99310 — Sbsq Nf Care High Mdm 45
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). SBSQ NF CARE HIGH MDM 45 (HCPCS 99310) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/99310?code_type=HCPCS
MLA (9th ed.)
“SBSQ NF CARE HIGH MDM 45 (HCPCS 99310) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/99310?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“SBSQ NF CARE HIGH MDM 45 (HCPCS 99310) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/99310?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $135–$348 (25th–75th percentile) across 1,246 hospitals · 3,466 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 99310 — 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
$135
$195 typical
$348
The middle 50% of negotiated facility rates for this procedure, measured across 1,246 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. | $195 |
| Physician fee Estimate national typical Medicare $140 × 1.22 commercial. | $171 |
| Likely subtotal | $366 |
Complete-episode estimate (typical)
~$366
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 | Health Benefit Exchange | — | $440.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Fidelis | Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP | — | $440.00 | — | 2025-05-02 | 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 | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Gilsbar 360 | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | HMO | — | — | — | 2026-03-17 | 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 | — | $440.00 | — | 2025-05-02 | 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 | — | $440.00 | — | 2025-05-02 | 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 | Humana | 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 | HS Technology | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Louisiana Healthcare Connection | Medicaid | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | VA CCN | — | — | — | 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 | USA Managed Care Organization | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Medical Cost Containment Professionals | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | Community Coffee Group | — | — | — | 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 | Amerihealth Caritas | Medicaid | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | First Health | Aetna Medical Rental Network | — | — | — | 2026-03-17 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Humana | MGMCD | — | — | — | 2026-03-01 | 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 ↗ |
| 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 | Cigna | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Humana | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Vantage Health Plan Inc. | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Multiplan/PHCS | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | United | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | AmeriHealth Mercy LA LaCare | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | United Healthcare | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Humana | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | First Choice | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Amerigroup | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Aetna Better Health | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Vantage Health Plan Inc. | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Multiplan/PHCS | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Commercial | — | — | — | 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 | Wellcare | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Cigna | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | First Choice | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| Willis-knighton Medical Center OutpatientFacility | Bcbs | All Commercial Plans | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | United Healthcare | Default | $1.59 | $246.00 | $184.50 | 2025-03-07 | MRF ↗ |
| COMANCHE COUNTY MEDICAL CENTER Outpatient | MPI - ALL PLANS | MPI - ALL PLANS | $3.52 | $426.00 | $276.90 | 2026-05-07 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $3.79 | $234.00 | $44.46 | 2026-01-25 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $3.80 | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $3.80 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $3.80 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $3.80 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $3.80 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $3.80 | — | — | 2026-04-01 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $3.80 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $3.80 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $3.80 | — | — | 2026-04-01 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $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 | MEDICAID | MEDICAID BEACON HEALTH | $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 ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $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 ↗ |
| STOUGHTON HOSPITAL Outpatient | WPS - ALL PLANS | WPS - ALL PLANS | $6.47 | $487.62 | $268.19 | 2026-01-19 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $7.50 | $375.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $7.50 | $375.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $7.50 | $375.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $7.50 | $375.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $7.50 | $375.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $7.50 | $375.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $7.50 | $375.00 | — | 2026-03-31 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $7.58 | $335.00 | $335.00 | 2026-02-13 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $10.02 | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $10.02 | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $10.02 | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $10.02 | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $10.02 | $149.34 | $149.34 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $10.02 | $149.34 | $149.34 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN BEHAVIORAL HEALTH [5293] | NMC UNITED HEALTH COMMUNITY | $11.02 | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN [5034] | NMC UNITED HEALTH COMMUNITY | $11.02 | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN BEHAVIORAL HEALTH [5293] | NMC UNITED HEALTH COMMUNITY | $11.02 | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN [5034] | NMC UNITED HEALTH COMMUNITY | $11.02 | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN [5034] | NMC UNITED HEALTH COMMUNITY | $11.02 | $149.34 | $149.34 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN BEHAVIORAL HEALTH [5293] | NMC UNITED HEALTH COMMUNITY | $11.02 | $149.34 | $149.34 | 2026-04-01 | MRF ↗ |
| THE PHYSICIANS' HOSPITAL IN ANADARKO Inpatient | Medicaid | Traditional | — | $763.47 | $458.08 | 2026-03-23 | MRF ↗ |
| RURAL WELLNESS STROUD HOSPITAL Inpatient | Medicaid | Traditional | — | $763.47 | $458.08 | 2026-03-23 | MRF ↗ |
| RURAL WELLNESS FAIRFAX HOSPITAL Inpatient | Medicaid | Traditional | — | $763.47 | $458.08 | 2026-03-23 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FIDELIS CARE MEDICAID [5509] | NMC FEDELIS CARE MANAGED MEDICAID | $11.53 | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICAID [5006] | NMC WELLPOINT MANAGED MEDICAID | $11.53 | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICAID [5006] | NMC WELLPOINT MANAGED MEDICAID | $11.53 | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FIDELIS CARE MEDICAID [5509] | NMC FEDELIS CARE MANAGED MEDICAID | $11.53 | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICAID [5006] | NMC WELLPOINT MANAGED MEDICAID | $11.53 | $149.34 | $149.34 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FIDELIS CARE MEDICAID [5509] | NMC FEDELIS CARE MANAGED MEDICAID | $11.53 | $149.34 | $149.34 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA BETTER HEALTH [5005] | NMC AETNA BETTER HEALTH | $12.02 | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA BETTER HEALTH [5005] | NMC AETNA BETTER HEALTH | $12.02 | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA BETTER HEALTH [5005] | NMC AETNA BETTER HEALTH | $12.02 | $149.34 | $149.34 | 2026-04-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE [5035] | HMC UNITED MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE [5035] | HMC UNITED MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH CARITAS VIP CARE [5313] | HMC AMERIHEALTH CARITAS | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC [5455] | HMC UPMCHP CONTRACT | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE BEHAVIORAL [5409] | HMC UNITED MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMBETTER [5432] | HMC AMBETTER WELLCARE OF NJ | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC [5455] | HMC UPMCHP CONTRACT | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBS OUT OF STATE MEDICARE IP SPLITS [5461] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC MEDICARE IP SPLITS [5484] | HMC UPMCHP CONTRACT | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE [5003] | HMC AETNA NNJ PRIME | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE IP SPLITS [5470] | HMC AETNA MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE HEALTH PLANS IP SPLITS [5475] | HMC WELLCARE/FEDELIS MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBS OUT OF STATE MEDICARE IP SPLITS [5461] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC MEDICARE IP SPLITS [5484] | HMC UPMCHP CONTRACT | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC MEDICARE [5454] | HMC UPMCHP CONTRACT | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA ASSURE PREMIER PLUS [5422] | HMC AETNA MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMBETTER [5432] | HMC AMBETTER WELLCARE OF NJ | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH CARITAS VIP CARE [5313] | HMC AMERIHEALTH CARITAS | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH MEDIGAP [5049] | HMC AMERIHEALTH MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE BEHAVIORAL [5409] | HMC UNITED MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE IP SPLITS [5471] | HMC UNITED MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH MEDIGAP [5049] | HMC AMERIHEALTH MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH CARITAS VIP CARE IP SPLITS [5460] | HMC AMERIHEALTH CARITAS | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK WHOLECARE HEALTH PLAN [5413] | HMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICARE [5312] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK WHOLECARE HEALTH PLAN IP SPLITS [5464] | HMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK WHOLECARE HEALTH PLAN IP SPLITS [5464] | HMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA ASSURE PREMIER PLUS [5422] | HMC AETNA MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA ASSURE PREMIER PLUS IP SPLITS [5466] | HMC AETNA MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CLAIMDOC [5434] | HMC CLAIMDOC PLAN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK WHOLECARE HEALTH PLAN [5413] | HMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICARE [5312] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | KAREN ANN QUINLAN [5285] | HMC KAREN ANN QUINLAN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA ASSURE PREMIER PLUS IP SPLITS [5466] | HMC AETNA MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO IP SPLITS [5467] | HMC LONGEVITY | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE HEALTH PLANS IP SPLITS [5475] | HMC WELLCARE/FEDELIS MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CLAIMDOC [5434] | HMC CLAIMDOC PLAN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE IP SPLITS [5470] | HMC AETNA MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | KAREN ANN QUINLAN [5285] | HMC KAREN ANN QUINLAN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA [5002] | HMC AETNA HTC | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO IP SPLITS [5467] | HMC LONGEVITY | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CARELON BEHAVIORAL HEALTH [5508] | AHS CARELON/VALUE OPTIONS BEHAVIORAL HEALTH | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC MEDICARE [5454] | HMC UPMCHP CONTRACT | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO [5428] | HMC LONGEVITY | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | TRICARE [5251] | HMC TRICARE CONTRACT | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | LONGEVITY MEDICARE ADVANTAGE HMO [5428] | HMC LONGEVITY | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | TRICARE [5251] | HMC TRICARE-EAST (HUMANA MILITARY) | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBSNJ BRAVEN HEALTH IP SPLITS [5477] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBS OUT OF STATE MEDICARE [5325] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | TRICARE [5251] | HMC TRICARE CONTRACT | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBSNJ BRAVEN HEALTH [5416] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UNTD HLTH MEDICARE IP SPLITS [5471] | HMC UNITED MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLPOINT MANAGED MEDICARE [5007] | HMC WELLPOINT MEDICARE ADVANTAGE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBSNJ BRAVEN HEALTH IP SPLITS [5477] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CHAMPVA [5354] | HMC TRICARE CONTRACT | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLPOINT MANAGED MEDICARE [5007] | HMC WELLPOINT MEDICARE ADVANTAGE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | US FAMILY HEALTH PLAN [5258] | HMC TRICARE CONTRACT | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | MEDICAID PENDING [5302] | HMC SELF PAY | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | LUMINARE HEALTH AHS RETIREE [5013] | HMC AETNA AHS EMPLOYEE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | SEDGWICK WTC HEALTH PROGRAM WC [5514] | HMC PRIME HEALTH SERVICES | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AARP MEDICARE COMP [5039] | HMC UNITED MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | US FAMILY HEALTH PLAN [5258] | HMC TRICARE CONTRACT | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CARELON BEHAVIORAL HEALTH [5508] | AHS CARELON/VALUE OPTIONS BEHAVIORAL HEALTH | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | COSMETIC SURGERY/LAP BAND/GASTRIC BYPASS [5289] | HMC SELF PAY | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | MEDICAID PENDING [5302] | HMC SELF PAY | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM MEDICARE PFFS IP SPLITS [5474] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | COSMETIC SURGERY/LAP BAND/GASTRIC BYPASS [5289] | HMC SELF PAY | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AARP MEDICARE COMP [5039] | HMC UNITED MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA TOTALCARE (HMO D-SNP) IP SPLITS [5465] | HMC CIGNA MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CHAMPVA [5354] | HMC TRICARE CONTRACT | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM MEDICARE PFFS IP SPLITS [5474] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | SEDGWICK WTC HEALTH PROGRAM WC [5514] | HMC PRIME HEALTH SERVICES | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | TRICARE [5251] | HMC TRICARE-EAST (HUMANA MILITARY) | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE HEALTH PLANS [5269] | HMC WELLCARE/FEDELIS MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBSNJ BRAVEN HEALTH [5416] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK COMMUNITY BLUE MEDICARE [5534] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBS OUT OF STATE MEDICARE [5325] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA TOTALCARE (HMO D-SNP) IP SPLITS [5465] | HMC CIGNA MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM MEDICARE PFFS [5052] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM MEDICARE PFFS [5052] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH ADMINISTRATORS SUPPLEMENTAL [5512] | HMC AMERIHEALTH MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH ADMINISTRATORS SUPPLEMENTAL [5512] | HMC AMERIHEALTH MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA TOTALCARE (HMO D-SNP) [5419] | HMC CIGNA MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | VA COMMUNITY CARE NETWORK [5403] | HMC VETERAN AFFAIRS COMMUNITY CARE NETWORK | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON MEDICARE BLUE IP SPLITS [5456] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICAID [5511] | HMC MEDICAID | $14.41 | $149.34 | $149.34 | 2026-04-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA TOTALCARE (HMO D-SNP) [5419] | HMC CIGNA MEDICARE | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM BCBSNY MEDICARE IP SPLITS [5476] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA CENTRASTATE EMPLOYEE [5425] | HMC AETNA HTC | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | SPECIALTY IMAGING [5433] | HMC SELF PAY | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON MEDICARE BLUE IP SPLITS [5456] | HMC HORIZON BRAVEN | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | VA COMMUNITY CARE NETWORK [5403] | HMC VETERAN AFFAIRS COMMUNITY CARE NETWORK | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | SPECIALTY IMAGING [5433] | HMC SELF PAY | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | FAIROS [5491] | HMC FAIROS | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CLAIM WATCHER/HOMESTEAD [5488] | HMC CLAIM WATCHER TIER 1 | — | $149.34 | $149.34 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | MEDICAID [5022] | HMC MEDICAID | $14.41 | $149.34 | $149.34 | 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.