99468 — Pr E&m Critically Ill Neonate 28 Days/< Ini Ip Neonatal Critical Care/Day
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PR E&M Critically Ill Neonate 28 Days/< Ini IP Neonatal Critical Care/Day (CPT 99468) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/99468?code_type=CPT
MLA (9th ed.)
“PR E&M Critically Ill Neonate 28 Days/< Ini IP Neonatal Critical Care/Day (CPT 99468) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/99468?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“PR E&M Critically Ill Neonate 28 Days/< Ini IP Neonatal Critical Care/Day (CPT 99468) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/99468?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $857–$2,586 (25th–75th percentile) across 998 hospitals · 1,940 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 99468 — 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
$857
$1,270 typical
$2,586
The middle 50% of negotiated facility rates for this procedure, measured across 998 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. | $1,270 |
| Physician fee Estimate national typical Medicare $779 × 1.22 commercial. | $950 |
| Likely subtotal | $2,220 |
Complete-episode estimate (typical)
~$2,220
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 $857–$2,586.
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 |
|---|---|---|---|---|---|---|---|
| DOCTORS MEDICAL CENTER OutpatientFacility | ALIGNMENT HEALTH PLAN | ALIGNMENT HEALTH PLAN MEDICARE | — | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | GUIDANT HEALTH PLAN MEDICARE ADVANTAGE DUAL | GUIDANT HEALTH PLAN MEDICARE ADVANTAGE DUAL | — | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | ASTIVA HEALTH MEDICARE ADVANTAGE | ASTIVA HEALTH MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | CENTENE | CENTENE/HN/WELLCARE MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | DEVOTED HEALTH MEDICARE ADVANTAGE | DEVOTED HEALTH MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | COMMONWEALTH CARE ALLIANCE MEDICARE ADVANTAGE | COMMONWEALTH CARE ALLIANCE MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | PROVIDER NETWORK OF AMERICA MEDICARE ADVANTAGE | PROVIDER NETWORK OF AMERICA MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | SCAN HEALTH PLAN MEDICARE ADVANTAGE | SCAN HEALTH PLAN MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | CAREMORE MEDICARE ADVANTAGE | CAREMORE MEDICARE ADVANTAGE | $0.21 | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | HILL PHYSICIANS MEDICARE ADVANTAGE | HILL PHYSICIANS MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | GUIDANT HEALTH PLAN MEDICARE ADVANTAGE | GUIDANT HEALTH PLAN MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | GOLDEN STATE MEDICARE ADVANTAGE | GOLDEN STATE MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | CLEVER CARE | CLEVER CARE MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| DOCTORS MEDICAL CENTER OutpatientFacility | CLOVER MEDICARE ADVANTAGE | CLOVER MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | 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 | CLOVER MEDICARE ADVANTAGE | CLOVER MEDICARE ADVANTAGE | — | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | CENTENE | CENTENE/HN/WELLCARE MEDICARE ADVANTAGE | — | — | — | 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 | PROVIDER NETWORK OF AMERICA MEDICARE ADVANTAGE | PROVIDER NETWORK OF AMERICA MEDICARE ADVANTAGE | — | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | AMERIHEALTH CARITAS MEDICARE ADVANTAGE | AMERIHEALTH CARITAS MEDICARE ADVANTAGE | — | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $0.29 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | CLEVER CARE | CLEVER CARE MEDICARE ADVANTAGE | — | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | DEVOTED HEALTH MEDICARE ADVANTAGE | DEVOTED HEALTH MEDICARE ADVANTAGE | — | — | — | 2026-09-01 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | GUIDANT HEALTH PLAN MEDICARE ADVANTAGE | GUIDANT HEALTH PLAN MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | GUIDANT HEALTH PLAN MEDICARE ADVANTAGE DUAL | GUIDANT HEALTH PLAN MEDICARE ADVANTAGE DUAL | — | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | ASTIVA HEALTH MEDICARE ADVANTAGE | ASTIVA HEALTH MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | CLEVER CARE | CLEVER CARE MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | DEVOTED HEALTH MEDICARE ADVANTAGE | DEVOTED HEALTH MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | SCAN HEALTH PLAN MEDICARE ADVANTAGE | SCAN HEALTH PLAN MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | PROVIDER NETWORK OF AMERICA MEDICARE ADVANTAGE | PROVIDER NETWORK OF AMERICA MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | CHOICE PHYSICIAN NETWORK IPA MEDICARE ADVANTAGE | CHOICE PHYSICIAN NETWORK IPA MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | CLOVER MEDICARE ADVANTAGE | CLOVER MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | COMMONWEALTH CARE ALLIANCE MEDICARE ADVANTAGE | COMMONWEALTH CARE ALLIANCE MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | ALIGNMENT HEALTH PLAN | ALIGNMENT HEALTH PLAN MEDICARE | — | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | MEDCARE PARTNERS MEDICARE ADVANTAGE | MEDCARE PARTNERS MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | IEHP HEALTH ACCESS MEDICARE ADVANTAGE | IEHP HEALTH ACCESS MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | RIOS HEALTH PLAN MEDICARE ADVANTAGE | RIOS HEALTH PLAN MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | CENTENE | CENTENE/HN/WELLCARE MEDICARE ADVANTAGE | — | — | — | 2026-09-02 | MRF ↗ |
| HI-DESERT MEDICAL CENTER OutpatientFacility | PROSPECT HEALTH PLAN MEDICARE ADVANTAGE | PROSPECT HEALTH PLAN MEDICARE ADVANTAGE | $0.30 | — | — | 2026-09-02 | 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 ↗ |
| 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 ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW MEXICO MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH 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 ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS STATE | $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 ↗ |
| Harper University Hospital OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH HIX | $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 ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE OPTIONS/BLUE PRECISION | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| PELLA REGIONAL HEALTH CENTER Outpatient | Wellmark Inc Dba Wellmark Blue Cross And Blue Shield Of Iowa | Ppo | $12.03 | $2,037.00 | $2,037.00 | 2026-07-15 | MRF ↗ |
| W J MANGOLD MEMORIAL HOSPITAL Inpatient | Cigna Healthcare | Commercial | $12.80 | $2,530.00 | $2,530.00 | 2026-07-31 | MRF ↗ |
| W J MANGOLD MEMORIAL HOSPITAL Inpatient | Blue Cross Blue Shield | Commercial | $12.80 | $2,530.00 | $2,530.00 | 2026-07-31 | MRF ↗ |
| WINNMED Outpatient | AETNA/FIRST HEALTH PHO | AETNA/FIRST HEALTH PHO | $19.59 | $2,892.00 | $2,024.40 | 2026-07-14 | MRF ↗ |
| WINNMED Outpatient | AETNA/FIRST HEALTH PPO-ALL OTHER PLANS | AETNA/FIRST HEALTH PPO-ALL OTHER PLANS | $19.59 | $2,892.00 | $2,024.40 | 2026-07-14 | MRF ↗ |
| WINNMED Outpatient | AETNA/FIRST HEALTH HMO | AETNA/FIRST HEALTH HMO | $19.59 | $2,892.00 | $2,024.40 | 2026-07-14 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Group Health Coop (Ghc) | Ghc Commercial (Kaiser) | $19.60 | $196.00 | $196.00 | 2026-07-15 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $24.26 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Tricare | All | $24.26 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | VA Health | All | $24.26 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | UHC | Medicare Advantage | $24.26 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $24.26 | — | — | 2026-03-28 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Cigna | Commercial | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Blue Cross | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | United Health Care | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | First Choice Select Health | Managed Medicaid | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | America'S First Choice | Medicare Advantage | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Aetna | Commercial | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Both | Aetna | Managed Medicare | — | — | — | 2026-10-03 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $25.33 | $2,435.15 | $2,435.15 | 2026-04-24 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $25.77 | $4,285.00 | $1,585.45 | 2026-03-31 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $25.98 | $2,159.00 | $410.21 | 2026-05-20 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $25.98 | $1,339.00 | $254.41 | 2026-01-25 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $26.22 | — | — | 2026-07-15 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| DECATUR COUNTY MEMORIAL HOSPITAL Outpatient | UHC-ALL OTHER PLANS | UHC-ALL OTHER PLANS | $30.00 | $2,348.00 | $1,761.00 | 2026-03-18 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Cigna | MCR Advantage | $38.25 | $85.00 | $76.50 | 2026-07-08 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | United Healthcare | MCR Advantage | $38.25 | $85.00 | $76.50 | 2026-07-08 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | United Healthcare | MCR Advantage | $38.25 | $85.00 | $76.50 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Anthem | MCR Advantage | $38.25 | $85.00 | $76.50 | 2026-07-08 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Martins Point | MCR Advantage | $38.25 | $85.00 | $76.50 | 2026-07-08 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Wellcare | MCR Advantage | $38.25 | $85.00 | $76.50 | 2026-07-08 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Aetna | MCR Advantage | $38.25 | $85.00 | $76.50 | 2026-07-08 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Cigna | MCR Advantage | $38.25 | $85.00 | $76.50 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Anthem | MCR Advantage | $38.25 | $85.00 | $76.50 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Aetna | MCR Advantage | $38.25 | $85.00 | $76.50 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Wellcare | MCR Advantage | $38.25 | $85.00 | $76.50 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Martins Point | MCR Advantage | $38.25 | $85.00 | $76.50 | 2026-04-05 | MRF ↗ |
| MOBRIDGE REGIONAL HOSPITAL - CAH Outpatient | SANFORD HEALTHPLAN-ALL PLANS | SANFORD HEALTHPLAN-ALL PLANS | $39.00 | $588.00 | $588.00 | 2026-07-16 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Caresource | Caresourcemedicaid | $42.34 | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Anthem | Anthemmedicaid | $42.34 | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Molina | Molinamedicaid | $43.61 | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | United Healthcare | Unitedmedicaid | $43.61 | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Amerihealth | Amerihealthmedicaid | $43.61 | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Buckeye | Buckeyemedicaid | $43.61 | — | — | 2026-07-31 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA ACA PPO - ALL OTHER PLANS | AVERA ACA PPO - ALL OTHER PLANS | $46.00 | $2,935.00 | $1,761.00 | 2025-12-20 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA HMO | AVERA HMO | $46.00 | $2,935.00 | $1,761.00 | 2025-12-20 | MRF ↗ |
| WITHAM HEALTH SERVICES Outpatient | ENCORE-ALL PLANS | ENCORE-ALL PLANS | $48.00 | $1,714.65 | $1,200.26 | 2026-03-31 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA ASO PPO | AVERA ASO PPO | $48.00 | $2,935.00 | $1,761.00 | 2025-12-20 | MRF ↗ |
| WITHAM HEALTH SERVICES Outpatient | ENCORE-ALL PLANS | ENCORE-ALL PLANS | $48.00 | $1,714.65 | $1,200.26 | 2026-03-31 | MRF ↗ |
| PROWERS MEDICAL CENTER Both | Standard_Charged|Medicare|Negotiated_Percentage | — | $49.00 | $2,575.00 | $1,545.00 | 2026-08-01 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | United Healthcare | Commercial | $51.00 | $85.00 | $76.50 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | United Healthcare | Commercial | $51.00 | $85.00 | $76.50 | 2026-07-08 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $51.96 | $2,498.00 | $2,498.00 | 2026-06-03 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $51.96 | $2,498.00 | $2,498.00 | 2026-02-13 | MRF ↗ |
| HURON REGIONAL MEDICAL CENTER Outpatient | AVERA NONACA PPO | AVERA NONACA PPO | $54.00 | $2,935.00 | $1,761.00 | 2025-12-20 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Care First Health Plan | Care 1St Medicare Advantage | $54.88 | $196.00 | $196.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Veterans Administrations | Veterans Administration | $54.88 | $196.00 | $196.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Group Health Coop (Ghc) | Ghc Medicare | $54.88 | $196.00 | $196.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Managed Medicare Plans | Managed Medicare Plans | $54.88 | $196.00 | $196.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Umvs | Umvs | $54.88 | $196.00 | $196.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Champva | Champva/Health Net | $54.88 | $196.00 | $196.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Tricare | Tricare For Life | $54.88 | $196.00 | $196.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Cigna | Cigna Medicare Advantage | $54.88 | $196.00 | $196.00 | 2026-07-15 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | HealthNet | Commercial | $55.25 | $85.00 | $76.50 | 2026-04-05 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | HealthNet | Commercial | $55.25 | $85.00 | $76.50 | 2026-07-08 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Chpw | Chpw | $55.71 | $196.00 | $196.00 | 2026-07-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $56.32 | — | — | 2026-06-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Regence | Regence Medicare | $57.62 | $196.00 | $196.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Bcbs | Blue Cross Medicare Advanatage | $57.62 | $196.00 | $196.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Uhc | Uhc Medicare Advantage | $57.62 | $196.00 | $196.00 | 2026-07-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Managed Medicare Plans | Managed Medicare Plans | — | $206.00 | $206.00 | 2026-10-02 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Champva | Champva/Health Net | — | $206.00 | $206.00 | 2026-10-02 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $58.51 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $58.51 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $58.51 | — | — | 2026-06-15 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $59.20 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $59.20 | — | — | 2025-01-01 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $59.62 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $59.62 | — | — | 2026-06-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Bcbs | Medicare Advantage | — | $206.00 | $206.00 | 2026-10-02 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Regence | Regence Medicare | — | $206.00 | $206.00 | 2026-10-02 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Humana | Humana Medicare Advantage | $60.86 | $196.00 | $196.00 | 2026-07-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | Paramount | Managed Medicaid | $61.06 | — | — | 2026-06-15 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | UHC | Medicaid | $61.57 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | UHC | Medicaid | $61.57 | — | — | 2025-01-01 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Aetna | Aetna Medicare Advantage | $61.74 | $196.00 | $196.00 | 2026-07-15 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Molina | Medicaid | $62.16 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Anthem | Medicaid | $62.16 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Molina | Medicaid | $62.16 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Anthem | Medicaid | $62.16 | — | — | 2025-01-01 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $62.24 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $62.24 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $62.24 | — | — | 2026-06-15 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Humana | Medicaid | $62.75 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Humana | Medicaid | $62.75 | — | — | 2025-01-01 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | United BH | Managed Medicaid | $62.84 | — | — | 2026-06-15 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | AmeriHealth Caritas | Medicaid | $63.34 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye (Centene) | Medicaid | $63.34 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Caresource | Medicaid | $63.34 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye (Centene) | Medicaid | $63.34 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | AmeriHealth Caritas | Medicaid | $63.34 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye Community Health | Medicaid | $63.34 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye Community Health | Medicaid | $63.34 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Caresource | Medicaid | $63.34 | — | — | 2025-01-01 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $63.43 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $63.43 | — | — | 2026-06-15 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Humana | Medicare Advantage | — | $206.00 | $206.00 | 2026-10-02 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | PARAMOUNT | Medicaid | $64.53 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Safe Program | Medicaid | $64.53 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | PARAMOUNT | Medicaid | $64.53 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Safe Program | Medicaid | $64.53 | — | — | 2025-01-01 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Aetna | Medicare Advantage | — | $206.00 | $206.00 | 2026-10-02 | MRF ↗ |
| Seymour Hospital Outpatient | United Medicare Advantage | Medicare Advantage | $65.00 | $2,752.00 | $1,926.40 | 2026-01-12 | MRF ↗ |
| Seymour Hospital Outpatient | Aetna - Medicare Advantage | Medicare Advantage | $65.00 | $2,752.00 | $1,926.40 | 2026-01-12 | MRF ↗ |
| Seymour Hospital Outpatient | Wellmed | Medicare Advantage | $65.00 | $2,752.00 | $1,926.40 | 2026-01-12 | MRF ↗ |
| Seymour Hospital Outpatient | Humana Medicare Advantage | Medicare Advantage | $65.00 | $2,752.00 | $1,926.40 | 2026-01-12 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | AMERIHEALTH | Managed Medicaid | $65.21 | — | — | 2026-06-15 | MRF ↗ |
| GREAT PLAINS OF SABETHA Outpatient | BCBS BLUE CHOICE | BCBS BLUE CHOICE | $66.00 | $1,925.00 | $1,732.50 | 2026-03-10 | MRF ↗ |
| GREAT PLAINS OF SABETHA Outpatient | BCBS KS CAP-ALL OTHER PLANS | BCBS KS CAP-ALL OTHER PLANS | $66.00 | $1,925.00 | $1,732.50 | 2026-03-10 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Anthem | Commercial | $66.13 | $85.00 | $76.50 | 2026-07-08 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Anthem | Commercial | $66.13 | $85.00 | $76.50 | 2026-04-05 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | BLUE CROSS MCS-ALL OTHER PLANS | BLUE CROSS MCS-ALL OTHER PLANS | $66.41 | $2,159.00 | $431.80 | 2026-05-24 | MRF ↗ |
| ADVENTIST HEALTH UKIAH VALLEY Outpatient | BLUE CROSS NON-MCS | BLUE CROSS NON-MCS | $66.41 | $2,159.00 | $431.80 | 2026-05-24 | MRF ↗ |
| GOODALL WITCHER HOSPITAL Inpatient | BCBS Blue Advantage | Blue Advantage | $69.92 | $788.00 | $551.60 | 2026-01-13 | MRF ↗ |
| Seymour Hospital Inpatient | Aetna - Meritain | UNKNOWN | $70.00 | $2,752.00 | $1,926.40 | 2026-01-12 | MRF ↗ |
| Seymour Hospital Inpatient | Aetna - HMO/PPO | HMO/PPO/POS | $70.00 | $2,752.00 | $1,926.40 | 2026-01-12 | MRF ↗ |
| GRANT REGIONAL HEALTH CENTER Outpatient | DEAN HEALTH PLAN - ALL PLANS | DEAN HEALTH PLAN - ALL PLANS | $71.99 | $3,440.00 | $2,236.00 | 2026-01-15 | MRF ↗ |
| MOUNT DESERT ISLAND HOSPITAL BothFacility | Community Health Options | Commercial | $72.25 | $85.00 | $76.50 | 2026-07-08 | 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.