99345 — Home/res Vst New High Mdm 75
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). HOME/RES VST NEW HIGH MDM 75 (HCPCS 99345) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/99345?code_type=HCPCS
MLA (9th ed.)
“HOME/RES VST NEW HIGH MDM 75 (HCPCS 99345) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/99345?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“HOME/RES VST NEW HIGH MDM 75 (HCPCS 99345) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/99345?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $192–$500 (25th–75th percentile) across 1,155 hospitals · 2,463 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 99345 — 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
$192
$251 typical
$500
The middle 50% of negotiated facility rates for this procedure, measured across 1,155 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. | $251 |
| Physician fee Estimate national typical Medicare $210 × 1.22 commercial. | $256 |
| Likely subtotal | $508 |
Complete-episode estimate (typical)
~$508
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 $192–$500.
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 | Community Plan | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | VA CCN | — | — | — | 2026-03-17 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Excellus BCBS | Managed Medicaid _CHP_SP | — | $732.00 | — | 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 | Humana | 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 | HS Technology | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Louisiana Healthcare Connection | Medicaid | — | — | — | 2026-03-17 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Fidelis | Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP | — | $732.00 | — | 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 | Cigna of LA | 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 | Aetna | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Health Benefit Exchange | — | $732.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Managed Medicaid_Aliessa and QHP | — | $732.00 | — | 2025-05-02 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Amerihealth Caritas | Medicaid | — | — | — | 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 | Peoples Health | Medicare Enrollees | — | — | — | 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 | Aetna | Medicare Advantage | — | — | — | 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 | Better Health | — | — | — | 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 | USA Managed Care Organization | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Humana | MGMCD | — | — | — | 2026-03-01 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Vantage Health Plan Inc. | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Wellcare | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Amerigroup | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | United | 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 | Humana | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | United | CHIP | — | — | — | 2026-03-01 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | AmeriHealth Mercy LA LaCare | MCD | — | — | — | 2026-03-01 | 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 ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | PPOplus Llc | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Cigna | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | First Choice | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Louisiana Healthcare Connections, Inc. | MCD | — | — | — | 2026-03-01 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Medicare Advantage | — | — | — | 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 ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Humana | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| RAPIDES REGIONAL MEDICAL CENTER Outpatient | Aetna Better Health | MCD | — | — | — | 2026-03-01 | 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 | First Choice | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE EXCHANGE HIX | $0.23 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE 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 ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.49 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $0.60 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW MEXICO MEDICAID | $1.00 | — | — | 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 ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $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 ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW MEXICO MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS STATE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $6.27 | $494.00 | $93.86 | 2026-05-20 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $6.32 | — | — | 2026-07-15 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $12.54 | $479.00 | $479.00 | 2026-06-03 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $12.54 | $479.00 | $479.00 | 2026-02-13 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $14.95 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $14.95 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - HAZLETON Outpatient | UNITED HEALTHCARE | CHIP | $14.95 | — | — | 2025-08-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | UNITED HEALTHCARE | CHIP | $14.95 | — | — | 2025-08-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | UNITED HEALTHCARE | CHIP | $15.34 | — | — | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $15.34 | — | — | 2026-07-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | UNITED HEALTHCARE | MANAGED MEDICAID | $15.99 | — | — | 2025-08-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $16.47 | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $16.47 | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $16.47 | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $16.47 | $245.44 | $245.44 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | ANTHEM BCBSNY MEDICAID [5511] | NMC MEDICAID | $16.47 | $245.44 | $245.44 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | MEDICAID [5022] | NMC MEDICAID | $16.47 | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $16.89 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $16.89 | — | — | 2026-04-01 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $16.89 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $16.89 | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $16.89 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $16.89 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $16.89 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $16.89 | — | — | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN BEHAVIORAL HEALTH [5293] | NMC UNITED HEALTH COMMUNITY | $18.11 | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN BEHAVIORAL HEALTH [5293] | NMC UNITED HEALTH COMMUNITY | $18.11 | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN [5034] | NMC UNITED HEALTH COMMUNITY | $18.11 | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN [5034] | NMC UNITED HEALTH COMMUNITY | $18.11 | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN [5034] | NMC UNITED HEALTH COMMUNITY | $18.11 | $245.44 | $245.44 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | UNTD HLTH COMMUNITY PLAN BEHAVIORAL HEALTH [5293] | NMC UNITED HEALTH COMMUNITY | $18.11 | $245.44 | $245.44 | 2026-04-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL Outpatient | UNITED HEALTHCARE | CHIP | $18.20 | — | — | 2025-08-01 | MRF ↗ |
| BERGEN NEW BRIDGE MEDICAL CENTER OutpatientFacility | HORIZON BCBS | DEVELOPMENTAL DISABILITIES | $18.23 | — | — | 2025-12-29 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICAID [5006] | NMC WELLPOINT MANAGED MEDICAID | $18.95 | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICAID [5006] | NMC WELLPOINT MANAGED MEDICAID | $18.95 | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FIDELIS CARE MEDICAID [5509] | NMC FEDELIS CARE MANAGED MEDICAID | $18.95 | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FIDELIS CARE MEDICAID [5509] | NMC FEDELIS CARE MANAGED MEDICAID | $18.95 | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | FIDELIS CARE MEDICAID [5509] | NMC FEDELIS CARE MANAGED MEDICAID | $18.95 | $245.44 | $245.44 | 2026-04-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | WELLPOINT MANAGED MEDICAID [5006] | NMC WELLPOINT MANAGED MEDICAID | $18.95 | $245.44 | $245.44 | 2026-04-01 | MRF ↗ |
| WINNMED Outpatient | AETNA/FIRST HEALTH PPO-ALL OTHER PLANS | AETNA/FIRST HEALTH PPO-ALL OTHER PLANS | $19.59 | $580.00 | $406.00 | 2026-07-14 | MRF ↗ |
| WINNMED Outpatient | AETNA/FIRST HEALTH HMO | AETNA/FIRST HEALTH HMO | $19.59 | $580.00 | $406.00 | 2026-07-14 | MRF ↗ |
| WINNMED Outpatient | AETNA/FIRST HEALTH PHO | AETNA/FIRST HEALTH PHO | $19.59 | $580.00 | $406.00 | 2026-07-14 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA BETTER HEALTH [5005] | NMC AETNA BETTER HEALTH | $19.76 | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA BETTER HEALTH [5005] | NMC AETNA BETTER HEALTH | $19.76 | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| NEWTON MEDICAL CENTER Outpatient | AETNA BETTER HEALTH [5005] | NMC AETNA BETTER HEALTH | $19.76 | $245.44 | $245.44 | 2026-04-01 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | United Healthcare | United Healthcare CHIP | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | United Healthcare | United Healthcare Medicaid | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | United Healthcare | United Healthcare Medicaid | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| ALLEGHENY VALLEY HOSPITAL Outpatient | United Healthcare | United Healthcare CHIP | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| JEFFERSON HOSPITAL Outpatient | United Healthcare | United Healthcare Medicaid | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | United Healthcare | United Healthcare Medicaid | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | United Healthcare | United Healthcare CHIP | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | United Healthcare | United Healthcare Medicaid | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | United Healthcare | United Healthcare CHIP | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| WEST PENN HOSPITAL Outpatient | United Healthcare | United Healthcare CHIP | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| SAINT VINCENT HOSPITAL Outpatient | United Healthcare | United Healthcare Medicaid | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | United Healthcare | United Healthcare CHIP | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | United Healthcare | United Healthcare CHIP | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| AHN WEXFORD HOSPITAL Outpatient | United Healthcare | United Healthcare Medicaid | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| GROVE CITY MEDICAL CENTER Outpatient | United Healthcare | United Healthcare Medicaid | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | United Healthcare | United Healthcare CHIP | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | United Healthcare | United Healthcare Medicaid | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| FORBES HOSPITAL Outpatient | United Healthcare | United Healthcare CHIP | $20.80 | — | — | 2026-04-14 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH CARITAS VIP CARE IP SPLITS [5460] | HMC AMERIHEALTH CARITAS | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE HEALTH PLANS [5269] | HMC WELLCARE/FEDELIS MEDICARE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH CARITAS VIP CARE IP SPLITS [5460] | HMC AMERIHEALTH CARITAS | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | FAIROS [5491] | HMC FAIROS | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBS OUT OF STATE MEDICARE IP SPLITS [5461] | HMC HORIZON BRAVEN | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CLAIM WATCHER/HOMESTEAD [5488] | HMC CLAIM WATCHER TIER 1 | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | US FAMILY HEALTH PLAN [5258] | HMC TRICARE CONTRACT | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE HEALTH PLANS [5269] | HMC WELLCARE/FEDELIS MEDICARE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA CENTRASTATE EMPLOYEE [5425] | HMC AETNA HTC | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CHAMPVA [5354] | HMC TRICARE CONTRACT | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | FAIROS [5491] | HMC FAIROS | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA AHS EMPLOYEE [5306] | HMC AETNA AHS EMPLOYEE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CLAIM WATCHER/HOMESTEAD [5488] | HMC CLAIM WATCHER TIER 1 | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AARP MEDICARE COMP [5039] | HMC UNITED MEDICARE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE [5003] | HMC AETNA NNJ PRIME | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE [5003] | HMC AETNA MEDICARE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | TRICARE [5251] | HMC TRICARE CONTRACT | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | MEDICAID [5022] | HMC MEDICAID | $23.68 | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA CENTRASTATE EMPLOYEE [5425] | HMC AETNA HTC | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | SEDGWICK WTC HEALTH PROGRAM WC [5514] | HMC PRIME HEALTH SERVICES | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMBETTER [5432] | HMC AMBETTER WELLCARE OF NJ | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA [5002] | HMC AETNA HTC | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM MEDICARE PFFS IP SPLITS [5474] | HMC HORIZON BRAVEN | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA ASSURE PREMIER PLUS [5422] | HMC AETNA MEDICARE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK COMMUNITY BLUE MEDICARE [5534] | HMC HORIZON BRAVEN | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | TRICARE [5251] | HMC TRICARE-EAST (HUMANA MILITARY) | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM MEDICARE PFFS IP SPLITS [5474] | HMC HORIZON BRAVEN | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA [5002] | HMC AETNA HTC | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | COSMETIC SURGERY/LAP BAND/GASTRIC BYPASS [5289] | HMC SELF PAY | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE [5003] | HMC AETNA MEDICARE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK WHOLECARE HEALTH PLAN IP SPLITS [5464] | HMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBS OUT OF STATE MEDICARE [5325] | HMC HORIZON BRAVEN | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE [5003] | HMC AETNA NNJ PRIME | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC [5455] | HMC UPMCHP CONTRACT | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON BCBS OUT OF STATE MEDICARE [5325] | HMC HORIZON BRAVEN | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK WHOLECARE HEALTH PLAN [5413] | HMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | COSMETIC SURGERY/LAP BAND/GASTRIC BYPASS [5289] | HMC SELF PAY | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | MEDICAID PENDING [5302] | HMC SELF PAY | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | TRICARE [5251] | HMC TRICARE CONTRACT | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | MEDICAID PENDING [5302] | HMC SELF PAY | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC MEDICARE [5454] | HMC UPMCHP CONTRACT | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | TRICARE [5251] | HMC TRICARE-EAST (HUMANA MILITARY) | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HIGHMARK WHOLECARE HEALTH PLAN IP SPLITS [5464] | HMC HIGHMARK WHOLECARE / GATEWAY HEALTH PLAN INC | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | US FAMILY HEALTH PLAN [5258] | HMC TRICARE CONTRACT | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLPOINT MANAGED MEDICARE [5007] | HMC WELLPOINT MEDICARE ADVANTAGE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | HORIZON MEDICARE BLUE IP SPLITS [5456] | HMC HORIZON BRAVEN | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA TOTALCARE (HMO D-SNP) IP SPLITS [5465] | HMC CIGNA MEDICARE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM MEDICARE PFFS [5052] | HMC HORIZON BRAVEN | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA TOTALCARE (HMO D-SNP) [5419] | HMC CIGNA MEDICARE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH ADMINISTRATORS SUPPLEMENTAL [5512] | HMC AMERIHEALTH MEDICARE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CLAIMDOC [5434] | HMC CLAIMDOC PLAN | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMERIHEALTH ADMINISTRATORS SUPPLEMENTAL [5512] | HMC AMERIHEALTH MEDICARE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CLAIMDOC [5434] | HMC CLAIMDOC PLAN | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CHAMPVA [5354] | HMC TRICARE CONTRACT | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AMBETTER [5432] | HMC AMBETTER WELLCARE OF NJ | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA ASSURE PREMIER PLUS [5422] | HMC AETNA MEDICARE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CARELON BEHAVIORAL HEALTH [5508] | AHS CARELON/VALUE OPTIONS BEHAVIORAL HEALTH | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA MEDICARE IP SPLITS [5470] | HMC AETNA MEDICARE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA ASSURE PREMIER PLUS IP SPLITS [5466] | HMC AETNA MEDICARE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | UPMC [5455] | HMC UPMCHP CONTRACT | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | CIGNA TOTALCARE (HMO D-SNP) IP SPLITS [5465] | HMC CIGNA MEDICARE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | ANTHEM MEDICARE PFFS [5052] | HMC HORIZON BRAVEN | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | AETNA ASSURE PREMIER PLUS IP SPLITS [5466] | HMC AETNA MEDICARE | — | $245.44 | $245.44 | 2026-01-01 | MRF ↗ |
| AHS HOSPITAL CORP Outpatient | WELLCARE BEHAVIORAL HEALTH [5335] | HMC WELLCARE/FEDELIS MEDICARE | — | $245.44 | $245.44 | 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.