99305 — 1st Nf Care Moderate Mdm 35
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). 1ST NF CARE MODERATE MDM 35 (HCPCS 99305) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/99305?code_type=HCPCS
MLA (9th ed.)
“1ST NF CARE MODERATE MDM 35 (HCPCS 99305) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/99305?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“1ST NF CARE MODERATE MDM 35 (HCPCS 99305) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/99305?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $122–$262 (25th–75th percentile) across 1,592 hospitals · 3,768 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 99305 — 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
$122
$162 typical
$262
The middle 50% of negotiated facility rates for this procedure, measured across 1,592 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. | $162 |
| Physician fee Estimate national typical Medicare $120 × 1.22 commercial. | $146 |
| Likely subtotal | $308 |
Complete-episode estimate (typical)
~$308
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 $122–$262.
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 | USA Managed Care Organization | All Plans | — | — | — | 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 | Gilsbar 360 | All Plans | — | — | — | 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 | Amerihealth Caritas | Medicaid | — | — | — | 2026-03-17 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Fidelis | Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP | — | $427.00 | — | 2025-05-02 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Medical Cost Containment Professionals | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Excellus BCBS | Managed Medicaid _CHP_SP | — | $427.00 | — | 2025-05-02 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Three Rivers Provider Network | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Health Benefit Exchange | — | $427.00 | — | 2025-05-02 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Cigna of LA | All Plans | — | — | — | 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 | Humana | All Plans | — | — | — | 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 | Womans Hospital Employees | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Managed Medicaid_Aliessa and QHP | — | $427.00 | — | 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 | First Health | Aetna Medical Rental Network | — | — | — | 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 | Aetna | Better Health | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | Exchange Compass | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | — | — | — | 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 | Louisiana Healthcare Connection | Medicaid | — | — | — | 2026-03-17 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Cigna | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Humana | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | AmeriHealth Mercy LA LaCare | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Wellcare | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Vantage Health Plan Inc. | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | United | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | United Healthcare | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | First Choice | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| HARDTNER MEDICAL CENTER Both | United Healthcare | Default | — | $225.00 | $45.00 | 2025-01-02 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | PPOplus Llc | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Cigna | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Amerigroup | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Louisiana Healthcare Connections, Inc. | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Multiplan/PHCS | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | PPOplus Llc | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Multiplan/PHCS | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | First Choice | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Aetna Better Health | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Humana | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | United | CHIP | — | — | — | 2026-03-01 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Wellcare | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Vantage Health Plan Inc. | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Humana | MGMCD | — | — | — | 2026-03-01 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | United Healthcare | Commercial | — | — | — | 2026-03-05 | 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 ↗ |
| 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 | 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 ↗ |
| 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 ↗ |
| 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 ↗ |
| 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 ↗ |
| ST MARY'S 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 | BCBS PREFERRED BLUE PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-02 | 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 | UNITED HEALTHCARE | UNITED HEALTHCARE NEW MEXICO MEDICAID | $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 ↗ |
| 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 ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $1.31 | $162.00 | $121.50 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $1.31 | $162.00 | $121.50 | 2025-03-07 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $2.84 | $273.45 | $273.45 | 2026-04-24 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $3.65 | $328.00 | $62.32 | 2026-08-02 | MRF ↗ |
| WALLOWA MEMORIAL HOSPITAL Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $3.65 | $361.00 | $361.00 | 2026-07-09 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $3.65 | $202.00 | $38.38 | 2026-01-25 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $3.71 | — | — | 2026-07-15 | MRF ↗ |
| BAXTER HEALTH FULTON COUNTY HOSPITAL Outpatient | Medicaid Arkansas | Default | $5.00 | $246.00 | $172.20 | 2026-07-15 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $5.20 | $260.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $5.20 | $260.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $5.20 | $260.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $5.20 | $260.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $5.20 | $260.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $5.20 | $260.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $5.20 | $260.00 | — | 2026-03-31 | MRF ↗ |
| STOUGHTON HOSPITAL Outpatient | WPS - ALL PLANS | WPS - ALL PLANS | $5.39 | $460.62 | $253.34 | 2026-01-19 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $5.64 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $5.64 | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $5.64 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $5.64 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $5.64 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $5.64 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $5.64 | — | — | 2026-04-01 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $5.64 | — | — | 2026-04-01 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $7.30 | $317.00 | $317.00 | 2026-06-03 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $7.30 | $317.00 | $317.00 | 2026-02-13 | MRF ↗ |
| MOAB REGIONAL HOSPITAL Both | Humana | Default | $8.64 | $166.00 | $101.26 | 2026-07-15 | MRF ↗ |
| RURAL WELLNESS FAIRFAX HOSPITAL Outpatient | Medicaid | Traditional | — | $718.59 | $431.15 | 2026-03-23 | MRF ↗ |
| THE PHYSICIANS' HOSPITAL IN ANADARKO Outpatient | Medicaid | Traditional | — | $718.59 | $431.15 | 2026-03-23 | MRF ↗ |
| RURAL WELLNESS STROUD HOSPITAL Outpatient | Medicaid | Traditional | — | $718.59 | $431.15 | 2026-03-23 | MRF ↗ |
| THE PHYSICIANS' HOSPITAL IN ANADARKO Outpatient | Humana | Medicare Advantage | — | $718.59 | $431.15 | 2026-03-23 | MRF ↗ |
| READING HOSPITAL Inpatient | Geisinger | All Commercial Plans | $13.87 | $285.00 | $199.50 | 2026-07-15 | MRF ↗ |
| RURAL WELLNESS STROUD HOSPITAL Outpatient | Aetna Better Health | Medicaid | — | $718.59 | $431.15 | 2026-03-23 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL Both | BCBS [800] | PHU HB UPSTATE BLUE EXCHANGE REEDY - OMH | $15.16 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| Taylor Regional Hospital OutpatientFacility | BCBS HEALTHCARE PLAN OF GA | Medicaid | $17.49 | $170.00 | $170.00 | 2026-01-01 | MRF ↗ |
| COLUMBIA MEMORIAL HOSPITAL BothFacility | WASHINGTON STATE DSHS - Medicaid | WASHINGTON STATE DSHS - Medicaid | $17.90 | $117.00 | $93.60 | 2026-01-05 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL Both | BCBS [800] | PHU HB BLUES EXCHANGE OCONEE | $18.07 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL Both | BLUECHOICE [810] | PHU HB BLUES EXCHANGE OCONEE | $18.07 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| MERCY HOSPITAL LINCOLN OutpatientFacility | MOLINA HEALTHCARE MEDICAID CONTRACTED [320265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $18.85 | $290.00 | $188.50 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL LINCOLN OutpatientFacility | MOLINA HEALTHCARE MEDICAID [20265] | HB WASH JEFN LINC SAMC MOLINA HEALTHCHOICE OF IL MEDICAID NEW 040125 | $18.85 | $290.00 | $188.50 | 2026-03-12 | MRF ↗ |
| MERCY HOSPITAL LINCOLN OutpatientFacility | MERIDIAN MEDICAID CONTRACTED [320430] | HB WASH JEFN LINC SAMC MERIDIAN HEALTH PLAN OF IL MEDICAID 103% | $18.85 | $290.00 | $188.50 | 2026-03-12 | MRF ↗ |
| BIENVILLE MEDICAL CENTER Inpatient | MMD AETNA BETTER HLTH | MCD AETNA OP | $19.07 | $325.00 | $195.00 | 2025-12-04 | MRF ↗ |
| BIENVILLE MEDICAL CENTER Inpatient | MMD HEALTHY BLUE | MCD HEALTHY BLUE IP | $19.07 | $325.00 | $195.00 | 2025-12-04 | MRF ↗ |
| BIENVILLE MEDICAL CENTER Inpatient | MMD UHC | MCD UHC OP | $19.07 | $325.00 | $195.00 | 2025-12-04 | MRF ↗ |
| BIENVILLE MEDICAL CENTER Inpatient | MMD HEALTHY BLUE | MCD HEALTHY BLUE OP | $19.07 | $325.00 | $195.00 | 2025-12-04 | MRF ↗ |
| BIENVILLE MEDICAL CENTER Inpatient | MMD UHC | MCD UHC IP | $19.07 | $325.00 | $195.00 | 2025-12-04 | MRF ↗ |
| BIENVILLE MEDICAL CENTER Inpatient | MMD MISC | MCD MISC OP | $19.07 | $325.00 | $195.00 | 2025-12-04 | MRF ↗ |
| BIENVILLE MEDICAL CENTER Inpatient | MMD MISC | MCD MISC IP | $19.07 | $325.00 | $195.00 | 2025-12-04 | MRF ↗ |
| BIENVILLE MEDICAL CENTER Inpatient | MMD AMERIHEALTH CARITAS | MCD AMERIHEALTH IP | $19.07 | $325.00 | $195.00 | 2025-12-04 | MRF ↗ |
| BIENVILLE MEDICAL CENTER Inpatient | MMD AMERIHEALTH CARITAS | MCD AMERIHEALTH OP | $19.07 | $325.00 | $195.00 | 2025-12-04 | MRF ↗ |
| BIENVILLE MEDICAL CENTER Inpatient | MMD LA HLTH CONN | MCD LHC IP | $19.07 | $325.00 | $195.00 | 2025-12-04 | MRF ↗ |
| BIENVILLE MEDICAL CENTER Inpatient | MEDICAID LA | MEDICAID IP | $19.07 | $325.00 | $195.00 | 2025-12-04 | MRF ↗ |
| BIENVILLE MEDICAL CENTER Inpatient | MEDICAID LA | MEDICAID OP | $19.07 | $325.00 | $195.00 | 2025-12-04 | MRF ↗ |
| BIENVILLE MEDICAL CENTER Inpatient | MMD LA HLTH CONN | MCD LHC OP | $19.07 | $325.00 | $195.00 | 2025-12-04 | MRF ↗ |
| BIENVILLE MEDICAL CENTER Inpatient | MMD AETNA BETTER HLTH | MCD AETNA IP | $19.07 | $325.00 | $195.00 | 2025-12-04 | MRF ↗ |
| PRISMA HEALTH TUOMEY HOSPITAL Both | BLUECHOICE [810] | PHM HB BLUES EXCHANGE - TUOMEY | $19.08 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH TUOMEY HOSPITAL Both | BCBS [800] | PHM HB BLUES EXCHANGE - TUOMEY | $19.08 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL Both | MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $19.46 | $126.37 | $39.17 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL Both | MEDICAID NC-AMERIHEALTH [3225] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL Both | MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $19.46 | $126.37 | $39.17 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST EASLEY HOSPITAL Both | MEDICAID NC-AMERIHEALTH [3225] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL Both | MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| Prisma Health North Greenville Ltach Both | MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| Prisma Health North Greenville Ltach Both | MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| Prisma Health North Greenville Ltach Both | MEDICAID NC-AMERIHEALTH [3225] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| Prisma Health North Greenville Ltach Both | MEDICAID NC-UHC COMMUNITY PLAN [3226] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH TUOMEY HOSPITAL Both | MEDICAID NC-AMERIHEALTH [3225] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH LAURENS COUNTY HOSPITAL Both | MEDICAID NORTH CAROLINA [310] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| Prisma Health North Greenville Ltach Both | MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL Both | MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST PARKRIDGE Both | MEDICAID NC-UHC COMMUNITY PLAN [3226] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST Both | MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST PARKRIDGE Both | MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH PATEWOOD HOSPITAL Both | MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH LAURENS COUNTY HOSPITAL Both | MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH GREER MEMORIAL HOSPITAL Both | MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH PATEWOOD HOSPITAL Both | MEDICAID NC-AMERIHEALTH [3225] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST Both | MEDICAID NC-UHC COMMUNITY PLAN [3226] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| Prisma Health North Greenville Ltach Both | MEDICAID NORTH CAROLINA [310] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST PARKRIDGE Both | MEDICAID NORTH CAROLINA [310] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL Both | MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL Both | MEDICAID NC-UHC COMMUNITY PLAN [3226] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL Both | MEDICAID NORTH CAROLINA [310] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH RICHLAND HOSPITAL Both | MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH RICHLAND HOSPITAL Both | MEDICAID NORTH CAROLINA [310] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH RICHLAND HOSPITAL Both | MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST EASLEY HOSPITAL Both | MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH RICHLAND HOSPITAL Both | MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL Both | MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH GREER MEMORIAL HOSPITAL Both | MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH RICHLAND HOSPITAL Both | MEDICAID NC-AMERIHEALTH [3225] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH RICHLAND HOSPITAL Both | MEDICAID NC-UHC COMMUNITY PLAN [3226] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST PARKRIDGE Both | MEDICAID NC-AMERIHEALTH [3225] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH GREER MEMORIAL HOSPITAL Both | MEDICAID NC-AMERIHEALTH [3225] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH GREER MEMORIAL HOSPITAL Both | MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST EASLEY HOSPITAL Both | MEDICAID NC-UHC COMMUNITY PLAN [3226] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH GREER MEMORIAL HOSPITAL Both | MEDICAID NC-UHC COMMUNITY PLAN [3226] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST EASLEY HOSPITAL Both | MEDICAID NORTH CAROLINA [310] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST Both | MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH LAURENS COUNTY HOSPITAL Both | MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST PARKRIDGE Both | MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH TUOMEY HOSPITAL Both | MEDICAID NC-UHC COMMUNITY PLAN [3226] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH TUOMEY HOSPITAL Both | MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST Both | MEDICAID NC-AMERIHEALTH [3225] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL Both | MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL Both | MEDICAID NC-UHC COMMUNITY PLAN [3226] | PH North Carolina Medicaid | $19.46 | $126.37 | $39.17 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL Both | MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $19.46 | $126.37 | $39.17 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL Both | MEDICAID NC-AMERIHEALTH [3225] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH TUOMEY HOSPITAL Both | MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH HILLCREST HOSPITAL Both | MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH HILLCREST HOSPITAL Both | MEDICAID NORTH CAROLINA [310] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH LAURENS COUNTY HOSPITAL Both | MEDICAID NC-AMERIHEALTH [3225] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH HILLCREST HOSPITAL Both | MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH GREER MEMORIAL HOSPITAL Both | MEDICAID NORTH CAROLINA [310] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH TUOMEY HOSPITAL Both | MEDICAID NORTH CAROLINA [310] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH HILLCREST HOSPITAL Both | MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH TUOMEY HOSPITAL Both | MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST EASLEY HOSPITAL Both | MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST EASLEY HOSPITAL Both | MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH PATEWOOD HOSPITAL Both | MEDICAID NC-UHC COMMUNITY PLAN [3226] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH HILLCREST HOSPITAL Both | MEDICAID NC-UHC COMMUNITY PLAN [3226] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST PARKRIDGE Both | MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH PATEWOOD HOSPITAL Both | MEDICAID NC-CAROLINA COMPLETE [3229] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL Both | MEDICAID NORTH CAROLINA [310] | PH North Carolina Medicaid | $19.46 | $126.37 | $39.17 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH PATEWOOD HOSPITAL Both | MEDICAID NC-WELLCARE [3224] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | MRF ↗ |
| PRISMA HEALTH BAPTIST Both | MEDICAID NC-HEALTHY BLUE [3227] | PH North Carolina Medicaid | $19.46 | $126.37 | $82.14 | 2026-03-01 | 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.