99309 — Sbsq Nf Care Moderate Mdm 30
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). SBSQ NF CARE MODERATE MDM 30 (CPT 99309) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/99309?code_type=CPT
MLA (9th ed.)
“SBSQ NF CARE MODERATE MDM 30 (CPT 99309) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/99309?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“SBSQ NF CARE MODERATE MDM 30 (CPT 99309) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/99309?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $94–$239 (25th–75th percentile) across 1,286 hospitals · 3,823 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 99309 — 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
$94
$131 typical
$239
The middle 50% of negotiated facility rates for this procedure, measured across 1,286 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. | $131 |
| Physician fee Estimate national typical Medicare $99 × 1.22 commercial. | $120 |
| Likely subtotal | $251 |
Complete-episode estimate (typical)
~$251
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 | United Healthcare | VA CCN | — | — | — | 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 | Gilsbar 360 | All Plans | — | — | — | 2026-03-17 | 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 | Peoples Health | Medicare Enrollees | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Womans Hospital Employees | All Plans | — | — | — | 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 | Medical Cost Containment Professionals | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Three Rivers Provider Network | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | USA Managed Care Organization | 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_Aliessa and QHP | — | $298.00 | — | 2025-05-02 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Aetna | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Health Benefit Exchange | — | $298.00 | — | 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 | Louisiana Healthcare Connection | Medicaid | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | Community Coffee Group | — | — | — | 2026-03-17 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Fidelis | Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP | — | $298.00 | — | 2025-05-02 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Aetna | Better Health | — | — | — | 2026-03-17 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Excellus BCBS | Managed Medicaid _CHP_SP | — | $298.00 | — | 2025-05-02 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Humana | 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 | United Healthcare | Exchange Compass | — | — | — | 2026-03-17 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | First Choice | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | United Healthcare | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | PPOplus Llc | 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 | Vantage Health Plan Inc. | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Aetna Better Health | 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 | AmeriHealth Mercy LA LaCare | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Amerigroup | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Cigna | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Humana | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Humana | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | United | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Humana | MGMCD | — | — | — | 2026-03-01 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Cigna | PPO | — | — | — | 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 | United | CHIP | — | — | — | 2026-03-01 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Louisiana Healthcare Connections, Inc. | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| HARDTNER MEDICAL CENTER Both | United Healthcare | Default | — | $169.00 | $33.80 | 2025-01-02 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Wellcare | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | United Healthcare | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Multiplan/PHCS | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| Willis-knighton Medical Center OutpatientFacility | Bcbs | All Commercial Plans | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $0.23 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $0.23 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $0.23 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $0.23 | — | — | 2026-04-01 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $0.23 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $0.23 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $0.23 | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $0.23 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $0.23 | — | — | 2026-04-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $1.17 | $164.00 | $123.00 | 2025-03-07 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $2.00 | $191.85 | $191.85 | 2026-04-24 | MRF ↗ |
| COMANCHE COUNTY MEDICAL CENTER Outpatient | MPI - ALL PLANS | MPI - ALL PLANS | $2.39 | $288.00 | $187.20 | 2026-05-07 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $2.57 | $164.00 | $31.16 | 2026-01-25 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $3.61 | $180.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $3.61 | $180.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $3.61 | $180.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $3.61 | $180.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $3.61 | $180.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $3.61 | $180.50 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $3.61 | $180.50 | — | 2026-03-31 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $5.14 | $227.00 | $227.00 | 2026-02-13 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $6.12 | $306.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $6.12 | $306.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $6.12 | $306.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $6.12 | $306.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $6.12 | $306.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $6.12 | $306.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $6.12 | $306.00 | — | 2026-03-31 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $6.81 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $6.81 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $6.81 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $6.81 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $6.81 | $101.48 | $101.48 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $6.81 | $101.48 | $101.48 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN [5034] | NMC UNITED HEALTH COMMUNITY | $7.49 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN BEHAVIORAL HEALTH [5293] | NMC UNITED HEALTH COMMUNITY | $7.49 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN [5034] | NMC UNITED HEALTH COMMUNITY | $7.49 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN BEHAVIORAL HEALTH [5293] | NMC UNITED HEALTH COMMUNITY | $7.49 | $101.48 | $101.48 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN BEHAVIORAL HEALTH [5293] | NMC UNITED HEALTH COMMUNITY | $7.49 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN [5034] | NMC UNITED HEALTH COMMUNITY | $7.49 | $101.48 | $101.48 | 2026-04-01 | MRF ↗ |
| WEST CARROLL MEMORIAL HOSPITAL Inpatient | CIGNA HEALTH AND LIFE INSURANCE COMPANY | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7.67 | $219.00 | — | 2026-03-26 | MRF ↗ |
| WEST CARROLL MEMORIAL HOSPITAL Inpatient | CIGNA HEALTH AND LIFE INSURANCE COMPANY | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7.67 | $219.00 | — | 2026-03-26 | MRF ↗ |
| THE PHYSICIANS' HOSPITAL IN ANADARKO Inpatient | Medicaid | Traditional | — | $534.48 | $320.69 | 2026-03-23 | MRF ↗ |
| RURAL WELLNESS FAIRFAX HOSPITAL Inpatient | Medicaid | Traditional | — | $534.48 | $320.69 | 2026-03-23 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FIDELIS CARE MEDICAID [5509] | NMC FEDELIS CARE MANAGED MEDICAID | $7.83 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICAID [5006] | NMC WELLPOINT MANAGED MEDICAID | $7.83 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICAID [5006] | NMC WELLPOINT MANAGED MEDICAID | $7.83 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FIDELIS CARE MEDICAID [5509] | NMC FEDELIS CARE MANAGED MEDICAID | $7.83 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FIDELIS CARE MEDICAID [5509] | NMC FEDELIS CARE MANAGED MEDICAID | $7.83 | $101.48 | $101.48 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICAID [5006] | NMC WELLPOINT MANAGED MEDICAID | $7.83 | $101.48 | $101.48 | 2026-04-01 | MRF ↗ |
| RURAL WELLNESS STROUD HOSPITAL Inpatient | Medicaid | Traditional | — | $534.48 | $320.69 | 2026-03-23 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA BETTER HEALTH [5005] | NMC AETNA BETTER HEALTH | $8.17 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA BETTER HEALTH [5005] | NMC AETNA BETTER HEALTH | $8.17 | $101.48 | $101.48 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA BETTER HEALTH [5005] | NMC AETNA BETTER HEALTH | $8.17 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH CARITAS VIP CARE [5313] | HMC AMERIHEALTH CARITAS | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | VA COMMUNITY CARE NETWORK [5403] | HMC VETERAN AFFAIRS COMMUNITY CARE NETWORK | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM MEDICARE PFFS [5052] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE [5035] | HMC UNITED MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE [5035] | HMC UNITED MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH CARITAS VIP CARE [5313] | HMC AMERIHEALTH CARITAS | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM MEDICARE PFFS [5052] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMBETTER [5432] | HMC AMBETTER WELLCARE OF NJ | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMBETTER [5432] | HMC AMBETTER WELLCARE OF NJ | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH MEDIGAP [5049] | HMC AMERIHEALTH MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MCARE SUPPLEMENTAL [5041] | HMC AETNA MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MCARE SUPPLEMENTAL [5041] | HMC AETNA MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH MEDIGAP [5049] | HMC AMERIHEALTH MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC [5455] | HMC UPMCHP CONTRACT | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE [5003] | HMC AETNA MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CLAIM WATCHER/HOMESTEAD [5488] | HMC CLAIM WATCHER TIER 1 | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE [5003] | HMC AETNA MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE [5003] | HMC AETNA NNJ PRIME | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CARELON BEHAVIORAL HEALTH [5508] | AHS CARELON/VALUE OPTIONS BEHAVIORAL HEALTH | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO [5428] | HMC LONGEVITY | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE IP SPLITS [5471] | HMC UNITED MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE HEALTH PLANS [5269] | HMC WELLCARE/FEDELIS MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICAID [5511] | HMC MEDICAID | $9.79 | $101.48 | $101.48 | 2026-04-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | FAIROS [5491] | HMC FAIROS | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE HEALTH PLANS [5269] | HMC WELLCARE/FEDELIS MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CLAIM WATCHER/HOMESTEAD [5488] | HMC CLAIM WATCHER TIER 1 | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC [5455] | HMC UPMCHP CONTRACT | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO [5428] | HMC LONGEVITY | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE [5003] | HMC AETNA NNJ PRIME | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK COMMUNITY BLUE MEDICARE [5534] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK COMMUNITY BLUE MEDICARE [5534] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK WHOLECARE HEALTH PLAN IP SPLITS [5464] | HMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE IP SPLITS [5471] | HMC UNITED MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH CARITAS VIP CARE IP SPLITS [5460] | HMC AMERIHEALTH CARITAS | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | VA COMMUNITY CARE NETWORK [5403] | HMC VETERAN AFFAIRS COMMUNITY CARE NETWORK | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC MEDICARE IP SPLITS [5484] | HMC UPMCHP CONTRACT | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC MEDICARE IP SPLITS [5484] | HMC UPMCHP CONTRACT | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBSNJ BRAVEN HEALTH [5416] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBS OUT OF STATE MEDICARE IP SPLITS [5461] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE BEHAVIORAL HEALTH [5335] | HMC WELLCARE/FEDELIS MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBS OUT OF STATE MEDICARE IP SPLITS [5461] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBSNJ BRAVEN HEALTH [5416] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA ASSURE PREMIER PLUS [5422] | HMC AETNA MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK WHOLECARE HEALTH PLAN [5413] | HMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICARE [5312] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO IP SPLITS [5467] | HMC LONGEVITY | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO IP SPLITS [5467] | HMC LONGEVITY | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICARE [5312] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC MEDICARE [5454] | HMC UPMCHP CONTRACT | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC MEDICARE [5454] | HMC UPMCHP CONTRACT | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA [5002] | HMC AETNA HTC | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA MEDICARE IP SPLITS [5478] | HMC CIGNA MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBSNJ BRAVEN HEALTH IP SPLITS [5477] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA MEDICARE IP SPLITS [5478] | HMC CIGNA MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLPOINT MANAGED MEDICARE [5007] | HMC WELLPOINT MEDICARE ADVANTAGE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBSNJ BRAVEN HEALTH IP SPLITS [5477] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | SPECIALTY IMAGING [5433] | HMC SELF PAY | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | TRICARE [5251] | HMC TRICARE CONTRACT | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA CENTRASTATE EMPLOYEE [5425] | HMC AETNA HTC | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBS OUT OF STATE MEDICARE [5325] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | TRICARE [5251] | HMC TRICARE-EAST (HUMANA MILITARY) | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | KAREN ANN QUINLAN [5285] | HMC KAREN ANN QUINLAN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE BEHAVIORAL [5409] | HMC UNITED MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE BEHAVIORAL [5409] | HMC UNITED MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA MEDICARE [5440] | HMC CIGNA MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICARE IP SPLITS [5476] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | KINDRED GIRALDA HOSPITAL [5341] | HMC KINDRED | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICAID [5511] | HMC MEDICAID | $9.79 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA MEDICARE [5440] | HMC CIGNA MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE BEHAVIORAL HEALTH [5335] | HMC WELLCARE/FEDELIS MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | KAREN ANN QUINLAN [5285] | HMC KAREN ANN QUINLAN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON MEDICARE BLUE IP SPLITS [5456] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA ASSURE PREMIER PLUS [5422] | HMC AETNA MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA AHS EMPLOYEE [5306] | HMC AETNA AHS EMPLOYEE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK WHOLECARE HEALTH PLAN [5413] | HMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA AHS EMPLOYEE [5306] | HMC AETNA AHS EMPLOYEE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | MEDICAID [5022] | HMC MEDICAID | $9.79 | $101.48 | $101.48 | 2026-04-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE HEALTH PLANS IP SPLITS [5475] | HMC WELLCARE/FEDELIS MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE HEALTH PLANS IP SPLITS [5475] | HMC WELLCARE/FEDELIS MEDICARE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | US FAMILY HEALTH PLAN [5258] | HMC TRICARE CONTRACT | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | MEDICAID [5022] | HMC MEDICAID | $9.79 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLPOINT MANAGED MEDICARE IP SPLITS [5453] | HMC WELLPOINT MEDICARE ADVANTAGE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | MEDICAID [5022] | HMC MEDICAID | $9.79 | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE MEDICARE BY ALLWELL [5506] | HMC WELLCARE PHW | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICARE IP SPLITS [5476] | HMC HORIZON BRAVEN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CLAIMDOC [5434] | HMC CLAIMDOC PLAN | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | KINDRED GIRALDA HOSPITAL [5341] | HMC KINDRED | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CHAMPVA [5354] | HMC TRICARE CONTRACT | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | US FAMILY HEALTH PLAN [5258] | HMC TRICARE CONTRACT | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLPOINT MANAGED MEDICARE IP SPLITS [5453] | HMC WELLPOINT MEDICARE ADVANTAGE | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH CARITAS VIP CARE IP SPLITS [5460] | HMC AMERIHEALTH CARITAS | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE MEDICARE BY ALLWELL [5506] | HMC WELLCARE PHW | — | $101.48 | $101.48 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA ASSURE PREMIER PLUS IP SPLITS [5466] | HMC AETNA MEDICARE | — | $101.48 | $101.48 | 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.