D5120 — Dentures Complete Mandible
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). DENTURES COMPLETE MANDIBLE (HCPCS D5120) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/D5120?code_type=HCPCS
MLA (9th ed.)
“DENTURES COMPLETE MANDIBLE (HCPCS D5120) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/D5120?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“DENTURES COMPLETE MANDIBLE (HCPCS D5120) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/D5120?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $508–$1,400 (25th–75th percentile) across 435 hospitals · 656 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS D5120 — 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 |
|---|---|---|---|---|---|---|---|
| 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 ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS STATE | $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 ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW MEXICO MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $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 ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $4.44 | $2,464.00 | — | 2024-12-31 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Tufts | HMO | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Harvard Pilgrim Health Care | CommercialAllPlans | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Tufts | PPO | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Health New England | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Aetna | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Tufts | PPO | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Cigna | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusCentralHMO | $4.73 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | United Healthcare | CommercialAllPlans | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Tufts | POS | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | United Healthcare | CommercialAllPlans | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | Indemnity | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Health New England | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | HMO | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusCentralHMO | $4.73 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusHMO | $4.73 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusHMO | $4.73 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | HMO | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Tufts | HMO | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Cigna | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Aetna | MedicareAdvantage | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | Indemnity | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Aetna | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Harvard Pilgrim Health Care | CommercialAllPlans | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Tufts | POS | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Aetna | MedicareAdvantage | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | PPA | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | PPA | — | — | — | 2025-04-16 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | — | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | — | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - All Social Mission | — | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | — | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | — | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Indemnity | — | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | — | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | — | — | — | 2026-05-14 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - My Blue Access Ppo | — | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Managed Care | — | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Performance Blue | — | — | — | 2026-05-23 | MRF ↗ |
| PENN HIGHLANDS MON VALLEY Outpatient | Blue Cross | Highmark - Aca | — | — | — | 2026-05-23 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Highmark - All Social Mission | — | — | — | 2026-07-15 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Highmark - Indemnity | — | — | — | 2026-07-15 | MRF ↗ |
| PENN HIGHLANDS CONNELLSVILLE Outpatient | Blue Cross | Highmark - All Community Blue | — | — | — | 2026-07-15 | 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 ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid | Medicaid Nhhf | $37.13 | $404.00 | $121.20 | 2026-07-15 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid | Medicaid-Trad | $40.40 | $404.00 | $121.20 | 2026-07-15 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid-Amerihealth | Medicaid-Amerihealth | $40.80 | $404.00 | $121.20 | 2026-07-15 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Outpatient | Bcbs | Sc Preferred | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Outpatient | Bcbs | Blue Choice | — | — | — | 2026-10-03 | MRF ↗ |
| BEAUFORT COUNTY MEMORIAL HOSPITAL Outpatient | Bcbs | Bc State | — | — | — | 2026-10-03 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Medicaid | Medicaid-Wellsense | $51.59 | $404.00 | $121.20 | 2026-07-15 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | MERITAIN HEALTH [1023] | BMC HB AETNA | $54.77 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | AETNA [2022] | BMC HB AETNA STUDENT HEALTH | $54.77 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | ZZZAETNA [1001] | BMC HB AETNA | $54.77 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | ZZZAETNA [1001] | BMC HB AETNA STUDENT HEALTH | $54.77 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | AETNA [2022] | BMC HB AETNA | $54.77 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| SWEDISH HOSPITAL | Medicaid/Medicaid Mco | — | $59.28 | $480.00 | $480.00 | 2026-07-17 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | MASS GENERAL BRIGHAM HEALTH PLAN COMMERCIAL [8009] | BMC HB MASS GENERAL BRIGHAM HEALTH HMO/PPO/UNSUBSIDIZED QHP | $60.41 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Aetna | Aetna Hmo/Pos/Ppo - Arnb | $61.09 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Aetna | Aetna - Hmo/Pos/Ppo | $61.09 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Aetna | Aetna Hmo/Pos/Ppo | $61.09 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Maine Community Health Options | Mcho Indiv - Exchange | — | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Maine Community Health Options | Mcho Shop - Exchange | — | — | — | 2026-07-18 | MRF ↗ |
| SWEDISH HOSPITAL Outpatient | Medicaid Replacement | — | $64.80 | $480.00 | $220.80 | 2026-07-31 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | ZZZUNITED [1008] | BMC HB UNITED HEALTHCARE COMMERCIAL | $67.45 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | OXFORD HEALTH [1007] | BMC HB UNITED HEALTHCARE COMMERCIAL | $67.45 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | UMR [2031] | BMC HB UNITED HEALTHCARE COMMERCIAL | $67.45 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | UNITED [2025] | BMC HB UNITED HEALTHCARE COMMERCIAL | $67.45 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | OXFORD HEALTH [2024] | BMC HB UNITED HEALTHCARE COMMERCIAL | $67.45 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| SWEDISH HOSPITAL | Medicare/Medicare Advantage | — | $67.87 | $480.00 | $480.00 | 2026-07-17 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | BCBS [6001] | BMC HB BLUE CROSS | $69.79 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | BCBS OUT OF STATE [6002] | BMC HB BLUE CROSS | $69.79 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | TUFTS CONNCARE/QHP [8020] | BMC HB TUFTS NON-SUBSIDIZED PLANS | $70.06 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| SWEDISH HOSPITAL Outpatient | Medicare Advantage | — | $70.56 | $480.00 | $220.80 | 2026-07-31 | MRF ↗ |
| NORTH SHORE MEDICAL CENTER Outpatient | CURATIVE - ALL PLANS | CURATIVE - ALL PLANS | $75.00 | $1,175.00 | $1,175.00 | 2026-10-13 | MRF ↗ |
| JUPITER MEDICAL CENTER Outpatient | CURATIVE - ALL PLANS | CURATIVE - ALL PLANS | $75.00 | $1,175.00 | $1,175.00 | 2026-09-23 | MRF ↗ |
| SWEDISH HOSPITAL Outpatient | Ambetter | Commercial | $75.36 | $480.00 | $220.80 | 2026-07-31 | MRF ↗ |
| SWEDISH HOSPITAL Inpatient | Medicaid Replacement | — | $78.24 | $480.00 | $220.80 | 2026-07-31 | MRF ↗ |
| NORTHSHORE UNIVERSITY HEALTHSYSTEM - EVANSTON HOSPITAL Inpatient | — | — | — | $480.00 | $312.00 | 2025-01-01 | MRF ↗ |
| BELLEVUE MEDICAL CENTER Outpatient | AETNA COMM-ALL OTHER PLANS | AETNA COMM-ALL OTHER PLANS | $78.57 | $2,243.00 | $1,457.95 | 2026-08-10 | MRF ↗ |
| JUPITER MEDICAL CENTER Outpatient | AVMED SELECT/FIRST NTWRK | AVMED SELECT/FIRST NTWRK | $80.00 | $1,175.00 | $1,175.00 | 2026-09-23 | MRF ↗ |
| SWEDISH HOSPITAL Inpatient | Medicare Advantage | — | $82.56 | $480.00 | $220.80 | 2026-07-31 | MRF ↗ |
| NEBRASKA ORTHOPAEDIC HOSPITAL OutpatientFacility | AMERIGROUP | MEDICAID | $82.59 | — | — | 2025-12-27 | MRF ↗ |
| NEBRASKA ORTHOPAEDIC HOSPITAL OutpatientFacility | AMERIGROUP | MEDICAID | $82.59 | — | — | 2025-12-27 | MRF ↗ |
| SWEDISH HOSPITAL | Medicaid/Medicaid Mco | — | $82.75 | $480.00 | $480.00 | 2026-07-17 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | WELLPOINT [2034] | BMC HB WELLPOINT | $84.00 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | UNICARE [8004] | BMC HB WELLPOINT | $84.00 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| JUPITER MEDICAL CENTER Outpatient | AVMED COMM - ALL OTHER PLANS | AVMED COMM - ALL OTHER PLANS | $87.00 | $1,175.00 | $1,175.00 | 2026-09-23 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | ZZZCIGNA [1002] | BMC HB TUFTS PPO | $87.32 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | TUFTS [8002] | BMC HB TUFTS POS/HMO | $87.32 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | CIGNA [2023] | BMC HB TUFTS PPO | $87.32 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | TUFTS [8002] | BMC HB TUFTS PPO | $87.32 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | TUFTS [8002] | BMC HB TUFTS SELECT | $89.60 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| MOUNT NITTANY MEDICAL CENTER Outpatient | Highmark | Commercial | — | — | — | 2026-07-15 | MRF ↗ |
| MOUNT NITTANY MEDICAL CENTER Outpatient | Highmark | Commercial | — | — | — | 2026-07-15 | MRF ↗ |
| MOUNT NITTANY MEDICAL CENTER Outpatient | Highmark | Chip | — | — | — | 2026-07-15 | MRF ↗ |
| SWEDISH HOSPITAL | Medicare/Medicare Advantage | — | $94.08 | $480.00 | $480.00 | 2026-07-17 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | ZZZCIGNA [1002] | BMC HB CIGNA | $95.20 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | CIGNA [2023] | BMC HB CIGNA | $95.20 | $112.00 | $50.40 | 2026-03-13 | MRF ↗ |
| CONCORD HOSPITAL Outpatient | Harvard | Harvard Mktplace | $103.38 | $404.00 | $121.20 | 2026-07-15 | MRF ↗ |
| SWEDISH HOSPITAL | Blue Cross Blue Shield | — | $104.78 | $480.00 | $480.00 | 2026-07-17 | MRF ↗ |
| SWEDISH HOSPITAL Inpatient | Ambetter | Commercial | $107.04 | $480.00 | $220.80 | 2026-07-31 | MRF ↗ |
| SWEDISH HOSPITAL | Blue Cross Blue Shield | — | $107.62 | $480.00 | $480.00 | 2026-07-17 | MRF ↗ |
| SWEDISH HOSPITAL | Aetna | — | $114.53 | $480.00 | $480.00 | 2026-07-17 | MRF ↗ |
| SWEDISH HOSPITAL | United Healthcare | — | $121.73 | $480.00 | $480.00 | 2026-07-17 | MRF ↗ |
| SWEDISH HOSPITAL | United Healthcare | — | $123.12 | $480.00 | $480.00 | 2026-07-17 | MRF ↗ |
| SWEDISH HOSPITAL | Cigna | — | $126.86 | $480.00 | $480.00 | 2026-07-17 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | MEDICAID | MEDICAID | $129.32 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Anthem | Managed Medicaid | $129.32 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Dean Health Plan | Managed Medicaid | $129.32 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Quartz | Managed Medicaid | $129.32 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $131.91 | — | — | 2025-07-22 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | UHC | Medicaid | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Managed Health Service | Managed Medicaid | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Amerigroup | Medicaid HMO | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Iowa Total Care | Medicaid | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Anthem | Medicaid | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN TRI-COUNTY HOSPITAL & CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Group Health of South Central | Medicaid HMO | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Molina Health | Managed Medicaid | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Group Health Eau Claire | Medicaid HMO | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Managed Health Service | Managed Medicaid | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Molina Health | Managed Medicaid | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Group Health of South Central | Medicaid HMO | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | ICare | Medicaid HMO | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Iowa Total Care | Medicaid | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Anthem | Medicaid | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Amerigroup | Medicaid HMO | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | ICare | Medicaid HMO | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Group Health Eau Claire | Medicaid HMO | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN PALMER LUTHERAN HOSPITAL AND CLINICS OutpatientFacility | Molina Health | Managed Medicaid | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | UHC | Medicaid | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN PALMER LUTHERAN HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN ST JOSEPHS HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN MOUNDVIEW HOSPITAL AND CLINICS OutpatientFacility | Amerigroup | Medicaid HMO | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Managed Health Services | Managed Medicaid | $140.96 | — | — | 2025-07-22 | MRF ↗ |
| OHSU HOSPITAL AND CLINICS Outpatient | COMMUNITY HEALTH PLAN OF WASHINGTON | COMMUNITY HEALTH PLAN OF WA | $142.46 | $742.00 | $482.30 | 2026-03-23 | MRF ↗ |
| SWEDISH HOSPITAL | Humana | — | $147.46 | $480.00 | $480.00 | 2026-07-17 | MRF ↗ |
| SWEDISH HOSPITAL | Humana | — | $149.18 | $480.00 | $480.00 | 2026-07-17 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | TRICARE BLUE SHIELD - ALL PLANS | TRICARE BLUE SHIELD - ALL PLANS | $152.00 | $2,798.00 | $475.66 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | AETNA MCR ADV | AETNA MCR ADV | $152.00 | $2,798.00 | $475.66 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | HEALTHNET MCR ADV | HEALTHNET MCR ADV | $152.00 | $2,798.00 | $475.66 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | BLUE SHIELD MCARE | BLUE SHIELD MCARE | $152.00 | $2,798.00 | $475.66 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | HP OF SAN JOAQUIN MCR ADV | HP OF SAN JOAQUIN MCR ADV | $152.00 | $2,798.00 | $195.86 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | UHC MCR ADV | UHC MCR ADV | $152.00 | $2,175.00 | $369.75 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | KAISER MCR ADV | KAISER MCR ADV | $152.00 | $2,798.00 | $195.86 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | HEALTHNET MCARE | HEALTHNET MCARE | $152.00 | $2,798.00 | $195.86 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | BLUE SHIELD MCARE ADV | BLUE SHIELD MCARE ADV | $152.00 | $2,798.00 | $195.86 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | TRICARE BLUE SHIELD - ALL PLANS | TRICARE BLUE SHIELD - ALL PLANS | $152.00 | $2,798.00 | $195.86 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | UHC MCR ADV | UHC MCR ADV | $152.00 | $2,798.00 | $475.66 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | HUMANA MCR ADV - ALL PLANS | HUMANA MCR ADV - ALL PLANS | $152.00 | $2,798.00 | $195.86 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | UHC MCR ADV | UHC MCR ADV | $152.00 | $2,798.00 | $195.86 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | ALIGNMENT HEALTH PLAN (AHP)-ALL PLANS | ALIGNMENT HEALTH PLAN (AHP)-ALL PLANS | $152.00 | $2,798.00 | $195.86 | 2026-08-02 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | PHS PRIME HEALTH SRVCS-ALL PLANS | PHS PRIME HEALTH SRVCS-ALL PLANS | $152.00 | $2,798.00 | $475.66 | 2026-05-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | PHS PRIME HEALTH SRVCS-ALL PLANS | PHS PRIME HEALTH SRVCS-ALL PLANS | $152.00 | $2,175.00 | $369.75 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | BLUE SHIELD MCARE | BLUE SHIELD MCARE | $152.00 | $2,175.00 | $369.75 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | HEALTHNET MCR ADV | HEALTHNET MCR ADV | $152.00 | $2,175.00 | $369.75 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | AETNA MCR ADV | AETNA MCR ADV | $152.00 | $2,175.00 | $369.75 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | TRICARE BLUE SHIELD - ALL PLANS | TRICARE BLUE SHIELD - ALL PLANS | $152.00 | $2,175.00 | $369.75 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH LODI MEMORIAL Outpatient | CCA HEALTH PLAN MCR ADV- ALL PLANS | CCA HEALTH PLAN MCR ADV- ALL PLANS | $155.04 | $2,798.00 | $195.86 | 2026-08-02 | MRF ↗ |
| SWEDISH HOSPITAL | Aetna | — | $155.09 | $480.00 | $480.00 | 2026-07-17 | MRF ↗ |
| SWEDISH HOSPITAL Inpatient | Aetna | Commercial | $156.00 | $480.00 | $220.80 | 2026-07-31 | MRF ↗ |
| SWEDISH HOSPITAL Inpatient | Cigna | Commercial | $158.40 | $480.00 | $220.80 | 2026-07-31 | MRF ↗ |
| BAYLOR SCOTT & WHITE HEART & VASCULAR HOSPITAL - DALLAS OutpatientFacility | Superior Health Plan | Medicaid | $160.00 | $2,000.00 | $1,200.00 | 2026-02-21 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Life Trac National | Transplant (All Contracted Plans) | — | $1,632.00 | $1,060.80 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Interlink National | Transplant Medicaid (All Contracted Plans) | — | $1,632.00 | $1,060.80 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Humana National | Transplant (All Contracted Plans) | — | $1,632.00 | $1,060.80 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Interlink National | Transplant Commercial (All Contracted Plans) | — | $1,632.00 | $1,060.80 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Kaiser National | Transplant (All Contracted Plans) | — | $1,632.00 | $1,060.80 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Optum Health | Transplant Commercial (All Contracted Plans) | — | $1,632.00 | $1,060.80 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Optum Health | Transplant Government (All Contracted Plans) | — | $1,632.00 | $1,060.80 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | CCHA Behavioral Health | Medicaid (All Contracted Plans) | $163.20 | $1,632.00 | $1,060.80 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Anthem Centers for Medical Excellence | Transplant (All Contracted Plans) | — | $1,632.00 | $1,060.80 | 2026-04-17 | MRF ↗ |
| CHILDREN'S HOSPITAL COLORADO OutpatientFacility | Blue Cross Blue Shield Association BDCT | Transplant (All Contracted Plans) | — | $1,632.00 | $1,060.80 | 2026-04-17 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | IMPERIAL HP OF CA MCARE - ALL PLANS | IMPERIAL HP OF CA MCARE - ALL PLANS | $167.20 | $2,175.00 | $369.75 | 2026-01-24 | MRF ↗ |
| WYCKOFF HEIGHTS MEDICAL CENTER Outpatient | Metroplus | Medicaid, Hiv, Child Health Plus, Harp | — | $840.00 | $840.00 | 2026-07-15 | MRF ↗ |
| WYCKOFF HEIGHTS MEDICAL CENTER Outpatient | Empire Blue Cross Blue Shield | Mediblue Hmo/Ppo | — | $840.00 | $840.00 | 2026-07-15 | 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.