99487 — Cplx Chrnc Care 1st 60 Min
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). CPLX CHRNC CARE 1ST 60 MIN (CPT 99487) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/99487?code_type=CPT
MLA (9th ed.)
“CPLX CHRNC CARE 1ST 60 MIN (CPT 99487) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/99487?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“CPLX CHRNC CARE 1ST 60 MIN (CPT 99487) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/99487?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $134–$296 (25th–75th percentile) across 1,577 hospitals · 3,269 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS 99487 — 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
$134
$182 typical
$296
The middle 50% of negotiated facility rates for this procedure, measured across 1,577 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. | $182 |
| Physician fee Estimate national typical Medicare $79 × 1.22 commercial. | $97 |
| Likely subtotal | $279 |
Complete-episode estimate (typical)
~$279
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 $134–$296.
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 | Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP | — | $151.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Health Benefit Exchange | — | $151.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Excellus BCBS | Managed Medicaid _CHP_SP | — | $151.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Managed Medicaid_Aliessa and QHP | — | $151.00 | — | 2025-05-02 | 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 ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER BY SUNSHINE HIX | $0.27 | — | — | 2026-09-01 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| ST MARY'S MEDICAL CENTER OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.33 | — | — | 2026-09-01 | MRF ↗ |
| RESOLUTE HEALTH HOSPITAL OutpatientFacility | AMBETTER | AMBETTER EXCHANGE VALUE AND SELECT NONPAR | $0.49 | — | — | 2026-09-01 | MRF ↗ |
| 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 OPTIONS/BLUE PRECISION | $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 ↗ |
| 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 ↗ |
| 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 ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | OSCAR HEALTH PLAN | OSCAR HEALTH PLAN HIX | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS MYBLUE HEALTH 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 ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW MEXICO MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ADVENTIST HEALTH REEDLEY Outpatient | DIGNITY MCR ADV OP/PROFEE ONLY | DIGNITY MCR ADV OP/PROFEE ONLY | $1.48 | $221.00 | $41.99 | 2026-05-20 | MRF ↗ |
| WALLOWA MEMORIAL HOSPITAL Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $1.48 | $353.00 | $353.00 | 2026-07-09 | MRF ↗ |
| VIRGINIA MASON MEDICAL CENTER Outpatient | First Choice | Commercial | $2.63 | — | — | 2026-07-15 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $2.96 | $38.00 | $38.00 | 2026-06-03 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | HLTH ALLIANCE-ALL OTHER PLANS | HLTH ALLIANCE-ALL OTHER PLANS | $2.96 | $38.00 | $38.00 | 2026-02-13 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $3.36 | $323.40 | $323.40 | 2026-04-24 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $4.82 | — | — | 2026-03-18 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Bcbs Medicare | Medicare | $6.34 | $196.00 | $147.00 | 2026-10-01 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Medicare | Medicare | $6.34 | $196.00 | $147.00 | 2026-10-01 | MRF ↗ |
| MEMORIAL HOSPITAL OF CARBON COUNTY Outpatient | Vaccn | Medicare | $6.34 | $196.00 | $147.00 | 2026-10-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC NEW | 6787_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT NRIN 20230101 | $8.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9397_UNITED HEALTHCARE VWIN 20250101 | $8.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Inpatient | UHC BEHAVIORAL HEALTH | 8231_UNITED HEALTH CARE BEHAVIORAL HEALTH 20230401 | $8.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9384_UNITED HEALTHCARE CLIN 20250101 | $8.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Outpatient | UHC | 8493_UNITED HEALTHCARE SWIN 20240701 | $8.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9390_UNITED HEALTHCARE VAIN 20250101 | $8.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9393_UNITED HEALTHCARE VKIN 20250101 | $8.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $8.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6793_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ECIN 20230101 | $8.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | UHC NEW | 6790_UNITED HEALTHCARE NEW BUSINESS OUTPATIENT ASIN 20230101 | $8.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9395_UNITED HEALTHCARE VRIN 20250101 | $8.35 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | UHC SELF | 6788_UNITED HEALTHCARE SELF FUNDED OUTPATIENT NRIN 20230101 | $8.35 | — | — | 2026-01-01 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Blue Cross Blue Shield Of Nc | Commercial | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna Nc State Health Plan | Commercial | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Medcost | Commercial | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Tricare | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Healthy Blue | Managed Medicaid | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Troy | Medicare Advantage | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Blue Medicare Partner Health Plan | Medicare | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Multiplan | Commercial | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Onenet Ppo | $11.01 | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna | Medicare Advantage | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Medicare Advantage | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana Choicecare | Medicare Advantage | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Liberty Advantage | Medicare Advantage | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | First Carolina Care | Medicare Advantage | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Managed Medicaid | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana | Commercial | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Longevity | Medicare Advantage | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Humana Choicecare | Commercial | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Carolina Complete Health | Managed Medicaid | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Aetna | Commercial | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Cigna | Commercial | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Wellcare | Managed Medicaid | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | United Healthcare | Compass | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | Wellcare | Medicare Advantage | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL Outpatient | New Hanover | Medicare Advantage | — | $60.00 | $36.00 | 2026-07-31 | MRF ↗ |
| BAYLOR SCOTT & WHITE HEART & VASCULAR HOSPITAL - DALLAS OutpatientFacility | Superior Health Plan | Medicaid | $13.84 | $173.06 | $103.84 | 2026-02-21 | MRF ↗ |
| WHIDBEYHEALTH MEDICAL CENTER Outpatient | Group Health Coop (Ghc) | Ghc Commercial (Kaiser) | $14.20 | $142.00 | $142.00 | 2026-07-15 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | PLAIN CHURCH MG-ALL PLANS | PLAIN CHURCH MG-ALL PLANS | $15.20 | $38.00 | $38.00 | 2026-02-13 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | PLAIN CHURCH MG-ALL PLANS | PLAIN CHURCH MG-ALL PLANS | $15.20 | $38.00 | $38.00 | 2026-06-03 | MRF ↗ |
| OHIO COUNTY HOSPITAL BothFacility | HEALTHSMART BENEFIT SOLUTIONS - Medicare Part A | Medicare Advantage | $15.27 | $137.00 | $68.50 | 2026-01-12 | MRF ↗ |
| OHIO COUNTY HOSPITAL BothFacility | ANTHEM KY - Medicare Part A | Medicare Advantage | $15.27 | $137.00 | $68.50 | 2026-01-12 | MRF ↗ |
| OHIO COUNTY HOSPITAL BothFacility | ANTHEM KY - Medicare Part A | Medicare Advantage | $15.27 | $137.00 | $68.50 | 2026-01-12 | MRF ↗ |
| OHIO COUNTY HOSPITAL BothFacility | HEALTHSMART BENEFIT SOLUTIONS - Medicare Part A | Medicare Advantage | $15.27 | $137.00 | $68.50 | 2026-01-12 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $16.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| RAINY LAKE MEDICAL CENTER InpatientFacility | Blue Cross of Minnesota | Minnesota Health Care Programs | $16.00 | $73.21 | $56.38 | 2026-05-06 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT ANDERSON Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WILLIAMSPORT Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT FISHERS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT JENNINGS Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| Ascension St. Vincent Seton Specialty Hospital Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT MERCY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ST VINCENT HEART CENTER Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT SALEM Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC SELF | 6575_UNITED HEALTH CARE SELF FUNDED NON-CONTRACTED VEIN 20221002 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT RANDOLPH Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CLAY Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT WARRICK Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Both | UHC | 9470_UNITED HEALTHCARE VEIN 20250101 | $16.32 | — | — | 2026-01-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Carolina Complete Health | Managed Medicaid | $16.53 | $60.00 | $36.00 | 2026-08-01 | MRF ↗ |
| WINNMED Outpatient | UHC PREMIER - ALL PLANS | UHC PREMIER - ALL PLANS | $16.91 | $29.00 | $20.30 | 2026-07-14 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - United | Medicaid - United | $17.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| BETSY JOHNSON REGIONAL HOSPITAL Outpatient | Non Contracted Commercial | Non Contracted Commercial | $17.08 | $60.00 | $36.00 | 2026-08-01 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | MENNONITE-ALL PLANS | MENNONITE-ALL PLANS | $17.10 | $38.00 | $38.00 | 2026-02-13 | MRF ↗ |
| SARAH BUSH LINCOLN HEALTH CENTER Outpatient | MENNONITE-ALL PLANS | MENNONITE-ALL PLANS | $17.10 | $38.00 | $38.00 | 2026-06-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicaid - Meridian | Medicaid - Meridian | $18.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - Meridian | Medicaid - Meridian | $18.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $18.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - United | Medicaid - United | $19.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC Outpatient | Tricare | Commercial | $19.00 | $119.00 | $119.00 | 2025-11-07 | MRF ↗ |
| BAYLOR SCOTT & WHITE THE HEART HOSPITAL PLANO OutpatientFacility | Superior Health Plan | Medicaid | $19.04 | $173.06 | $103.84 | 2026-02-20 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER AT IRVING OutpatientFacility | Superior Health Plan | Medicaid | $19.04 | $173.06 | $103.84 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER AT IRVING OutpatientFacility | WellPoint (fka Amerigroup) | CHIP/Medicaid | $19.04 | $173.06 | $103.84 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT AND WHITE MEDICAL CENTER LAKE POINTE OutpatientFacility | WellPoint (fka Amerigroup) | CHIP/Medicaid | $19.04 | $173.06 | $103.84 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT AND WHITE MEDICAL CENTER LAKE POINTE OutpatientFacility | Superior Health Plan | Medicaid | $19.04 | $173.06 | $103.84 | 2026-02-21 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Ambetter | Commercial | $19.09 | $55.00 | $49.50 | 2026-07-15 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid | Medicaid Nhhf | $19.30 | $210.00 | $63.00 | 2026-07-15 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $20.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| COLUMBIA MEMORIAL HOSPITAL BothFacility | WASHINGTON STATE DSHS - Medicaid | WASHINGTON STATE DSHS - Medicaid | $20.35 | $133.00 | $106.40 | 2026-01-05 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid | Medicaid-Trad | $21.00 | $210.00 | $63.00 | 2026-07-15 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Medicaid - Meridian | Medicaid - Meridian | $21.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | United Healthcare | Compass | $21.00 | $60.00 | $36.00 | 2026-08-01 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | VA Health | All | $21.03 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Interwest Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Montana Health CoOp | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | UHC | Medicare Advantage | $21.03 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | First Health Network | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Prime Health | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Coventry | All | — | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $21.03 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $21.03 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Tricare | All | $21.03 | — | — | 2026-03-28 | MRF ↗ |
| FALLON MEDICAL COMPLEX HOSPITAL OutpatientFacility | Pacific Source | All | — | — | — | 2026-03-28 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid-Amerihealth | Medicaid-Amerihealth | $21.21 | $210.00 | $63.00 | 2026-07-15 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Traditional Medicaid HMO PPO | Traditional Medicaid HMO PPO | $22.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - United | Medicaid - United | $22.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Wellcare | Managed Medicaid | $22.42 | $60.00 | $36.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | United Healthcare | Managed Medicaid | $22.42 | $60.00 | $36.00 | 2026-08-01 | MRF ↗ |
| CAPE FEAR VALLEY MEDICAL CENTER Outpatient | Healthy Blue | Managed Medicaid | $22.42 | $60.00 | $36.00 | 2026-08-01 | MRF ↗ |
| JASPER GENERAL HOSPITAL Outpatient | Mpcn | Commercial | $22.50 | $50.00 | — | 2026-10-07 | MRF ↗ |
| ST BERNARDS FIVE RIVERS MEDICAL CENTER Outpatient | Bcbs | Exchange | $22.55 | $55.00 | $49.50 | 2026-07-15 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST OutpatientFacility | Superior Health Plan | Medicaid | $22.61 | $188.45 | $113.07 | 2026-02-19 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST OutpatientFacility | Humana Military | TRICARE | — | $188.45 | $113.07 | 2026-02-19 | MRF ↗ |
| RAINY LAKE MEDICAL CENTER InpatientFacility | United Healthcare | Minnesota Medicaid Benefit Plans/CHIP | — | $104.56 | $80.52 | 2026-05-06 | MRF ↗ |
| RAINY LAKE MEDICAL CENTER InpatientFacility | Blue Cross of Minnesota | Minnesota Health Care Programs | $22.86 | $104.56 | $80.52 | 2026-05-06 | MRF ↗ |
| RAINY LAKE MEDICAL CENTER InpatientFacility | UCare Minnesota | MinnesotaCare/Senior Care Plus/Non-Integrated Special Needs Dual Eligible/Medicare Select | — | $104.56 | $80.52 | 2026-05-06 | MRF ↗ |
| RAINY LAKE MEDICAL CENTER InpatientFacility | UCare Minnesota | Individual and Family Plans | — | $104.56 | $80.52 | 2026-05-06 | MRF ↗ |
| RAINY LAKE MEDICAL CENTER InpatientFacility | UCare Minnesota | MSHO/Integrated Dual Eligible Special Needs/Medicare Advantage | — | $104.56 | $80.52 | 2026-05-06 | MRF ↗ |
| RAINY LAKE MEDICAL CENTER InpatientFacility | Humana/ChoiceCare | Medicare Advantage | — | $104.56 | $80.52 | 2026-05-06 | MRF ↗ |
| RAINY LAKE MEDICAL CENTER InpatientFacility | Medica | Medicare Advantage | — | $104.56 | $80.52 | 2026-05-06 | MRF ↗ |
| RAINY LAKE MEDICAL CENTER InpatientFacility | United Healthcare | Commercial Plans | — | $104.56 | $80.52 | 2026-05-06 | MRF ↗ |
| RAINY LAKE MEDICAL CENTER InpatientFacility | Medica | Minnesota Health Care Programs | — | $104.56 | $80.52 | 2026-05-06 | MRF ↗ |
| RAINY LAKE MEDICAL CENTER InpatientFacility | HealthPartners | Medicare Advantage | — | $104.56 | $80.52 | 2026-05-06 | MRF ↗ |
| MCLAREN NORTHERN MICHIGAN Outpatient | Tricare | Tricare | $23.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | Baylor Scott & White Health Plan | Medicare Advantage | $23.27 | $188.45 | $113.07 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | Humana Military | TRICARE | — | $188.45 | $113.07 | 2026-02-21 | MRF ↗ |
| WARD MEMORIAL HOSPITAL Outpatient | Medicare Advantage | Medicare Advantage | $24.00 | $125.00 | $88.00 | 2025-06-13 | MRF ↗ |
| MCLAREN MACOMB Outpatient | Medicaid - Molina | Medicaid - Molina | $24.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| WARD MEMORIAL HOSPITAL Outpatient | FirstCare | Commercial | $24.00 | $125.00 | $88.00 | 2025-06-13 | MRF ↗ |
| WARD MEMORIAL HOSPITAL Outpatient | FirstCare | Medicare Advantage | $24.00 | $125.00 | $88.00 | 2025-06-13 | MRF ↗ |
| MCLAREN OAKLAND Outpatient | Medicaid - Molina | Medicaid - Molina | $24.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| WARD MEMORIAL HOSPITAL Outpatient | Superior HealthPlan | HMO | $24.00 | $125.00 | $88.00 | 2025-06-13 | MRF ↗ |
| WARD MEMORIAL HOSPITAL Outpatient | Blue Cross Blue Shield - Tx | VA PCCC | $24.00 | $125.00 | $88.00 | 2025-06-13 | MRF ↗ |
| WARD MEMORIAL HOSPITAL Outpatient | Superior HealthPlan | PPO | $24.00 | $125.00 | $88.00 | 2025-06-13 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Dean Health Plan | Managed Medicaid | $24.06 | $233.00 | $74.56 | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Quartz | Managed Medicaid | $24.06 | $233.00 | $74.56 | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Anthem | Managed Medicaid | $24.06 | $233.00 | $74.56 | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | MEDICAID | MEDICAID | $24.06 | $233.00 | $74.56 | 2025-07-22 | MRF ↗ |
| Baylor Scott & White Medical Center - Frisco at PGA Parkway OutpatientFacility | Superior Health Plan | Medicaid | $24.23 | $173.06 | $103.84 | 2026-02-23 | MRF ↗ |
| BAYLOR SCOTT AND WHITE MEDICAL CENTER MCKINNEY OutpatientFacility | Superior Health Plan | Medicaid | $24.23 | $173.06 | $103.84 | 2026-02-19 | MRF ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | TriWest | Community Care Network | $24.50 | $188.45 | $113.07 | 2026-02-21 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $24.54 | $233.00 | $74.56 | 2025-07-22 | MRF ↗ |
| UNIVERSITY MEDICAL CENTER OF EL PASO Outpatient | Aetna | Qhp | $24.63 | $129.61 | $25.92 | 2026-07-15 | MRF ↗ |
| MCLAREN MACOMB Outpatient | WC - Workers Compensation | WC - Workers Compensation | $25.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Traditional Medicare HMO PPO | Traditional Medicare HMO PPO | $25.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| JASPER GENERAL HOSPITAL Outpatient | Aetna | Commercial | $25.00 | $50.00 | — | 2026-10-07 | MRF ↗ |
| MCLAREN CENTRAL MICHIGAN Outpatient | Medicare - United | Medicare - United | $25.00 | $130.00 | $65.00 | 2025-02-03 | MRF ↗ |
| GUNDERSEN MOUNDVIEW HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $25.05 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN TRI-COUNTY HOSPITAL & CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $25.05 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN ST JOSEPHS HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $25.05 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $25.05 | — | — | 2025-06-27 | 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.