99245 — Hc Office Consult Level 5
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). HC OFFICE CONSULT LEVEL 5 (CPT 99245) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/99245?code_type=CPT
MLA (9th ed.)
“HC OFFICE CONSULT LEVEL 5 (CPT 99245) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/99245?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“HC OFFICE CONSULT LEVEL 5 (CPT 99245) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/99245?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $166–$559 (25th–75th percentile) across 1,265 hospitals · 3,621 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 99245 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | None | — | — | $489.00 | $48.90 | 2026-04-01 | MRF ↗ |
| TIPPAH COUNTY HOSPITAL Both | Humana | Medicare Advantage | — | $615.00 | $615.00 | 2025-07-29 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | None | — | — | $489.00 | $48.90 | 2026-06-01 | MRF ↗ |
| TIPPAH COUNTY HOSPITAL Both | Aetna | Medicare Advantage | — | $615.00 | $615.00 | 2025-07-29 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | None | — | — | $489.00 | $48.90 | 2026-04-01 | MRF ↗ |
| TIPPAH COUNTY HOSPITAL Both | Medicare A MS JH | Default | — | $615.00 | $615.00 | 2025-07-29 | MRF ↗ |
| TIPPAH COUNTY HOSPITAL Both | Molina Healthcare of Mississippi | Default | — | $615.00 | $615.00 | 2025-07-29 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $0.94 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $0.94 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $0.94 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $0.96 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $0.99 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $1.01 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.21 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.21 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $1.24 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.24 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.24 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.24 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.26 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.29 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.32 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $1.37 | $253.00 | $240.35 | 2026-02-20 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $2.85 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $2.85 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $2.85 | — | — | 2026-04-01 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $2.85 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $2.85 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $2.85 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $2.85 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $2.85 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $2.85 | — | — | 2026-04-01 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $2.94 | $1,634.00 | — | 2024-12-31 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | SUMMIT COMMUNITY CARE CONTRACTED [320368] | HB FTSM SUMMIT | $5.00 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | SUMMIT COMMUNITY CARE CONTRACTED [320368] | HB FTSM SUMMIT | $5.00 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| MARSHALL BROWNING HOSPITAL Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $5.00 | $561.00 | $392.70 | 2026-01-22 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | MEDICAID [20240] | HB FTSM ARK MEDICAID | $5.00 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| FAYETTE COUNTY HOSPITAL Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $5.00 | $421.00 | $421.00 | 2026-04-08 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | MEDICAID [20240] | HB FTSM ARK MEDICAID | $5.00 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| MORRIS HOSPITAL & HEALTHCARE CENTERS Outpatient | CIGNA IFP | CIGNA IFP | $5.00 | $319.00 | $76.75 | 2026-05-07 | MRF ↗ |
| MORRIS HOSPITAL & HEALTHCARE CENTERS Outpatient | CIGNA PPO - ALL OTHER PLANS | CIGNA PPO - ALL OTHER PLANS | $5.00 | $319.00 | $76.75 | 2026-05-07 | MRF ↗ |
| WEATHERFORD REGIONAL HOSPITAL, INC OF WEATHERFORD Outpatient | CIGNA-ALL PLANS | CIGNA-ALL PLANS | $5.00 | $512.00 | $409.60 | 2026-01-05 | MRF ↗ |
| CHAMBERS MEMORIAL HOSPITAL Outpatient | CIGNA COMM - ALL OTHER PLANS | CIGNA COMM - ALL OTHER PLANS | $5.00 | $358.48 | $179.24 | 2026-05-05 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | SUMMIT COMMUNITY CARE CONTRACTED [320368] | HB ROGR SUMMIT | $5.00 | $196.00 | $127.40 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | ARKANSAS DEPARTMENT OF HEALTH [20036] | HB FTSM ARK MEDICAID | $5.00 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | ARKANSAS DEPARTMENT OF HEALTH [20036] | HB ROGR ARKANSAS MEDICAID | $5.00 | $196.00 | $127.40 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Springfield OutpatientFacility | MEDICAID [20240] | HB SPRG/JOPL ARK MEDICAID | $5.00 | $254.00 | $165.10 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL OKLAHOMA CITY, INC OutpatientFacility | MEDICAID [20240] | HB OKLC ARK MEDICAID | $5.00 | $184.00 | $119.60 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | SUMMIT COMMUNITY CARE [20368] | HB ROGR ARKANSAS MEDICAID | $5.00 | $196.00 | $127.40 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | MEDICAID [20240] | HB ROGR ARKANSAS MEDICAID | $5.00 | $196.00 | $127.40 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | SUMMIT COMMUNITY CARE [20368] | HB FTSM ARK MEDICAID | $5.00 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | ARKANSAS DEPARTMENT OF HEALTH [20036] | HB FTSM ARK MEDICAID | $5.00 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | SUMMIT COMMUNITY CARE [20368] | HB FTSM ARK MEDICAID | $5.00 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| KERN VALLEY HEALTHCARE DISTRICT Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $5.00 | $514.00 | — | 2026-02-25 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | CARESOURCE MEDICAID CONTRACTED [320460] | HB FTSM CARESOURCE MEDICAID | $5.10 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | CARESOURCE MEDICAID CONTRACTED [320460] | HB ROGR CARESOURCE MEDICAID | $5.10 | $196.00 | $127.40 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | CARESOURCE MEDICAID [20460] | HB FTSM CARESOURCE MEDICAID | $5.10 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | CARESOURCE MEDICAID CONTRACTED [320460] | HB FTSM CARESOURCE MEDICAID | $5.10 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | CARESOURCE MEDICAID [20460] | HB FTSM CARESOURCE MEDICAID | $5.10 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | CARESOURCE MEDICAID [20460] | HB ROGR CARESOURCE MEDICAID | $5.10 | $196.00 | $127.40 | 2026-03-13 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $5.45 | $526.00 | $99.94 | 2026-01-25 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | EMPOWER HEALTHCARE SOLUTIONS MEDICAID [20118] | HB FTSM PASSE EMPOWER | $6.35 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | EMPOWER HEALTHCARE SOLUTIONS MEDICAID CONTRACTED [320118] | HB ROGR PASSE EMPOWER | $6.35 | $196.00 | $127.40 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | EMPOWER HEALTHCARE SOLUTIONS MEDICAID CONTRACTED [320118] | HB FTSM PASSE EMPOWER | $6.35 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | EMPOWER HEALTHCARE SOLUTIONS MEDICAID [20118] | HB FTSM PASSE EMPOWER | $6.35 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | EMPOWER HEALTHCARE SOLUTIONS MEDICAID CONTRACTED [320118] | HB FTSM PASSE EMPOWER | $6.35 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $7.48 | $374.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $7.48 | $374.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $7.48 | $374.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $7.48 | $374.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $7.48 | $374.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $7.48 | $374.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $7.48 | $374.00 | — | 2026-03-31 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $10.90 | $779.00 | $779.00 | 2026-02-13 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | Security Health Plan | Badgercare Plus | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | Security Health Plan | Medicare Advantage | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicaid | — | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | My Choice Wisconsin, Inc. | Family Care / Family Care Partnership - Medicare | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | United Health Care | Medicare Advantage | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | Anthem BCBS | Medicaid | — | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | Security Health Plan | Badgercare Plus | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicaid | — | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | Anthem BCBS | Medicaid | — | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | My Choice Wisconsin, Inc. | Family Care / Family Care Partnership - Medicare | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | My Choice Wisconsin, Inc. | Medicaid SSI | — | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | My Choice Wisconsin, Inc. | Medicare Dual Advantage | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | Quartz Health Solutions, Inc | Medicaid/BadgerCare | — | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | My Choice Wisconsin, Inc. | Family Care / Family Care Partnership - Medicaid | — | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | United Health Care | Medicare Advantage | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | United Health Care | VA Plan | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | United Health Care | Medicaid | — | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | Anthem BCBS | Medicare Advantage | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | Security Health Plan | Medicare Advantage | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | Quartz Health Solutions, Inc | Senior Preferred | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL BothFacility | Humana | Medicare Advantage | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | Quartz Health Solutions, Inc | Medicaid/BadgerCare | — | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | Anthem BCBS | Medicare Advantage | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL BothFacility | Humana | Medicare Advantage | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | United Health Care | Medicaid | — | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | My Choice Wisconsin, Inc. | Medicare Dual Advantage | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | My Choice Wisconsin, Inc. | Family Care / Family Care Partnership - Medicaid | — | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | My Choice Wisconsin, Inc. | Medicaid SSI | — | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | Quartz Health Solutions, Inc | Senior Preferred | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL OutpatientFacility | United Health Care | VA Plan | $11.22 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| PRISMA HEALTH BAPTIST PARKRIDGE Both | MEDICAID NC-AMERIHEALTH [3225] | PH North Carolina Medicaid | $11.24 | $73.00 | $47.45 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST PARKRIDGE Both | MEDICAID NORTH CAROLINA [310] | PH North Carolina Medicaid | $11.24 | $73.00 | $47.45 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH RICHLAND HOSPITAL Both | MEDICAID NORTH CAROLINA [310] | PH North Carolina Medicaid | $11.24 | $73.00 | $47.45 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST PARKRIDGE Both | MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $11.24 | $73.00 | $47.45 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH RICHLAND HOSPITAL Both | MEDICAID NC-UHC COMMUNITY PLAN [3226] | PH North Carolina Medicaid | $11.24 | $73.00 | $47.45 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH RICHLAND HOSPITAL Both | MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $11.24 | $73.00 | $47.45 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH RICHLAND HOSPITAL Both | MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $11.24 | $73.00 | $47.45 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH RICHLAND HOSPITAL Both | MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $11.24 | $73.00 | $47.45 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH RICHLAND HOSPITAL Both | MEDICAID NC-AMERIHEALTH [3225] | PH North Carolina Medicaid | $11.24 | $73.00 | $47.45 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST PARKRIDGE Both | MEDICAID NC-UHC COMMUNITY PLAN [3226] | PH North Carolina Medicaid | $11.24 | $73.00 | $47.45 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST PARKRIDGE Both | MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $11.24 | $73.00 | $47.45 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST PARKRIDGE Both | MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $11.24 | $73.00 | $47.45 | 2026-03-01 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | ARKANSAS TOTAL CARE [20039] | HB FTSM PASSE AR TOTAL CARE | $11.35 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL FORT SMITH OutpatientFacility | ARKANSAS TOTAL CARE CONTRACTED [320039] | HB FTSM PASSE AR TOTAL CARE | $11.35 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | ARKANSAS TOTAL CARE CONTRACTED [320039] | HB ROGR PASSE AR TOTAL CARE | $11.35 | $196.00 | $127.40 | 2026-03-13 | MRF ↗ |
| MERCY HOSPITAL NORTHWEST ARKANSAS OutpatientFacility | ARKANSAS TOTAL CARE [20039] | HB ROGR PASSE AR TOTAL CARE | $11.35 | $196.00 | $127.40 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | ARKANSAS TOTAL CARE [20039] | HB FTSM PASSE AR TOTAL CARE | $11.35 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| Mercy Orthopedic Hospital Fort Smith OutpatientFacility | ARKANSAS TOTAL CARE CONTRACTED [320039] | HB FTSM PASSE AR TOTAL CARE | $11.35 | $167.00 | $108.55 | 2026-03-13 | MRF ↗ |
| GLENDALE ADVENTIST MEDICAL CENTER Outpatient | BLUE CROSS MCS - ALL OTHER PLANS | BLUE CROSS MCS - ALL OTHER PLANS | $12.54 | $186.00 | $27.90 | 2026-01-25 | MRF ↗ |
| STOUGHTON HOSPITAL Outpatient | WPS - ALL PLANS | WPS - ALL PLANS | $12.72 | $847.66 | $466.21 | 2026-01-19 | MRF ↗ |
| PENOBSCOT VALLEY HOSPITAL Outpatient | Medicare A ME JK | Default | $13.37 | $29.03 | $23.22 | 2026-04-24 | MRF ↗ |
| PENOBSCOT VALLEY HOSPITAL Outpatient | United Healthcare | Medicare Advantage | $13.37 | $29.03 | $23.22 | 2026-04-24 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL BothFacility | Corvel | Workers' Compensation | $13.42 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL BothFacility | Corvel | Automobile liability / Accident & Health | $13.42 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL BothFacility | Corvel | Workers' Compensation | $13.42 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| BLACK RIVER MEMORIAL HOSPITAL BothFacility | Corvel | Automobile liability / Accident & Health | $13.42 | $22.00 | $19.80 | 2026-01-08 | MRF ↗ |
| PENOBSCOT VALLEY HOSPITAL Outpatient | Wellcare Health Plan Inc MCR Adv | Default | $13.50 | $29.03 | $23.22 | 2026-04-24 | MRF ↗ |
| PENOBSCOT VALLEY HOSPITAL Outpatient | Humana | Medicare Advantage | $13.50 | $29.03 | $23.22 | 2026-04-24 | MRF ↗ |
| PENOBSCOT VALLEY HOSPITAL Outpatient | Aetna Medicare Advantage | Medicare Advantage | $13.64 | $29.03 | $23.22 | 2026-04-24 | MRF ↗ |
| PENOBSCOT VALLEY HOSPITAL Outpatient | VA Community Care Network VACCN Region 1-3 Optum | Default | $13.64 | $29.03 | $23.22 | 2026-04-24 | MRF ↗ |
| PENOBSCOT VALLEY HOSPITAL Outpatient | Blue Cross Blue Shield of ME Anthem | Medicare Advantage | $13.77 | $29.03 | $23.22 | 2026-04-24 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $16.00 | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLCARE MEDICARE BY ALLWELL [5506] | NMC WELLCARE PHW | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICARE [5312] | NMC HORIZON BRAVEN | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLCARE BEHAVIORAL HEALTH [5335] | NMC WELLCARE/FEDELIS MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON BCBS OUT OF STATE MEDICARE IP SPLITS [5461] | NMC HORIZON BRAVEN | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $16.00 | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH MEDICARE IP SPLITS [5471] | NMC UNITED MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH MEDICARE BEHAVIORAL [5409] | NMC UNITED MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CIGNA TOTALCARE (HMO D-SNP) [5419] | NMC CIGNA MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CARELON BEHAVIORAL HEALTH [5508] | AHS CARELON/VALUE OPTIONS BEHAVIORAL HEALTH | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HIGHMARK COMMUNITY BLUE MEDICARE [5534] | NMC HORIZON BRAVEN | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CIGNA TOTALCARE (HMO D-SNP) IP SPLITS [5465] | NMC CIGNA MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLCARE HEALTH PLANS [5269] | NMC WELLCARE/FEDELIS MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CIGNA TOTALCARE (HMO D-SNP) IP SPLITS [5465] | NMC CIGNA MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UPMC MEDICARE IP SPLITS [5484] | NMC UPMCHP CONTRACT | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO [5428] | NMC LONGEVITY | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO IP SPLITS [5467] | NMC LONGEVITY | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | COSMETIC SURGERY/LAP BAND/GASTRIC BYPASS [5289] | NMC SELF PAY | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH MEDICARE IP SPLITS [5471] | NMC UNITED MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO [5428] | NMC LONGEVITY | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | KINDRED GIRALDA HOSPITAL [5341] | NMC KINDRED | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM MEDICARE PFFS IP SPLITS [5474] | NMC HORIZON BRAVEN | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HIGHMARK WHOLECARE HEALTH PLAN IP SPLITS [5464] | NMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA MEDICARE [5003] | NMC AETNA NNJ PRIME | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO IP SPLITS [5467] | NMC LONGEVITY | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICARE [5312] | NMC HORIZON BRAVEN | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA [5002] | NMC AETNA HTC | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON BCBS OUT OF STATE MEDICARE IP SPLITS [5461] | NMC HORIZON BRAVEN | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLCARE HEALTH PLANS IP SPLITS [5475] | NMC WELLCARE/FEDELIS MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CIGNA MEDICARE [5440] | NMC CIGNA MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| MEMORIAL MEDICAL CENTER Outpatient | GALAXY HEALTH NETWORK-ALL PLANS | GALAXY HEALTH NETWORK-ALL PLANS | $16.00 | $20.00 | $14.00 | 2025-12-20 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CLAIM WATCHER/HOMESTEAD [5488] | NMC CLAIM WATCHER TIER 1 | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICARE IP SPLITS [5453] | NMC WELLPOINT MEDICARE ADVANTAGE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA MEDICARE [5003] | NMC AETNA NNJ PRIME | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA MEDICARE [5003] | NMC AETNA MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA MEDICARE IP SPLITS [5470] | NMC AETNA MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON BCBSNJ BRAVEN HEALTH IP SPLITS [5477] | NMC HORIZON BRAVEN | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICARE [5007] | NMC WELLPOINT MEDICARE ADVANTAGE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON MEDICARE BLUE IP SPLITS [5456] | NMC HORIZON BRAVEN | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AMERIHEALTH ADMINISTRATORS SUPPLEMENTAL [5512] | NMC AMERIHEALTH MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM MEDICARE PFFS [5052] | NMC HORIZON BRAVEN | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA AHS EMPLOYEE [5306] | NMC AETNA AHS EMPLOYEE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA MEDICARE IP SPLITS [5470] | NMC AETNA MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AMERIHEALTH CARITAS VIP CARE [5313] | NMC AMERIHEALTH CARITAS | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | CLAIM WATCHER/HOMESTEAD [5488] | NMC CLAIM WATCHER TIER 1 | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA CENTRASTATE EMPLOYEE [5425] | NMC AETNA HTC | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON BCBS OUT OF STATE MEDICARE [5325] | NMC HORIZON BRAVEN | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID PENDING [5302] | NMC SELF PAY | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | LUMINARE HEALTH AHS RETIREE [5013] | NMC AETNA AHS EMPLOYEE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AMERIHEALTH MEDIGAP [5049] | NMC AMERIHEALTH MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AARP MEDICARE COMP [5039] | NMC UNITED MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLCARE HEALTH PLANS IP SPLITS [5475] | NMC WELLCARE/FEDELIS MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UPMC MEDICARE [5454] | NMC UPMCHP CONTRACT | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HIGHMARK WHOLECARE HEALTH PLAN IP SPLITS [5464] | NMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UPMC [5455] | NMC UPMCHP CONTRACT | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON BCBSNJ BRAVEN HEALTH [5416] | NMC HORIZON BRAVEN | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AMERIHEALTH CARITAS VIP CARE IP SPLITS [5460] | NMC AMERIHEALTH CARITAS | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICARE [5007] | NMC WELLPOINT MEDICARE ADVANTAGE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | VA COMMUNITY CARE NETWORK [5403] | NMC VETERAN AFFAIR COMMUNITY CARE NETWORK | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICARE IP SPLITS [5476] | NMC HORIZON BRAVEN | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | HORIZON BCBSNJ BRAVEN HEALTH IP SPLITS [5477] | NMC HORIZON BRAVEN | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA MCARE SUPPLEMENTAL [5041] | NMC AETNA MEDICARE | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AMBETTER [5432] | NMC AMBETTER WELLCARE OF NJ | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UPMC [5455] | NMC UPMCHP CONTRACT | — | $238.48 | $238.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AMERIHEALTH CARITAS VIP CARE [5313] | NMC AMERIHEALTH CARITAS | — | $238.48 | $238.48 | 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.