Ecounter Date
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PR Discharge Day Management Hospital IP/Obs <=30 Min on Ecounter Date (CPT 99238) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/99238?code_type=CPT
MLA (9th ed.)
“PR Discharge Day Management Hospital IP/Obs <=30 Min on Ecounter Date (CPT 99238) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/99238?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“PR Discharge Day Management Hospital IP/Obs <=30 Min on Ecounter Date (CPT 99238) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/99238?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $75–$216 (25th–75th percentile) across 1,950 hospitals · 5,097 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 99238 — 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
$75
$112 typical
$216
The middle 50% of negotiated facility rates for this procedure, measured across 1,950 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. | $112 |
| Physician fee Estimate national typical Medicare $75 × 1.22 commercial. | $91 |
| Likely subtotal | $203 |
Complete-episode estimate (typical)
~$203
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 $75–$216.
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_Fidelis Medicaid_ FamilyHealth Plus_CHP | — | $243.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Managed Medicaid_Aliessa and QHP | — | $243.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Health Benefit Exchange | — | $243.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Excellus BCBS | Managed Medicaid _CHP_SP | — | $243.00 | — | 2025-05-02 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $0.08 | — | — | 2026-04-01 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $0.08 | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $0.08 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $0.08 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $0.08 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $0.08 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $0.08 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $0.08 | — | — | 2026-04-01 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.22 | $121.00 | — | 2024-12-31 | 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 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 | BLUECHOICE HEALTHPLAN OF SC | $0.29 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $0.29 | — | — | 2026-09-01 | 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 ↗ |
| PEAK BEHAVIORAL HEALTH SERVICES, LLC Inpatient | MOLINA HEALTHCARE OF TX MEDICARE | MOLINA HEALTHCARE OF TX MEDICARE | $0.65 | $170.00 | — | 2026-05-20 | MRF ↗ |
| PEAK BEHAVIORAL HEALTH SERVICES, LLC Inpatient | UBH TX MEDICAID | UBH TX MEDICAID | $0.65 | $170.00 | — | 2026-05-20 | MRF ↗ |
| PEAK BEHAVIORAL HEALTH SERVICES, LLC Inpatient | TEXAS MEDICAID HEALTHCARE | TEXAS MEDICAID HEALTHCARE | $0.65 | $170.00 | — | 2026-05-20 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $0.80 | $166.00 | $124.50 | 2025-03-07 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $0.80 | $166.00 | $124.50 | 2026-07-01 | 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 | BLUE CROSS STATE | $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 ↗ |
| 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 | BCBS PREFERRED BLUE PPO | $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 ↗ |
| 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 ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 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 ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | 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 | $1.92 | $230.00 | $149.50 | 2026-05-07 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $2.06 | $123.00 | $23.37 | 2026-01-25 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $2.06 | $199.00 | $37.81 | 2026-05-20 | MRF ↗ |
| WALLOWA MEMORIAL HOSPITAL Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $2.06 | $215.00 | $215.00 | 2026-07-09 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $2.07 | — | — | 2026-07-15 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $2.88 | $144.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $2.88 | $144.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $2.88 | $144.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $2.88 | $144.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $2.88 | $144.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $2.88 | $144.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $2.88 | $144.00 | — | 2026-03-31 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.09 | $151.18 | $90.71 | 2025-08-11 | MRF ↗ |
| MOBRIDGE REGIONAL HOSPITAL - CAH Outpatient | SANFORD HEALTHPLAN-ALL PLANS | SANFORD HEALTHPLAN-ALL PLANS | $3.09 | $248.00 | $248.00 | 2026-07-16 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $3.09 | $151.18 | $90.71 | 2025-08-11 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | UnitedHealthcare | Community & State | $3.62 | $150.00 | — | 2026-08-17 | MRF ↗ |
| NORTHWEST FLORIDA COMMUNITY HOSPITAL Outpatient | Humana | Medicare | $3.84 | $20.00 | $16.00 | 2026-07-15 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | Wellpoint | Medicaid Managed Care | $3.98 | $150.00 | — | 2026-08-17 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $4.12 | $310.00 | $310.00 | 2026-06-03 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $4.12 | $310.00 | $310.00 | 2026-02-13 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | Wellpoint | Medicaid Managed Care | $4.26 | $150.00 | — | 2026-08-17 | MRF ↗ |
| CAREPOINT HEALTH - BAYONNE MEDICAL CENTER OutpatientFacility | UnitedHealthcare | Community & State | $4.74 | $150.00 | — | 2026-08-17 | MRF ↗ |
| RURAL WELLNESS FAIRFAX HOSPITAL Outpatient | Medicaid | Traditional | — | $347.31 | $208.39 | 2026-03-23 | MRF ↗ |
| MCGEHEE HOSPITAL Both | Arkansas Total Care | Medicaid Replacement | $5.00 | $210.00 | $140.70 | 2026-04-09 | 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 | $97.10 | $67.97 | 2026-07-15 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $5.43 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $5.43 | $80.99 | $80.99 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $5.43 | $80.99 | $80.99 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $5.43 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $5.43 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $5.43 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $5.48 | $274.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $5.48 | $274.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $5.48 | $274.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $5.48 | $274.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $5.48 | $274.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $5.48 | $274.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $5.48 | $274.00 | — | 2026-03-31 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Vaccn | Medicare | $5.76 | $263.00 | $197.25 | 2026-10-01 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Medicare | Medicare | $5.76 | $263.00 | $197.25 | 2026-10-01 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Bcbs Medicare | Medicare | $5.76 | $263.00 | $197.25 | 2026-10-01 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Inpatient | United Healthcare Medicare | Medicare Advantage | $5.78 | $197.00 | $118.20 | 2026-02-12 | MRF ↗ |
| TITUSVILLE AREA HOSPITAL Inpatient | United Healthcare Medicare | Medicare Advantage | $5.78 | $197.00 | $118.20 | 2026-02-12 | MRF ↗ |
| THE PHYSICIANS' HOSPITAL IN ANADARKO Outpatient | Medicaid | Traditional | — | $347.31 | $208.39 | 2026-03-23 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN [5034] | NMC UNITED HEALTH COMMUNITY | $5.98 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN BEHAVIORAL HEALTH [5293] | NMC UNITED HEALTH COMMUNITY | $5.98 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN [5034] | NMC UNITED HEALTH COMMUNITY | $5.98 | $80.99 | $80.99 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN BEHAVIORAL HEALTH [5293] | NMC UNITED HEALTH COMMUNITY | $5.98 | $80.99 | $80.99 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN BEHAVIORAL HEALTH [5293] | NMC UNITED HEALTH COMMUNITY | $5.98 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN [5034] | NMC UNITED HEALTH COMMUNITY | $5.98 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FIDELIS CARE MEDICAID [5509] | NMC FEDELIS CARE MANAGED MEDICAID | $6.25 | $80.99 | $80.99 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FIDELIS CARE MEDICAID [5509] | NMC FEDELIS CARE MANAGED MEDICAID | $6.25 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FIDELIS CARE MEDICAID [5509] | NMC FEDELIS CARE MANAGED MEDICAID | $6.25 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICAID [5006] | NMC WELLPOINT MANAGED MEDICAID | $6.25 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICAID [5006] | NMC WELLPOINT MANAGED MEDICAID | $6.25 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICAID [5006] | NMC WELLPOINT MANAGED MEDICAID | $6.25 | $80.99 | $80.99 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA BETTER HEALTH [5005] | NMC AETNA BETTER HEALTH | $6.52 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA BETTER HEALTH [5005] | NMC AETNA BETTER HEALTH | $6.52 | $80.99 | $80.99 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA BETTER HEALTH [5005] | NMC AETNA BETTER HEALTH | $6.52 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Anthem | MCR Advantage | $6.75 | $15.00 | $13.50 | 2026-07-08 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | United Healthcare | MCR Advantage | $6.75 | $15.00 | $13.50 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Cigna | MCR Advantage | $6.75 | $15.00 | $13.50 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Wellcare | MCR Advantage | $6.75 | $15.00 | $13.50 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | United Healthcare | MCR Advantage | $6.75 | $15.00 | $13.50 | 2026-07-08 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Aetna | MCR Advantage | $6.75 | $15.00 | $13.50 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Martins Point | MCR Advantage | $6.75 | $15.00 | $13.50 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Anthem | MCR Advantage | $6.75 | $15.00 | $13.50 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Cigna | MCR Advantage | $6.75 | $15.00 | $13.50 | 2026-07-08 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Wellcare | MCR Advantage | $6.75 | $15.00 | $13.50 | 2026-07-08 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Aetna | MCR Advantage | $6.75 | $15.00 | $13.50 | 2026-07-08 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Martins Point | MCR Advantage | $6.75 | $15.00 | $13.50 | 2026-07-08 | MRF ↗ |
| STARCARE SPECIALTY HEALTH /SUNRISE CANYON HOSPITAL Inpatient | Medicaid Managed Care Organization | Wellpoint | — | $75.00 | $54.58 | 2026-08-28 | MRF ↗ |
| STARCARE SPECIALTY HEALTH /SUNRISE CANYON HOSPITAL Inpatient | Medicaid Managed Care Organization | Wellpoint | — | $75.00 | $54.58 | 2026-08-28 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | SEDGWICK WTC HEALTH PROGRAM WC [5514] | HMC PRIME HEALTH SERVICES | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | COSMETIC SURGERY/LAP BAND/GASTRIC BYPASS [5289] | HMC SELF PAY | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | SEDGWICK WTC HEALTH PROGRAM WC [5514] | HMC PRIME HEALTH SERVICES | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICARE IP SPLITS [5476] | HMC HORIZON BRAVEN | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM MEDICARE PFFS IP SPLITS [5474] | HMC HORIZON BRAVEN | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM MEDICARE PFFS IP SPLITS [5474] | HMC HORIZON BRAVEN | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | MEDICAID PENDING [5302] | HMC SELF PAY | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK WHOLECARE HEALTH PLAN [5413] | HMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK COMMUNITY BLUE MEDICARE [5534] | HMC HORIZON BRAVEN | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA ASSURE PREMIER PLUS IP SPLITS [5466] | HMC AETNA MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA ASSURE PREMIER PLUS IP SPLITS [5466] | HMC AETNA MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | COSMETIC SURGERY/LAP BAND/GASTRIC BYPASS [5289] | HMC SELF PAY | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | FAIROS [5491] | HMC FAIROS | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK COMMUNITY BLUE MEDICARE [5534] | HMC HORIZON BRAVEN | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | FAIROS [5491] | HMC FAIROS | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA TOTALCARE (HMO D-SNP) [5419] | HMC CIGNA MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA TOTALCARE (HMO D-SNP) IP SPLITS [5465] | HMC CIGNA MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMBETTER [5432] | HMC AMBETTER WELLCARE OF NJ | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICARE IP SPLITS [5476] | HMC HORIZON BRAVEN | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA TOTALCARE (HMO D-SNP) IP SPLITS [5465] | HMC CIGNA MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | MEDICAID PENDING [5302] | HMC SELF PAY | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA TOTALCARE (HMO D-SNP) [5419] | HMC CIGNA MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE BEHAVIORAL HEALTH [5335] | HMC WELLCARE/FEDELIS MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | MEDICAID [5022] | HMC MEDICAID | $7.82 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE BEHAVIORAL HEALTH [5335] | HMC WELLCARE/FEDELIS MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | MEDICAID [5022] | HMC MEDICAID | $7.82 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | SPECIALTY IMAGING [5433] | HMC SELF PAY | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBS OUT OF STATE MEDICARE IP SPLITS [5461] | HMC HORIZON BRAVEN | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICAID [5511] | HMC MEDICAID | $7.82 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | SPECIALTY IMAGING [5433] | HMC SELF PAY | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | MEDICAID [5022] | HMC MEDICAID | $7.82 | $80.99 | $80.99 | 2026-04-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK WHOLECARE HEALTH PLAN [5413] | HMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICARE [5312] | HMC HORIZON BRAVEN | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE [5035] | HMC UNITED MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA MEDICARE [5440] | HMC CIGNA MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE MEDICARE BY ALLWELL [5506] | HMC WELLCARE PHW | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE MEDICARE BY ALLWELL [5506] | HMC WELLCARE PHW | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICAID [5511] | HMC MEDICAID | $7.82 | $80.99 | $80.99 | 2026-04-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AARP MEDICARE COMP [5039] | HMC UNITED MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE [5035] | HMC UNITED MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | KINDRED GIRALDA HOSPITAL [5341] | HMC KINDRED | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MCARE SUPPLEMENTAL [5041] | HMC AETNA MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | KINDRED GIRALDA HOSPITAL [5341] | HMC KINDRED | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA MEDICARE [5440] | HMC CIGNA MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICAID [5511] | HMC MEDICAID | $7.82 | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE HEALTH PLANS IP SPLITS [5475] | HMC WELLCARE/FEDELIS MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMBETTER [5432] | HMC AMBETTER WELLCARE OF NJ | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE HEALTH PLANS [5269] | HMC WELLCARE/FEDELIS MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE [5003] | HMC AETNA NNJ PRIME | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH CARITAS VIP CARE IP SPLITS [5460] | HMC AMERIHEALTH CARITAS | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE HEALTH PLANS [5269] | HMC WELLCARE/FEDELIS MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE IP SPLITS [5470] | HMC AETNA MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE BEHAVIORAL [5409] | HMC UNITED MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO IP SPLITS [5467] | HMC LONGEVITY | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA [5002] | HMC AETNA HTC | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBSNJ BRAVEN HEALTH [5416] | HMC HORIZON BRAVEN | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE IP SPLITS [5470] | HMC AETNA MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO [5428] | HMC LONGEVITY | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO [5428] | HMC LONGEVITY | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CLAIM WATCHER/HOMESTEAD [5488] | HMC CLAIM WATCHER TIER 1 | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE IP SPLITS [5471] | HMC UNITED MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO IP SPLITS [5467] | HMC LONGEVITY | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH MEDIGAP [5049] | HMC AMERIHEALTH MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBSNJ BRAVEN HEALTH [5416] | HMC HORIZON BRAVEN | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | KAREN ANN QUINLAN [5285] | HMC KAREN ANN QUINLAN | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE IP SPLITS [5471] | HMC UNITED MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK WHOLECARE HEALTH PLAN IP SPLITS [5464] | HMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA CENTRASTATE EMPLOYEE [5425] | HMC AETNA HTC | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | KAREN ANN QUINLAN [5285] | HMC KAREN ANN QUINLAN | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE HEALTH PLANS IP SPLITS [5475] | HMC WELLCARE/FEDELIS MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC [5455] | HMC UPMCHP CONTRACT | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA ASSURE PREMIER PLUS [5422] | HMC AETNA MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBSNJ BRAVEN HEALTH IP SPLITS [5477] | HMC HORIZON BRAVEN | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE [5003] | HMC AETNA MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC MEDICARE [5454] | HMC UPMCHP CONTRACT | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC MEDICARE [5454] | HMC UPMCHP CONTRACT | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE BEHAVIORAL [5409] | HMC UNITED MEDICARE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBS OUT OF STATE MEDICARE [5325] | HMC HORIZON BRAVEN | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBSNJ BRAVEN HEALTH IP SPLITS [5477] | HMC HORIZON BRAVEN | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK WHOLECARE HEALTH PLAN IP SPLITS [5464] | HMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLPOINT MANAGED MEDICARE IP SPLITS [5453] | HMC WELLPOINT MEDICARE ADVANTAGE | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC MEDICARE IP SPLITS [5484] | HMC UPMCHP CONTRACT | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH CARITAS VIP CARE IP SPLITS [5460] | HMC AMERIHEALTH CARITAS | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA CENTRASTATE EMPLOYEE [5425] | HMC AETNA HTC | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | VA COMMUNITY CARE NETWORK [5403] | HMC VETERAN AFFAIRS COMMUNITY CARE NETWORK | — | $80.99 | $80.99 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CLAIMDOC [5434] | HMC CLAIMDOC PLAN | — | $80.99 | $80.99 | 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.