D0704 — 3d Photo Image Capture Only
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). 3d photo image capture only (CPT D0704) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/D0704?code_type=CPT
MLA (9th ed.)
“3d photo image capture only (CPT D0704) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/D0704?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“3d photo image capture only (CPT D0704) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/D0704?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $42–$96 (25th–75th percentile) across 104 hospitals · 124 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS D0704 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
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 |
|---|---|---|---|---|---|---|---|
| Roswell Park Cancer Institute OutpatientFacility | Univera | Special Programs Medicaid Managed Care Plan | $11.70 | — | — | 2026-04-01 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Anthem | Managed Medicaid | $15.63 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Quartz | Managed Medicaid | $15.63 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Dean Health Plan | Managed Medicaid | $15.63 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | MEDICAID | MEDICAID | $15.63 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $15.94 | — | — | 2025-07-22 | MRF ↗ |
| GUNDERSEN PALMER LUTHERAN HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Amerigroup | Medicaid HMO | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Managed Health Service | Managed Medicaid | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Managed Health Service | Managed Medicaid | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | ICare | Medicaid HMO | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN TRI-COUNTY HOSPITAL & CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Iowa Total Care | Medicaid | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN PALMER LUTHERAN HOSPITAL AND CLINICS OutpatientFacility | Molina Health | Managed Medicaid | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | UHC | Medicaid | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN MOUNDVIEW HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN ST JOSEPHS HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | UHC | Medicaid | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Molina Health | Managed Medicaid | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Anthem | Medicaid | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Group Health of South Central | Medicaid HMO | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | ICare | Medicaid HMO | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Group Health Eau Claire | Medicaid HMO | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Group Health of South Central | Medicaid HMO | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Molina Health | Managed Medicaid | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Amerigroup | Medicaid HMO | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Iowa Total Care | Medicaid | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Group Health Eau Claire | Medicaid HMO | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Anthem | Medicaid | $16.28 | — | — | 2025-06-27 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $16.57 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Healthy New York | $16.57 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $16.57 | — | — | 2026-04-14 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Essential Plan | $16.57 | — | — | 2026-04-14 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Managed Health Services | Managed Medicaid | $17.04 | — | — | 2025-07-22 | MRF ↗ |
| NEBRASKA ORTHOPAEDIC HOSPITAL OutpatientFacility | BCBS OF NEBRASKA SELECT | ALL PRODUCTS | $18.19 | — | — | 2025-12-27 | MRF ↗ |
| NEBRASKA ORTHOPAEDIC HOSPITAL OutpatientFacility | BCBS OF NEBRASKA SELECT | ALL PRODUCTS | $18.19 | — | — | 2025-12-27 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $19.50 | — | — | 2026-04-14 | MRF ↗ |
| Roswell Park Cancer Institute OutpatientFacility | Univera | Access All Commercial Plans | $19.50 | — | — | 2026-04-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $19.50 | — | — | 2026-04-14 | MRF ↗ |
| Roswell Park Cancer Institute OutpatientFacility | Univera | All Commercial Plans | $19.50 | — | — | 2026-04-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Commercial | $19.50 | — | — | 2026-04-14 | MRF ↗ |
| Roswell Park Cancer Institute OutpatientFacility | Univera | Medicare Managed Care Plan | $19.50 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | All Commercial Plans | $19.50 | — | — | 2026-04-01 | MRF ↗ |
| OLEAN GENERAL HOSPITAL OutpatientFacility | Univera | Essential Other Commercial Plan | $19.50 | — | — | 2026-04-01 | MRF ↗ |
| WESTFIELD MEMORIAL HOSPITAL, INC Outpatient | Univera | Univera Medicare | $19.50 | — | — | 2026-04-14 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | All Commercial Plans | $19.50 | — | — | 2026-04-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $20.59 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $20.59 | — | — | 2025-01-01 | MRF ↗ |
| ST JAMES PARISH HOSPITAL OutpatientFacility | Aetna | All Commercial Plans | $21.18 | — | — | 2026-04-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Molina | Medicaid | $21.62 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Molina | Medicaid | $21.62 | — | — | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | Albany Correctional Facility | Medicaid | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | CDPHP | HARP | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Correctional Facility | Medicaid | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Excellus Healthy | Medicaid | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Fidelis | MMC HARP CHP EPP 3_4 MLTC | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | UHC | HARD CHIP | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | CDPHP | HARP | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Fidelis | MMC HARP CHP EPP 3_4 MLTC | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Excellus Healthy | Medicaid | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | Fidelis | MMC HARP CHP EPP 3_4 MLTC | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | UHC | HARD CHIP | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Excellus BCBS | Medicaid | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | UHC | HARD CHIP | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | Fidelis | MMC HARP CHP EPP 3_4 MLTC | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | UHC | HARD CHIP | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | Albany Correctional Facility | Medicaid | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Molina | Medicaid | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | CDPHP | Medicaid | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Correctional Facility | Medicaid | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Excellus BCBS | Medicaid | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | Molina | Medicaid | $21.74 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Humana | Medicaid | $21.83 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Humana | Medicaid | $21.83 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Buckeye Community Health | Medicaid | $22.03 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | AmeriHealth Caritas | Medicaid | $22.03 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Buckeye Community Health | Medicaid | $22.03 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | AmeriHealth Caritas | Medicaid | $22.03 | — | — | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | MVP | Medicaid | $22.39 | — | — | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | MVP | Medicaid | $22.39 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Safe Program | Medicaid | $22.44 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | PARAMOUNT | Medicaid | $22.44 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | PARAMOUNT | Medicaid | $22.44 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Safe Program | Medicaid | $22.44 | — | — | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | Empire | Medicaid | $23.04 | — | — | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | Empire | Medicaid | $23.04 | — | — | 2025-01-01 | MRF ↗ |
| UF HEALTH LEESBURG HOSPITAL OutpatientFacility | Sunshine State | ALL PRODUCTS | $23.68 | — | — | 2026-03-31 | MRF ↗ |
| VILLAGES REGIONAL HOSPITAL, THE OutpatientFacility | Sunshine State | ALL PRODUCTS | $23.68 | — | — | 2026-03-31 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL - VENICE Outpatient | Simply Healthcare | Healthy Kids | $23.96 | — | — | 2025-08-01 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Humana | Managed Medicaid | $23.96 | — | — | 2026-02-06 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL - VENICE Outpatient | Simply Healthcare | Healthy Kids | $23.96 | — | — | 2025-08-01 | MRF ↗ |
| VILLAGES REGIONAL HOSPITAL, THE OutpatientFacility | Humana | MANAGED MEDICAID | $23.96 | — | — | 2026-03-31 | MRF ↗ |
| UF HEALTH LEESBURG HOSPITAL OutpatientFacility | Humana | MANAGED MEDICAID | $23.96 | — | — | 2026-03-31 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Amerigroup of Georgia | Managed Medicaid OOS | $23.96 | — | — | 2026-02-06 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare | Healthy Kids | $23.96 | — | — | 2025-08-01 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Nassaua County Sheriff's Office | Managed Medicaid | $23.96 | — | — | 2026-02-06 | MRF ↗ |
| UF HEALTH LEESBURG HOSPITAL OutpatientFacility | Simply Healthcare | MANAGED MEDICAID | $23.96 | — | — | 2026-03-31 | MRF ↗ |
| VILLAGES REGIONAL HOSPITAL, THE OutpatientFacility | Simply Healthcare | MANAGED MEDICAID | $23.96 | — | — | 2026-03-31 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Daniel Memorial | Managed Medicaid | $23.96 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Amerigroup of Georgia | Managed Medicaid OOS | $23.96 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Amerigroup of Georgia | Managed Medicaid OOS | $23.96 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Daniel Memorial | Managed Medicaid | $23.96 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Daniel Memorial | Managed Medicaid | $23.96 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | UHC COMMUNITY | MCAID HMO | $24.25 | — | — | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | UHC COMMUNITY | MCAID HMO | $24.25 | — | — | 2025-12-23 | MRF ↗ |
| HALIFAX HEALTH MEDICAL CENTER OutpatientFacility | FLORIDA MEDICAID | MANAGED MEDICAID | $24.26 | — | — | 2025-07-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | CHA HEALTH PLAN | HMO | $24.26 | — | — | 2025-12-23 | MRF ↗ |
| HALIFAX HEALTH MEDICAL CENTER OutpatientFacility | WEST VOLUSIA | MANAGED MEDICAID | $24.26 | — | — | 2025-07-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | AETNA | BETTER HLTHY KIDS | $24.26 | — | — | 2025-12-23 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Fidelis | Managed Medicaid_Fidelis Medicaid_ FamilyHealth Plus_CHP | $24.26 | — | — | 2025-05-02 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Community Care Plan | Healthy Kids | $24.26 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL REGIONAL HOSPITAL OutpatientFacility | Community Care Plan | Healthy Kids | $24.26 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | Community Care Plan | Healthy Kids | $24.26 | — | — | 2025-07-30 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | WEST VOLUSIA | MANAGED MEDICAID | $24.26 | — | — | 2025-07-23 | MRF ↗ |
| HOLY CROSS HOSPITAL OutpatientFacility | Centene | Medicaid | $24.26 | — | — | 2025-01-01 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | HCRA | MANAGED MEDICAID | $24.26 | — | — | 2025-07-23 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | COVENTRY | MANAGED MEDICAID | $24.26 | — | — | 2025-07-23 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | HUMANA | MANAGED MEDICAID | $24.26 | — | — | 2025-07-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | AETNA | BETTER HLTHY KIDS | $24.26 | — | — | 2025-12-23 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | MOLINA | MANAGED MEDICAID | $24.26 | — | — | 2025-07-23 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Community Care Plan | Healthy Kids | $24.26 | — | — | 2025-07-30 | MRF ↗ |
| HALIFAX HEALTH MEDICAL CENTER OutpatientFacility | HCRA | MANAGED MEDICAID | $24.26 | — | — | 2025-07-23 | MRF ↗ |
| HOLY CROSS HOSPITAL OutpatientFacility | Centene | Medicaid | $24.26 | — | — | 2025-01-01 | MRF ↗ |
| HALIFAX HEALTH MEDICAL CENTER OutpatientFacility | UHC AMERICHOICE | MANAGED MEDICAID | $24.26 | — | — | 2025-07-23 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | UHC AMERICHOICE | MANAGED MEDICAID | $24.26 | — | — | 2025-07-23 | MRF ↗ |
| HALIFAX HEALTH MEDICAL CENTER OutpatientFacility | HUMANA | MANAGED MEDICAID | $24.26 | — | — | 2025-07-23 | MRF ↗ |
| SCHUYLER HOSPITAL OutpatientFacility | Excellus BCBS | Managed Medicaid _CHP_SP | $24.26 | — | — | 2025-05-02 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | Community Care Plan | Healthy Kids | $24.26 | — | — | 2025-07-30 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | CHA HEALTH PLAN | HMO | $24.26 | — | — | 2025-12-23 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | FLORIDA MEDICAID | MANAGED MEDICAID | $24.26 | — | — | 2025-07-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | SIMPLY HEALTHCARE HEALTHY KIDS | ALL PRODUCTS | $24.26 | — | — | 2025-12-23 | MRF ↗ |
| HALIFAX HEALTH MEDICAL CENTER OutpatientFacility | MOLINA | MANAGED MEDICAID | $24.26 | — | — | 2025-07-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | CHA HEALTH PLAN | HMO | $24.26 | — | — | 2025-12-23 | MRF ↗ |
| HALIFAX HEALTH MEDICAL CENTER OutpatientFacility | COVENTRY | MANAGED MEDICAID | $24.26 | — | — | 2025-07-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | AETNA | BETTER HLTHY KIDS | $24.26 | — | — | 2025-12-23 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Community Care Plan | Healthy Kids | $24.26 | — | — | 2025-07-30 | MRF ↗ |
| UF HEALTH SHANDS HOSPITAL OutpatientFacility | Simply Healthcare | MCD HMO | $24.71 | — | — | 2026-03-31 | MRF ↗ |
| HOLY CROSS HOSPITAL OutpatientFacility | Sunshine State Health Plan | Medicaid | $24.99 | — | — | 2025-01-01 | MRF ↗ |
| HOLY CROSS HOSPITAL OutpatientFacility | Sunshine State Health Plan | Medicaid | $24.99 | — | — | 2025-01-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL - VENICE Outpatient | Simply Healthcare | Medicaid HMO | $25.16 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL - VENICE Outpatient | Sunshine State | Medicaid HMO | $25.16 | — | — | 2025-08-01 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Simply Healthcare Plans - CHA | Managed Medicaid | $25.16 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Simply Healthcare Plans | Managed Medicaid | $25.16 | — | — | 2026-02-06 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare | Medicaid HMO | $25.16 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Sunshine State | Medicaid HMO | $25.16 | — | — | 2025-08-01 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Simply Healthcare Plans - CHA | Managed Medicaid | $25.16 | — | — | 2026-02-06 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL - VENICE Outpatient | Sunshine State | Medicaid HMO | $25.16 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL - VENICE Outpatient | Simply Healthcare | Medicaid HMO | $25.16 | — | — | 2025-08-01 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Simply Healthcare Plans - CHA | Managed Medicaid | $25.16 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Simply Healthcare Plans | Managed Medicaid | $25.16 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Simply Healthcare Plans | Managed Medicaid | $25.16 | — | — | 2026-02-06 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Sunshine | MEDICAID | $25.23 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Sunshine | Child Welfare Program | $25.23 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Sunshine | MEDICAID | $25.23 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Sunshine | Child Welfare Program | $25.23 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL REGIONAL HOSPITAL OutpatientFacility | Sunshine | Child Welfare Program | $25.23 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | Sunshine | Child Welfare Program | $25.23 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | Sunshine | MEDICAID | $25.23 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL REGIONAL HOSPITAL OutpatientFacility | Sunshine | MEDICAID | $25.23 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Sunshine | MEDICAID | $25.23 | — | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | Sunshine | MEDICAID | $25.23 | — | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | Sunshine | Child Welfare Program | $25.23 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Sunshine | Child Welfare Program | $25.23 | — | — | 2025-07-30 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | UHC | Essential Plan | $25.44 | — | — | 2025-01-01 | MRF ↗ |
| ST JOSEPH'S HOSPITAL HEALTH CENTER OutpatientFacility | UHC | Essential Plan | $25.44 | — | — | 2025-01-01 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | SUNSHINE STATE HEALTH PLAN | MANAGED MEDICAID | $25.47 | — | — | 2025-07-23 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | UNITED | MEDICAID | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | HUMANA | MEDICAID HMO | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | Simply | Medicaid/Clear Health Alliance | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | Florida Community Care | MEDICAID | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | Freedom Health Inc. | MEDICAID | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Freedom Health Inc. | MEDICAID | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Florida Community Care | MEDICAID | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Simply | Medicaid/Clear Health Alliance | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | HUMANA | MEDICAID HMO | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | UNITED | MEDICAID | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL REGIONAL HOSPITAL OutpatientFacility | UNITED | MEDICAID | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL REGIONAL HOSPITAL OutpatientFacility | HUMANA | MEDICAID HMO | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL REGIONAL HOSPITAL OutpatientFacility | Simply | Medicaid/Clear Health Alliance | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL REGIONAL HOSPITAL OutpatientFacility | Florida Community Care | MEDICAID | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL REGIONAL HOSPITAL OutpatientFacility | Freedom Health Inc. | MEDICAID | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | STAYWELL | ALL PRODUCTS | $25.47 | — | — | 2025-12-23 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | UNITED | MEDICAID | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | HUMANA | MEDICAID HMO | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Simply | Medicaid/Clear Health Alliance | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | MH SUNSHINE MCAID | ALL PRODUCTS | $25.47 | — | — | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | SUNSHINE HEALTH | CAID HMO | $25.47 | — | — | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | HUMANA | MEDICAID HMO | $25.47 | — | — | 2025-12-23 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Florida Community Care | MEDICAID | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Freedom Health Inc. | MEDICAID | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | HUMANA | MEDICAID HMO | $25.47 | — | — | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | STAYWELL | ALL PRODUCTS | $25.47 | — | — | 2025-12-23 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | HUMANA | MEDICAID HMO | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | Freedom Health Inc. | MEDICAID | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | Florida Community Care | MEDICAID | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Florida Community Care | MEDICAID | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Simply | Medicaid/Clear Health Alliance | $25.47 | — | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | UNITED | MEDICAID | $25.47 | — | — | 2025-07-30 | 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.