A0428 — Bls
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). BLS (HCPCS A0428) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/A0428?code_type=HCPCS
MLA (9th ed.)
“BLS (HCPCS A0428) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/A0428?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“BLS (HCPCS A0428) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/A0428?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $279–$794 (25th–75th percentile) across 1,102 hospitals · 2,682 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS A0428 — 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 this costs at this hospital
The hospital facility charge for this code — an actual negotiated rate from our data. A separate professional fee isn’t separately estimable for this code (see the note below).
What hospitals actually negotiate
Measured
$279
$454 typical
$794
The middle 50% of negotiated facility rates for this procedure, measured across 1,102 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $454 |
| Likely subtotal | $454 |
Facility charge (no separate professional fee)
$454
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 $279–$794.
- This is a drug/supply code billed by the facility; there is no separate professional fee to estimate — the figure above is the facility charge only.
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
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_Aliessa and QHP | — | $792.00 | — | 2025-05-02 | MRF ↗ |
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | — | — | — | $1,224.40 | $612.20 | 2024-12-15 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Excellus BCBS | Managed Medicaid _CHP_SP | — | $792.00 | — | 2025-05-02 | MRF ↗ |
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | — | — | — | $1,224.40 | $612.20 | 2024-12-15 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Fidelis | Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP | — | $792.00 | — | 2025-05-02 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | FIDELIS | Health Benefit Exchange | — | $792.00 | — | 2025-05-02 | 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 ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $0.60 | — | — | 2026-09-01 | MRF ↗ |
| James Cancer Hospital & Solove Research Institute Outpatient | Cigna | Cigna - Transplant | $0.62 | — | — | 2026-07-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| ENGLEWOOD HOSPITAL AND MEDICAL CENTER OutpatientFacility | United Healthcare_775 | Managed Medicare | $1.00 | $2,146.00 | $214.60 | 2026-02-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| ATLANTICARE REGIONAL MEDICAL CENTER - CITY CAMPUS OutpatientFacility | AMERIGROUP | Managed Medicaid | $1.00 | $1,179.00 | — | 2026-03-18 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS STATE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Medical Associates | Medicare | $1.04 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Aetna | Medicare Ppo | $1.04 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Va | Commercial | $1.04 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Coventry Aetna | Medicare | $1.04 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Coventry Aetna | Medicare Ppo | $1.04 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Aetna | Medicare Hmo | $1.04 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Coventry Aetna | Medicare Hmo | $1.04 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | United Healthcare | Medicare | $1.04 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Uhc | Medicare | $1.04 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Wellmark | Medicare | $1.04 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Blue Cross | Medicare | $1.04 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Aetna | Medicare | $1.04 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Humana | Medicare | $1.04 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Molina | Medicare | $1.09 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Humana | Medicare | $1.10 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Molina | Medicare | $1.14 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Iowa Total Care | Medicaid | $1.17 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Iowa Total Care | Medicaid | $1.20 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Inpatient | Wellmark | Ppo | $1.34 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Inpatient | Blue Cross | Ppo | $1.34 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Inpatient | Blue Cross | Hmo | $1.34 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Inpatient | Wellmark | Hmo | $1.34 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Midlands Choice | Commercial | $1.40 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Midlands Choice | Commercial | $1.40 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Health Partners | Commercial | $1.40 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Health Partners | Commercial | $1.40 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Medical Associates | Hmo | $1.50 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Medical Associates | Hmo | $1.50 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Quartz | Commercial | $1.60 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Quartz | Commercial | $1.60 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Medical Associates | Medicare | $1.72 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Health Choices | Commercial | $1.72 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Health Choices | Commercial | $1.72 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | United Healthcare | Commercial | $1.84 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Uhc | Commercial | $1.84 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $1.92 | $1,065.00 | — | 2024-12-31 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Wellmark | Hmo | $2.00 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Oscar | Medicaid | $2.00 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Blue Cross | Hmo | $2.00 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Wellmark | Ppo | $2.00 | $2.00 | $1.60 | 2026-05-13 | MRF ↗ |
| GUTTENBERG MUNICIPAL HOSPITAL Outpatient | Blue Cross | Ppo | $2.00 | $2.00 | $1.60 | 2026-05-08 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $3.75 | $1,014.00 | $963.30 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $3.75 | $1,014.00 | $963.30 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $3.75 | $1,014.00 | $963.30 | 2026-02-20 | MRF ↗ |
| Kentfield Hospital | First Health , Affordable, Ccn, Coventry 700 | — | $3.84 | $6.00 | — | 2026-07-30 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $3.85 | $1,014.00 | $963.30 | 2026-02-20 | MRF ↗ |
| Kentfield Hospital | Tricare Healthnet 232 | — | $3.90 | $6.00 | — | 2026-07-30 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $3.95 | $1,014.00 | $963.30 | 2026-02-20 | MRF ↗ |
| LAMB HEALTHCARE CENTER Outpatient | Aetna | PPO | $4.00 | $7.00 | $3.00 | 2025-02-12 | MRF ↗ |
| LAMB HEALTHCARE CENTER Outpatient | Department of Assistive and Rehabilitative Services | Commercial | $4.00 | $7.00 | $3.00 | 2025-02-12 | MRF ↗ |
| LAMB HEALTHCARE CENTER Outpatient | Team Choice | University Medical Center Employee Health Plan | $4.00 | $7.00 | $3.00 | 2025-02-12 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $4.06 | $1,014.00 | $963.30 | 2026-02-20 | MRF ↗ |
| Kentfield Hospital | Tricare 369 | — | $4.20 | $6.00 | — | 2026-07-30 | MRF ↗ |
| CHERRY COUNTY HOSPITAL Outpatient | AMBETTER COMM - ALL PLANS | AMBETTER COMM - ALL PLANS | $4.43 | $426.35 | $426.35 | 2026-04-24 | MRF ↗ |
| Kentfield Hospital | Multiplan Complimentary 737 Multiplan, Value Point | — | $4.80 | $6.00 | — | 2026-07-30 | MRF ↗ |
| LAMB HEALTHCARE CENTER Outpatient | Team Choice | Resident Plan - Lubbock | $5.00 | $7.00 | $3.00 | 2025-02-12 | MRF ↗ |
| LAMB HEALTHCARE CENTER Outpatient | HealthSmart | PPO | $5.00 | $7.00 | $3.00 | 2025-02-12 | MRF ↗ |
| LAMB HEALTHCARE CENTER Outpatient | Humana | PPO | $5.00 | $7.00 | $3.00 | 2025-02-12 | MRF ↗ |
| LAMB HEALTHCARE CENTER Outpatient | Cigna | Commercial | $5.00 | $7.00 | $3.00 | 2025-02-12 | MRF ↗ |
| LAMB HEALTHCARE CENTER Outpatient | Aetna | Medicare Advantage | $5.00 | $7.00 | $3.00 | 2025-02-12 | MRF ↗ |
| LAMB HEALTHCARE CENTER Outpatient | CapStar | Commercial | $5.00 | $7.00 | $3.00 | 2025-02-12 | MRF ↗ |
| LAMB HEALTHCARE CENTER Outpatient | Great West Healthcare | PPO | $5.00 | $7.00 | $3.00 | 2025-02-12 | MRF ↗ |
| LAMB HEALTHCARE CENTER Outpatient | Team Choice | Physician Network Services Employee Health Plan | $5.00 | $7.00 | $3.00 | 2025-02-12 | MRF ↗ |
| LAMB HEALTHCARE CENTER Outpatient | Prime Health Services | Commercial | $5.00 | $7.00 | $3.00 | 2025-02-12 | MRF ↗ |
| LAMB HEALTHCARE CENTER Outpatient | Team Choice | TeamChoice Advantage | $5.00 | $7.00 | $3.00 | 2025-02-12 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $5.10 | $1,040.00 | $988.00 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $5.10 | $1,040.00 | $988.00 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $5.20 | $1,040.00 | $988.00 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $5.41 | $1,040.00 | $988.00 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $5.62 | $1,040.00 | $988.00 | 2026-02-20 | MRF ↗ |
| LAMB HEALTHCARE CENTER Outpatient | Team Choice | TeamChoice Platinum | $6.00 | $7.00 | $3.00 | 2025-02-12 | MRF ↗ |
| LAMB HEALTHCARE CENTER Outpatient | Blue Cross Blue Shield | HMO | $6.00 | $7.00 | $3.00 | 2025-02-12 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $6.19 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $6.19 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $6.19 | — | — | 2026-03-18 | MRF ↗ |
| CAPE REGIONAL MEDICAL CENTER INC OutpatientFacility | Americhoice | MEDICAID | $6.50 | $64.00 | — | 2025-01-31 | MRF ↗ |
| CAPE REGIONAL MEDICAL CENTER INC OutpatientFacility | Aetna Better Health | BETTER HEALTH MEDICAID | $6.50 | $64.00 | — | 2025-01-31 | MRF ↗ |
| CAPE REGIONAL MEDICAL CENTER INC OutpatientFacility | Horizon NJ Health | ALL PRODUCTS | $6.78 | $64.00 | — | 2025-01-31 | MRF ↗ |
| CAPE REGIONAL MEDICAL CENTER INC OutpatientFacility | Amerigroup | ALL PRODUCTS | $6.78 | $64.00 | — | 2025-01-31 | MRF ↗ |
| CAPE REGIONAL MEDICAL CENTER INC OutpatientFacility | Aetna Better Health | BETTER HEALTH CHIP | $6.78 | $64.00 | — | 2025-01-31 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $7.09 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $7.09 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $7.09 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $7.72 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $7.72 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $7.72 | — | — | 2026-03-18 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $7.73 | $819.32 | $491.59 | 2025-08-11 | MRF ↗ |
| WEST FELICIANA PARISH HOSPITAL Both | Humana MCD Rep (Plan: Medicaid Replacement) | Humana MCD Rep (Plan: Medicaid Replacement) | $7.73 | $819.32 | $491.59 | 2025-08-11 | MRF ↗ |
| KIMBALL HEALTH SERVICES Outpatient | UHC MEDICARE ADV | UHC MEDICARE ADV | $10.00 | $25.00 | $25.00 | 2026-10-12 | MRF ↗ |
| KIMBALL HEALTH SERVICES Outpatient | VA - ALL PLANS | VA - ALL PLANS | $12.75 | $25.00 | $25.00 | 2026-10-12 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $13.07 | — | — | 2026-03-18 | MRF ↗ |
| CAPE REGIONAL MEDICAL CENTER INC OutpatientFacility | Aetna Medicare | Medicare | $13.44 | $64.00 | — | 2025-01-31 | MRF ↗ |
| SIDNEY HEALTH CENTER InpatientFacility | Blue Cross | HealthLink Network | $13.65 | $15.00 | $9.29 | 2026-04-30 | MRF ↗ |
| SIDNEY HEALTH CENTER InpatientFacility | Aetna | All Commercial Plans | $14.25 | $15.00 | $9.29 | 2026-04-30 | MRF ↗ |
| SIDNEY HEALTH CENTER InpatientFacility | Pacific Source | All Commercial Plans | $14.25 | $15.00 | $9.29 | 2026-04-30 | MRF ↗ |
| SIDNEY HEALTH CENTER InpatientFacility | Cigna | All Commercial Plans | $14.25 | $15.00 | $9.29 | 2026-04-30 | MRF ↗ |
| SIDNEY HEALTH CENTER InpatientFacility | United Healthcare | All Commercial Plans | $14.25 | $15.00 | $9.29 | 2026-04-30 | MRF ↗ |
| SIDNEY HEALTH CENTER InpatientFacility | Sanford Health Plan | All Commercial Plans | $14.25 | $15.00 | $9.29 | 2026-04-30 | MRF ↗ |
| SIDNEY HEALTH CENTER InpatientFacility | Employee Benefit Management System | All Commercial Plans | $14.25 | $15.00 | $9.29 | 2026-04-30 | MRF ↗ |
| SIDNEY HEALTH CENTER InpatientFacility | Allegiance | All Commercial Plans | $14.25 | $15.00 | $9.29 | 2026-04-30 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $14.41 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $14.41 | — | — | 2025-01-01 | MRF ↗ |
| SIDNEY HEALTH CENTER InpatientFacility | Mountain Health Co-Op | All Commercial Plans | $14.55 | $15.00 | $9.29 | 2026-04-30 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | UHC | Medicaid | $14.99 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | UHC | Medicaid | $14.99 | — | — | 2025-01-01 | MRF ↗ |
| SIDNEY HEALTH CENTER InpatientFacility | Blue Cross | Traditional Network | $15.00 | $15.00 | $9.29 | 2026-04-30 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Anthem | Medicaid | $15.13 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Anthem | Medicaid | $15.13 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Molina | Medicaid | $15.13 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Molina | Medicaid | $15.13 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Humana | Medicaid | $15.27 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Humana | Medicaid | $15.27 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye (Centene) | Medicaid | $15.42 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye (Centene) | Medicaid | $15.42 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Caresource | Medicaid | $15.42 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | AmeriHealth Caritas | Medicaid | $15.42 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Caresource | Medicaid | $15.42 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye Community Health | Medicaid | $15.42 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | AmeriHealth Caritas | Medicaid | $15.42 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Buckeye Community Health | Medicaid | $15.42 | — | — | 2025-01-01 | MRF ↗ |
| TIPPAH COUNTY HOSPITAL Both | United Healthcare | Default | $15.59 | $18.90 | $18.90 | 2025-07-29 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Safe Program | Medicaid | $15.71 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | PARAMOUNT | Medicaid | $15.71 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | Safe Program | Medicaid | $15.71 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL NEW ALBANY SURGICAL HOSPITAL OutpatientFacility | PARAMOUNT | Medicaid | $15.71 | — | — | 2025-01-01 | MRF ↗ |
| NEBRASKA ORTHOPAEDIC HOSPITAL OutpatientFacility | BCBS OF NEBRASKA SELECT | ALL PRODUCTS | $16.73 | — | — | 2025-12-27 | MRF ↗ |
| NEBRASKA ORTHOPAEDIC HOSPITAL OutpatientFacility | BCBS OF NEBRASKA SELECT | ALL PRODUCTS | $16.73 | — | — | 2025-12-27 | MRF ↗ |
| KIMBALL HEALTH SERVICES Outpatient | UHC MEDICAID | UHC MEDICAID | $18.50 | $25.00 | $25.00 | 2026-10-12 | MRF ↗ |
| TIPPAH COUNTY HOSPITAL Both | Molina Healthcare of Mississippi | Default | $18.90 | $18.90 | $18.90 | 2025-07-29 | MRF ↗ |
| KIMBALL HEALTH SERVICES Outpatient | UHC ALL PAYER - ALL OTHER PLANS | UHC ALL PAYER - ALL OTHER PLANS | $20.55 | $25.00 | $25.00 | 2026-10-12 | MRF ↗ |
| HCA FLORIDA LAWNWOOD HOSPITAL Outpatient | Aetna | MCR | $20.56 | $298.00 | $298.00 | 2026-03-01 | MRF ↗ |
| THE NEBRASKA METHODIST HOSPITAL Outpatient | Bcbs | Bcbs | $20.66 | $737.00 | $265.32 | 2026-07-31 | MRF ↗ |
| Methodist Women's Hospital Outpatient | Bcbs | Bcbs | $20.66 | $737.00 | $265.32 | 2026-07-15 | MRF ↗ |
| THE NEBRASKA METHODIST HOSPITAL Outpatient | Bcbs | Bcbs Select | $20.66 | $737.00 | $265.32 | 2026-07-31 | MRF ↗ |
| Methodist Women's Hospital Outpatient | Bcbs | Bcbs Select | $20.66 | $737.00 | $265.32 | 2026-07-15 | MRF ↗ |
| METHODIST JENNIE EDMUNDSON Outpatient | Bcbs | Bcbs | $20.66 | $737.00 | $221.10 | 2026-07-15 | MRF ↗ |
| METHODIST JENNIE EDMUNDSON Outpatient | Bcbs | Bcbs Select | $20.66 | $737.00 | $221.10 | 2026-07-15 | MRF ↗ |
| HCA FLORIDA LAWNWOOD HOSPITAL Outpatient | BCBS | MCRHMO | $21.46 | $298.00 | $298.00 | 2026-03-01 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Caresource Wv | All Plans | $22.14 | $24.60 | — | 2026-09-21 | MRF ↗ |
| LIBERTY REGIONAL MEDICAL CENTER Both | Medicaid Georgia | Default | $22.46 | $139.00 | $104.25 | 2026-04-01 | MRF ↗ |
| LIBERTY REGIONAL MEDICAL CENTER Both | Amerigroup NM, GA, DC | Default | $22.52 | $139.00 | $104.25 | 2026-04-01 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Carefirst Ppo | All Plans | $22.71 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Aetna Medicare Advantage | All Plans | $22.71 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Provider Partners | All Plans | $22.71 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Vibra Health Plan Medicare Advantage | All Plans | $22.71 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Humana Military | Tricare | $22.71 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Senior Advantage | Isnp | $22.71 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Humana Medicare Advantage | All Plans | $22.71 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Highmark Wv Medicare Advantage | All Plans | $22.71 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | United Mine Workers Of America | Retirees | $22.71 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Unitedhealthcare Medicare Advantage | All Plans | $22.71 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Upmc For You Medicare Advantage | All Plans | $22.71 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Highmark Wholecare Medicare Advantage | All Plans | $22.71 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Carefirst D-Snp | All Plans | $22.71 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | The Health Plan Medicare Advantage | All Plans | $22.71 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Pa Health & Wellness Medicare Advantage | All Plans | $22.71 | $24.60 | — | 2026-09-21 | MRF ↗ |
| LIBERTY REGIONAL MEDICAL CENTER Both | WellCare of Georgia | Default | $22.97 | $139.00 | $104.25 | 2026-04-01 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Wellpoint Wv | Chip | $23.20 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Wellpoint Wv | Managed Medicaid | $23.20 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | The Health Plan Of Wv | Managed Medicaid | $23.20 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Aetna Better Health Wv | Chip | $23.20 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Maryland Physicians Care | Managed Medicaid | $23.20 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Highmark Health Options Wv | Managed Medicaid | $23.20 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Highmark Health Options Wv | Chip | $23.20 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Carefirst Community Health Plan | Medicaid | $23.20 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Uhc Community Health Plan Md | Managed Medicaid | $23.20 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Aetna Better Health Wv | Managed Medicaid | $23.20 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Aetna Better Health Maryland | Medicaid | $23.20 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Coventry | Workers Comp | $23.20 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Amerigroup | Medicaid | $23.20 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | The Health Plan Of Wv | Chip | $23.20 | $24.60 | — | 2026-09-21 | MRF ↗ |
| GARRETT REGIONAL MEDICAL CENTER Both | Multiplan | All Plans | $23.37 | $24.60 | — | 2026-09-21 | MRF ↗ |
| LIBERTY REGIONAL MEDICAL CENTER Both | CareSource GA | Default | $23.58 | $139.00 | $104.25 | 2026-04-01 | MRF ↗ |
| KIMBALL HEALTH SERVICES Outpatient | BCBS NE - ALL OTHER PLAND | BCBS NE - ALL OTHER PLAND | $23.75 | $25.00 | $25.00 | 2026-10-12 | 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.