A9604 — Sm 153 Lexidronam
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Sm 153 lexidronam (HCPCS A9604) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/A9604?code_type=HCPCS
MLA (9th ed.)
“Sm 153 lexidronam (HCPCS A9604) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/A9604?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Sm 153 lexidronam (HCPCS A9604) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/A9604?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $4,401–$23,711 (25th–75th percentile) across 1,701 hospitals · 3,402 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS A9604 — 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
$4,401
$12,749 typical
$23,711
The middle 50% of negotiated facility rates for this procedure, measured across 1,701 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $12,749 |
| Likely subtotal | $12,749 |
Facility charge (no separate professional fee)
$12,749
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 $4,401–$23,711.
- 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 |
|---|---|---|---|---|---|---|---|
| SUNNYVIEW HOSPITAL AND REHABILITATION CENTER OutpatientFacility | VNA Homecare Options | Medicaid | — | $57,456.00 | $48,837.60 | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | VNA Homecare Options | Medicaid | — | $57,456.00 | $48,837.60 | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | VNA Homecare Options | Medicaid | — | $57,456.00 | $48,837.60 | 2025-01-01 | MRF ↗ |
| JOHNSON MEMORIAL HOSPITAL OutpatientFacility | CTCare | Medicare Advantage | — | $95,760.00 | $52,668.00 | 2025-01-01 | MRF ↗ |
| SAINT MARY'S HOSPITAL OutpatientFacility | CTCare | Medicare Advantage | — | $57,456.00 | $31,600.80 | 2025-01-01 | MRF ↗ |
| JOHNSON MEMORIAL HOSPITAL OutpatientFacility | CTCare | Medicare Advantage | — | $95,760.00 | $52,668.00 | 2025-01-01 | MRF ↗ |
| James Cancer Hospital & Solove Research Institute Outpatient | Cigna | Cigna - Transplant | $0.62 | $58,635.00 | — | 2026-07-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-09-02 | 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 TRADITIONAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Medicaid | Medicaid | $1.00 | $113,980.16 | $56,990.08 | 2026-07-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $1.07 | $113,980.16 | $56,990.08 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $1.10 | $113,980.16 | $56,990.08 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $1.18 | $113,980.16 | $56,990.08 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Jefferson Health Plan | Jefferson Health Plan - Managed Medicaid | $1.20 | $113,980.16 | $56,990.08 | 2026-07-01 | MRF ↗ |
| GEISINGER MEDICAL CENTER Outpatient | United Healthcare | United Healthcare - Commercial | $1.27 | $113,980.16 | $70,667.70 | 2025-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - Managed Medicaid | $1.47 | $113,980.16 | $56,990.08 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - CHIP - Managed Medicare | $2.50 | $113,980.16 | $56,990.08 | 2026-07-01 | MRF ↗ |
| KULA HOSPITAL | Negotiated Base Rate | — | $7.43 | $46,899.69 | $18,290.88 | 2026-07-31 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | IRON CLAD INSURANCE [10026304] | $16.52 | $14,793.00 | $10,355.10 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP GIC NAVIGATOR POS [10026312] | $16.52 | $14,793.00 | $10,355.10 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP SELECT [10026309] | $16.52 | $14,793.00 | $10,355.10 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP HMO OUT IPA [10026302] | $16.52 | $14,793.00 | $10,355.10 | 2025-01-01 | MRF ↗ |
| LOWELL GENERAL HOSPITAL Outpatient | TUFTS HEALTH PLAN [100263] | THP POS/EPO [10026306] | $16.52 | $14,793.00 | $10,355.10 | 2025-01-01 | MRF ↗ |
| St. Louise Regional Hospital BothFacility | BLUE CROSS MEDI-CAL MC [320] | BLUE CROSS MCMC [320001] | $19.80 | $64,074.00 | $44,851.80 | 2026-09-01 | MRF ↗ |
| SANTA CLARA VALLEY MEDICAL CENTER BothFacility | BLUE CROSS MEDI-CAL MC [320] | BLUE CROSS MCMC [320001] | $19.80 | $64,074.00 | $44,851.80 | 2026-09-01 | MRF ↗ |
| O'connor Hospital BothFacility | BLUE CROSS MEDI-CAL MC [320] | BLUE CROSS MCMC [320001] | $19.80 | $64,074.00 | $44,851.80 | 2026-09-01 | MRF ↗ |
| ST JOE MERCY HOSPITAL SYSTEM LIVONIA OutpatientFacility | VACCN United | Veterans Affairs | $20.50 | $95,760.00 | $62,244.00 | 2025-01-01 | MRF ↗ |
| ST JOE MERCY HOSPITAL SYSTEM LIVONIA OutpatientFacility | VACCN United | Veterans Affairs | $20.50 | $95,760.00 | $62,244.00 | 2025-01-01 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | United Healthcare | Managed Medicaid | $30.82 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Amerihealth Caritas North Carolina | Managed Medicaid | $30.82 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Alliance | Managed Medicaid | $30.82 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Wellcare | Managed Medicaid | $30.82 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Carolina Complete Health | Managed Medicaid | $30.82 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Trillium | Managed Medicaid | $31.12 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Partners | Managed Medicaid | $31.74 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Vaya Health | Managed Medicaid | $31.74 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $42.01 | $23,340.00 | $17,259.85 | 2024-12-31 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Healthscope | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | Geha | Geha | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Surest | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Medica | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Surest | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Surest | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-07-15 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Surest | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Healthscope | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | Geha | Geha | — | — | — | 2026-07-15 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-07-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-07-15 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-07-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-07-15 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-07-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | Geha | Geha | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Medica | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-07-15 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-07-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Surest | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Healthscope | — | — | — | 2026-07-15 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | Geha | Geha | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-07-15 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-07-15 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-07-15 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Medica | — | — | — | 2026-07-15 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-07-15 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Healthscope | — | — | — | 2026-07-15 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-07-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | Geha | Geha | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Medica | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-07-15 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Medica | — | — | — | 2026-07-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-07-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-07-14 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Bcbs | Blue Home | $50.22 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Bcbs | Blue Value | $50.22 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Bcbs | Option Ppo | $50.22 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Umr | — | $52.50 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | United Healthcare | — | $52.50 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $56.88 | $31,600.80 | $17,259.85 | 2024-12-31 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $57.00 | $15,406.00 | $14,635.70 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $57.00 | $15,406.00 | $14,635.70 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $57.00 | $15,406.00 | $14,635.70 | 2026-02-20 | MRF ↗ |
| MID-COLUMBIA MEDICAL CENTER Outpatient | PROVIDENCE PPO - ALL PLANS | PROVIDENCE PPO - ALL PLANS | $58.00 | $17,032.00 | $8,175.36 | 2026-05-13 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $58.54 | $15,406.00 | $14,635.70 | 2026-02-20 | MRF ↗ |
| SAN ANTONIO REGIONAL HOSPITAL Outpatient | ANTHEM BLUE CROSS EXCHG | ANTHEM BLUE CROSS EXCHG | $58.65 | $26,830.00 | $13,415.00 | 2026-04-02 | MRF ↗ |
| KULA HOSPITAL Outpatient | Uhc | Quest | $60.00 | $46,899.69 | $18,291.00 | 2026-07-15 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Contigo | — | $60.06 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $60.08 | $15,406.00 | $14,635.70 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $61.62 | $15,406.00 | $14,635.70 | 2026-02-20 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Cigna | Choice | $61.85 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| SAINT MARY'S HOSPITAL OutpatientFacility | UHC | All Products | $62.00 | $57,456.00 | $31,600.80 | 2025-01-01 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $64.03 | $13,067.00 | $12,413.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $64.03 | $13,067.00 | $12,413.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $65.33 | $13,067.00 | $12,413.65 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $67.95 | $13,067.00 | $12,413.65 | 2026-02-20 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Aetna | State Health Plan | $68.25 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $70.56 | $13,067.00 | $12,413.65 | 2026-02-20 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Medcost | — | $72.03 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Medcost | Ppo | $72.03 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Aetna | Choice Pos | $76.65 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| SAINT MARY'S HOSPITAL OutpatientFacility | Aetna | Aetna Whole Health | $80.00 | $57,456.00 | $31,600.80 | 2025-01-01 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Brighton Health Plan | All Products | $82.15 | $23,340.00 | $17,259.85 | 2024-12-31 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | MVP | Individual Plan | $89.00 | $57,456.00 | $48,837.60 | 2025-01-01 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | First Health Network | — | $105.00 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | Aetna | Medicare Advantage | $105.00 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| UNC ROCKINGHAM Outpatient | United Healthcare | Exchange | $105.00 | $105.00 | $63.00 | 2026-07-15 | MRF ↗ |
| ST PETER'S HOSPITAL BothFacility | Empire | Medicare Advantage | $107.00 | $57,456.00 | $48,837.60 | 2025-01-01 | MRF ↗ |
| BANNER MCKEE MEDICAL CENTER OutpatientFacility | Banner Health | Banner Choice Plus/Banner Select | $111.54 | $434.00 | $197.04 | 2026-03-02 | MRF ↗ |
| ST CATHERINE OF SIENA HOSPITAL OutpatientFacility | Beacon Health Options | Medicare | $112.18 | $337,056.00 | — | 2026-02-19 | MRF ↗ |
| ST FRANCIS HOSPITAL & MEDICAL CENTER OutpatientFacility | United Behavioral Health | All Products | $124.10 | $57,456.00 | $31,600.80 | 2025-01-01 | MRF ↗ |
| ST FRANCIS HOSPITAL & MEDICAL CENTER OutpatientFacility | United Behavioral Health | All Products | $124.10 | $57,456.00 | $31,600.80 | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | BSNENY | Medicare Advantage | $157.00 | $57,456.00 | $48,837.60 | 2025-01-01 | MRF ↗ |
| ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL OutpatientFacility | Wellpoint | NJ Family Care | $157.19 | — | — | 2026-03-04 | MRF ↗ |
| JOHN H STROGER JR HOSPITAL Both | Uhc | Hmo | $158.46 | $7,900.00 | $5,530.00 | 2026-05-14 | MRF ↗ |
| JOHN H STROGER JR HOSPITAL Both | Uhc | Ppo | $158.46 | $7,900.00 | $5,530.00 | 2026-05-14 | MRF ↗ |
| PROVIDENT HOSPITAL OF CHICAGO Both | Uhc | Ppo | $158.46 | $7,900.00 | $5,530.00 | 2026-05-22 | MRF ↗ |
| PROVIDENT HOSPITAL OF CHICAGO Both | Uhc | Hmo | $158.46 | $7,900.00 | $5,530.00 | 2026-05-22 | MRF ↗ |
| HOMESTEAD HOSPITAL Both | VISTA | COVENTRY MEDICAID | $167.89 | $18,452.00 | $11,993.80 | 2026-03-30 | MRF ↗ |
| UNIONTOWN HOSPITAL Outpatient | University Of Pittsburgh Medical Ctr Health Plan | University Of Pittsburgh Medical Ctr Health Plan | $171.55 | $18,865.00 | $9,432.50 | 2026-05-13 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $171.58 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $171.58 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $171.58 | — | — | 2026-03-18 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | BCBS | BlueChoice | $174.11 | — | — | 2024-10-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | BCBS | BlueChoice | $174.11 | — | — | 2026-03-01 | MRF ↗ |
| Wesley Rehabilitation Hospital, An Affiliate Of En Outpatient | BCBS | Cap | $174.11 | — | — | 2026-03-01 | MRF ↗ |
| WESLEY MEDICAL CENTER Outpatient | BCBS | Cap | $174.11 | — | — | 2024-10-01 | MRF ↗ |
| CHELSEA HOSPITAL OutpatientFacility | Magellan Behavioral Health | Summit_Pinnacle | $181.00 | $95,760.00 | $62,244.00 | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL EAST & WEST OutpatientFacility | UHC | All Products | $187.00 | $57,456.00 | $37,346.40 | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | UHC | All Products | $187.00 | $57,456.00 | $37,346.40 | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | UHC | All Products | $187.00 | $57,456.00 | $37,346.40 | 2025-01-01 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $196.63 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $196.63 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $196.63 | — | — | 2026-03-18 | MRF ↗ |
| MERCY CATHOLIC MEDICAL CENTER- MERCY FITZGERALD OutpatientFacility | Independence Blue Cross | Traditional | $211.00 | $134,064.00 | $76,014.29 | 2025-01-01 | MRF ↗ |
| MERCY CATHOLIC MEDICAL CENTER- MERCY FITZGERALD OutpatientFacility | Independence Blue Cross | HMO_PPO | $211.00 | $134,064.00 | $87,543.79 | 2025-01-01 | MRF ↗ |
| NAZARETH HOSPITAL OutpatientFacility | Independence Blue Cross | HMO_PPO | $211.00 | $57,456.00 | $39,644.64 | 2025-01-01 | MRF ↗ |
| NAZARETH HOSPITAL OutpatientFacility | Independence Blue Cross | Traditional | $211.00 | $57,456.00 | $39,644.64 | 2025-01-01 | MRF ↗ |
| LINDSBORG COMMUNITY HOSPITAL Outpatient | BCBS -ALL PLANS | BCBS -ALL PLANS | $213.00 | $24,753.40 | $17,327.38 | 2026-04-06 | MRF ↗ |
| LINDSBORG COMMUNITY HOSPITAL Outpatient | BCBS -ALL PLANS | BCBS -ALL PLANS | $213.00 | $24,753.40 | $17,327.38 | 2026-04-06 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $214.09 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $214.09 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $214.09 | — | — | 2026-03-18 | MRF ↗ |
| RUSSELL REGIONAL HOSPITAL OutpatientFacility | BlueCross BlueShield of Kansas | Commercial | $215.13 | — | — | 2026-06-01 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Wellcare | by Allwell Medicare Advantage (Sunflower) | — | — | — | 2026-07-29 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Ambetter | PPO | — | — | — | 2026-07-29 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Ambetter | HMO | — | — | — | 2026-07-29 | MRF ↗ |
| LABETTE HEALTH OutpatientFacility | BCBS | All Products | $215.13 | — | — | 2025-06-28 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Health Partners | All Plans | — | — | — | 2026-07-29 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | UHC | VA CCN | — | — | — | 2026-07-29 | MRF ↗ |
| HOSPITAL DISTRICT #1 OF RICE COUNTY OutpatientFacility | Blue Cross Blue Shield Kansas | POS | $215.13 | — | — | 2026-03-24 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Cigna | HMO | — | — | — | 2026-07-29 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | United Healthcare | PPO | — | — | — | 2026-07-29 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Humana | ChoiceCare | — | — | — | 2026-07-29 | 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.