D5213 — Dentures Maxill Part Metal
Cite this view
HANK Price Transparency. (n.d.). DENTURES MAXILL PART METAL (HCPCS D5213) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/D5213?code_type=HCPCS
“DENTURES MAXILL PART METAL (HCPCS D5213) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/D5213?code_type=HCPCS. Accessed .
“DENTURES MAXILL PART METAL (HCPCS D5213) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/D5213?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $596–$1,408 (25th–75th percentile) across 335 hospitals · 557 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS D5213 — 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 |
|---|---|---|---|---|---|---|---|
| HEYWOOD HOSPITAL - Outpatient | Health New England | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Harvard Pilgrim Health Care | CommercialAllPlans | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Aetna | MedicareAdvantage | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | United Healthcare | CommercialAllPlans | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusHMO | $2.29 | — | — | 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 | Tufts | PPO | — | — | — | 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 | PPO | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Cigna | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Aetna | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Tufts | HMO | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | PPA | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Aetna | MedicareAdvantage | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Tufts | POS | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Cigna | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusCentralHMO | $2.29 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | Indemnity | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusCentralHMO | $2.29 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | HMO | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Health New England | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | Indemnity | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | United Healthcare | CommercialAllPlans | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | PPA | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusHMO | $2.29 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Tufts | POS | — | — | — | 2025-04-16 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $3.46 | $1,921.00 | — | 2024-12-31 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | 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 | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| Tyler Memorial Hospital OutpatientFacility | None | — | — | — | — | 2026-01-01 | 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 ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| BOSTON MEDICAL CENTER Both | AETNA [2022] | BMC HB AETNA | $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 | 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 STUDENT HEALTH | $54.77 | $112.00 | $50.40 | 2026-03-13 | 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 | 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 ↗ |
| 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 | ZZZUNITED [1008] | 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 ↗ |
| 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 | BCBS [6001] | 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 ↗ |
| JACKSON HEALTH SYSTEM Outpatient | CURATIVE - ALL PLANS | CURATIVE - ALL PLANS | $75.00 | $1,230.00 | — | 2026-04-01 | MRF ↗ |
| JUPITER MEDICAL CENTER Outpatient | CURATIVE - ALL PLANS | CURATIVE - ALL PLANS | $75.00 | $1,230.00 | — | 2026-03-26 | MRF ↗ |
| JUPITER MEDICAL CENTER Outpatient | AVMED SELECT/FIRST NTWRK | AVMED SELECT/FIRST NTWRK | $80.00 | $1,230.00 | — | 2026-03-26 | MRF ↗ |
| JACKSON HEALTH SYSTEM Outpatient | AVMED SELECT/FIRST NTWRK | AVMED SELECT/FIRST NTWRK | $81.00 | $1,230.00 | — | 2026-04-01 | 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 ↗ |
| 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 ↗ |
| JACKSON HEALTH SYSTEM Outpatient | AVMED COMM - ALL OTHER PLANS | AVMED COMM - ALL OTHER PLANS | $86.00 | $1,230.00 | — | 2026-04-01 | MRF ↗ |
| JUPITER MEDICAL CENTER Outpatient | AVMED COMM - ALL OTHER PLANS | AVMED COMM - ALL OTHER PLANS | $87.00 | $1,230.00 | — | 2026-03-26 | 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 | 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 POS/HMO | $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 ↗ |
| 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 ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Anthem | 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 | Dean Health Plan | Managed Medicaid | $129.32 | — | — | 2025-07-22 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | MEDICAID | 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 | Group Health Eau Claire | 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 of South Central | 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 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 | Group Health of South Central | Medicaid HMO | $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 | Anthem | Medicaid | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | UHC | 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 | 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 | ICare | Medicaid HMO | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN TRI-COUNTY HOSPITAL & 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 LUTHERAN MEDICAL CENTER OutpatientFacility | Molina Health | Managed Medicaid | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN MOUNDVIEW 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 PALMER LUTHERAN HOSPITAL AND CLINICS OutpatientFacility | Molina Health | Managed Medicaid | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN LUTHERAN MEDICAL CENTER OutpatientFacility | Iowa Total Care | Medicaid | $134.59 | — | — | 2025-06-27 | MRF ↗ |
| GUNDERSEN BOSCOBEL AREA 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 ↗ |
| ADVENTIST HEALTH SONORA Outpatient | TRICARE BLUE SHIELD - ALL PLANS | TRICARE BLUE SHIELD - ALL PLANS | $152.00 | $2,400.00 | $408.00 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | PHS PRIME HEALTH SRVCS-ALL PLANS | PHS PRIME HEALTH SRVCS-ALL PLANS | $152.00 | $2,400.00 | $408.00 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | BLUE SHIELD MCARE | BLUE SHIELD MCARE | $152.00 | $2,400.00 | $408.00 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | AETNA MCR ADV | AETNA MCR ADV | $152.00 | $2,400.00 | $408.00 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | HEALTHNET MCR ADV | HEALTHNET MCR ADV | $152.00 | $2,400.00 | $408.00 | 2026-01-24 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | UHC MCR ADV | UHC MCR ADV | $152.00 | $2,400.00 | $408.00 | 2026-01-24 | MRF ↗ |
| OHSU HOSPITAL AND CLINICS Outpatient | COMMUNITY HEALTH PLAN OF WASHINGTON | COMMUNITY HEALTH PLAN OF WA | $164.54 | $857.00 | $557.05 | 2026-03-23 | MRF ↗ |
| OHSU HOSPITAL AND CLINICS Outpatient | COMMUNITY HEALTH PLAN OF WASHINGTON | COMMUNITY HEALTH PLAN OF WA | $164.54 | $857.00 | $557.05 | 2026-03-23 | MRF ↗ |
| ADVENTIST HEALTH SONORA Outpatient | IMPERIAL HP OF CA MCARE - ALL PLANS | IMPERIAL HP OF CA MCARE - ALL PLANS | $167.20 | $2,400.00 | $408.00 | 2026-01-24 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Nassaua County Sheriff's Office | Managed Medicaid | $198.19 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Daniel Memorial | Managed Medicaid | $198.19 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Amerigroup of Georgia | Managed Medicaid OOS | $198.19 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Amerigroup of Georgia | Managed Medicaid OOS | $198.19 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Humana | Managed Medicaid | $198.19 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Daniel Memorial | Managed Medicaid | $198.19 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Daniel Memorial | Managed Medicaid | $198.19 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Amerigroup of Georgia | Managed Medicaid OOS | $198.19 | — | — | 2026-02-06 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL - VENICE Outpatient | Simply Healthcare | Healthy Kids | $198.20 | — | — | 2025-08-01 | MRF ↗ |
| JUPITER MEDICAL CENTER Outpatient | SIMPLY HLTH MCAID - ALL OTHER PLANS | SIMPLY HLTH MCAID - ALL OTHER PLANS | $198.20 | $1,230.00 | — | 2026-03-26 | MRF ↗ |
| JUPITER MEDICAL CENTER Outpatient | COMM CARE MCAID - ALL OTHER PLANS | COMM CARE MCAID - ALL OTHER PLANS | $198.20 | $1,230.00 | — | 2026-03-26 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL - VENICE Outpatient | Simply Healthcare | Healthy Kids | $198.20 | — | — | 2025-08-01 | MRF ↗ |
| JACKSON HEALTH SYSTEM Outpatient | WELLCARE MCAID | WELLCARE MCAID | $198.20 | $1,230.00 | — | 2026-04-01 | MRF ↗ |
| JACKSON HEALTH SYSTEM Outpatient | AMERIHEALTH MCAID | AMERIHEALTH MCAID | $198.20 | $1,230.00 | — | 2026-04-01 | MRF ↗ |
| JACKSON HEALTH SYSTEM Outpatient | SIMPLY HLTH MCAID - ALL OTHER PLANS | SIMPLY HLTH MCAID - ALL OTHER PLANS | $198.20 | $1,230.00 | — | 2026-04-01 | MRF ↗ |
| VILLAGES REGIONAL HOSPITAL, THE OutpatientFacility | Simply Healthcare | MANAGED MEDICAID | $198.20 | — | — | 2026-03-31 | MRF ↗ |
| VILLAGES REGIONAL HOSPITAL, THE OutpatientFacility | Humana | MANAGED MEDICAID | $198.20 | — | — | 2026-03-31 | MRF ↗ |
| JUPITER MEDICAL CENTER Outpatient | WELLCARE MCAID | WELLCARE MCAID | $198.20 | $1,230.00 | — | 2026-03-26 | MRF ↗ |
| JACKSON HEALTH SYSTEM Outpatient | SUNSHINE MCAID - ALL OTHER PLANS | SUNSHINE MCAID - ALL OTHER PLANS | $198.20 | $1,230.00 | — | 2026-04-01 | MRF ↗ |
| JUPITER MEDICAL CENTER Outpatient | AETNA BETTER HLTH MCAID | AETNA BETTER HLTH MCAID | $198.20 | $1,230.00 | — | 2026-03-26 | MRF ↗ |
| JUPITER MEDICAL CENTER Outpatient | SUNSHINE MCAID - ALL OTHER PLANS | SUNSHINE MCAID - ALL OTHER PLANS | $198.20 | $1,230.00 | — | 2026-03-26 | MRF ↗ |
| JUPITER MEDICAL CENTER Outpatient | AMERIHEALTH MCAID | AMERIHEALTH MCAID | $198.20 | $1,230.00 | — | 2026-03-26 | MRF ↗ |
| JACKSON HEALTH SYSTEM Outpatient | HUMANA MCAID | HUMANA MCAID | $198.20 | $1,230.00 | — | 2026-04-01 | MRF ↗ |
| UF HEALTH LEESBURG HOSPITAL OutpatientFacility | Humana | MANAGED MEDICAID | $198.20 | — | — | 2026-03-31 | MRF ↗ |
| UF HEALTH LEESBURG HOSPITAL OutpatientFacility | Simply Healthcare | MANAGED MEDICAID | $198.20 | — | — | 2026-03-31 | MRF ↗ |
| JUPITER MEDICAL CENTER Outpatient | HUMANA MCAID | HUMANA MCAID | $198.20 | $1,230.00 | — | 2026-03-26 | MRF ↗ |
| JACKSON HEALTH SYSTEM Outpatient | COMM CARE MCAID - ALL OTHER PLANS | COMM CARE MCAID - ALL OTHER PLANS | $198.20 | $1,230.00 | — | 2026-04-01 | MRF ↗ |
| JACKSON HEALTH SYSTEM Outpatient | AETNA BETTER HLTH MCAID | AETNA BETTER HLTH MCAID | $198.20 | $1,230.00 | — | 2026-04-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare | Healthy Kids | $198.20 | — | — | 2025-08-01 | MRF ↗ |
| HALIFAX HEALTH MEDICAL CENTER OutpatientFacility | HCRA | MANAGED MEDICAID | $200.66 | — | — | 2025-07-23 | MRF ↗ |
| HALIFAX HEALTH MEDICAL CENTER OutpatientFacility | COVENTRY | MANAGED MEDICAID | $200.66 | — | — | 2025-07-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | CHA HEALTH PLAN | HMO | $200.66 | — | — | 2025-12-23 | MRF ↗ |
| HALIFAX HEALTH MEDICAL CENTER OutpatientFacility | UHC AMERICHOICE | MANAGED MEDICAID | $200.66 | — | — | 2025-07-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | CHA HEALTH PLAN | HMO | $200.66 | — | — | 2025-12-23 | MRF ↗ |
| HALIFAX HEALTH MEDICAL CENTER OutpatientFacility | FLORIDA MEDICAID | MANAGED MEDICAID | $200.66 | — | — | 2025-07-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | SIMPLY HEALTHCARE HEALTHY KIDS | ALL PRODUCTS | $200.66 | — | — | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | UHC COMMUNITY | MCAID HMO | $200.66 | — | — | 2025-12-23 | MRF ↗ |
| GULF BREEZE HOSPITAL OutpatientFacility | AETNA | BETTER HLTHY KIDS | $200.66 | — | — | 2025-12-23 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | Community Care Plan | Healthy Kids | $200.66 | — | — | 2025-07-30 | MRF ↗ |
| HALIFAX HEALTH MEDICAL CENTER OutpatientFacility | WEST VOLUSIA | MANAGED MEDICAID | $200.66 | — | — | 2025-07-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | AETNA | BETTER HLTHY KIDS | $200.66 | — | — | 2025-12-23 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Community Care Plan | Healthy Kids | $200.66 | — | — | 2025-07-30 | MRF ↗ |
| HALIFAX HEALTH MEDICAL CENTER OutpatientFacility | HUMANA | MANAGED MEDICAID | $200.66 | — | — | 2025-07-23 | MRF ↗ |
| HALIFAX HEALTH MEDICAL CENTER OutpatientFacility | MOLINA | MANAGED MEDICAID | $200.66 | — | — | 2025-07-23 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | MOLINA | MANAGED MEDICAID | $200.66 | — | — | 2025-07-23 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | Community Care Plan | Healthy Kids | $200.66 | — | — | 2025-07-30 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | COVENTRY | MANAGED MEDICAID | $200.66 | — | — | 2025-07-23 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | HUMANA | MANAGED MEDICAID | $200.66 | — | — | 2025-07-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | CHA HEALTH PLAN | HMO | $200.66 | — | — | 2025-12-23 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | FLORIDA MEDICAID | MANAGED MEDICAID | $200.66 | — | — | 2025-07-23 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | WEST VOLUSIA | MANAGED MEDICAID | $200.66 | — | — | 2025-07-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | UHC COMMUNITY | MCAID HMO | $200.66 | — | — | 2025-12-23 | MRF ↗ |
| BAPTIST HOSPITAL OutpatientFacility | AETNA | BETTER HLTHY KIDS | $200.66 | — | — | 2025-12-23 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Community Care Plan | Healthy Kids | $200.66 | — | — | 2025-07-30 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | HCRA | MANAGED MEDICAID | $200.66 | — | — | 2025-07-23 | MRF ↗ |
| HALIFAX HEALTH /UF HEALTH MEDICAL CENTER OF DELTON OutpatientFacility | UHC AMERICHOICE | MANAGED MEDICAID | $200.66 | — | — | 2025-07-23 | MRF ↗ |
| MEMORIAL REGIONAL HOSPITAL OutpatientFacility | Community Care Plan | Healthy Kids | $200.66 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Community Care Plan | Healthy Kids | $200.66 | — | — | 2025-07-30 | MRF ↗ |
| HOLY CROSS HOSPITAL OutpatientFacility | Centene | Medicaid | $200.71 | — | — | 2025-01-01 | MRF ↗ |
| HOLY CROSS HOSPITAL OutpatientFacility | Centene | Medicaid | $200.71 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $204.54 | — | — | 2025-01-01 | MRF ↗ |
| MOUNT CARMEL ST ANN'S OutpatientFacility | Law Enforcement Franklin Co. | Medicaid | $204.54 | — | — | 2025-01-01 | MRF ↗ |
| HOLY CROSS HOSPITAL OutpatientFacility | Sunshine State Health Plan | Medicaid | $206.73 | — | — | 2025-01-01 | MRF ↗ |
| HOLY CROSS HOSPITAL OutpatientFacility | Sunshine State Health Plan | Medicaid | $206.73 | — | — | 2025-01-01 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Simply Healthcare Plans - CHA | Managed Medicaid | $208.10 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Simply Healthcare Plans | Managed Medicaid | $208.10 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Simply Healthcare Plans - CHA | Managed Medicaid | $208.10 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Simply Healthcare Plans | Managed Medicaid | $208.10 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Simply Healthcare Plans - CHA | Managed Medicaid | $208.10 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Simply Healthcare Plans | Managed Medicaid | $208.10 | — | — | 2026-02-06 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL - VENICE Outpatient | Simply Healthcare | Medicaid HMO | $208.11 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL - VENICE Outpatient | Sunshine State | Medicaid HMO | $208.11 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL - VENICE Outpatient | Simply Healthcare | Medicaid HMO | $208.11 | — | — | 2025-08-01 | MRF ↗ |
| JUPITER MEDICAL CENTER Outpatient | MOLINA KIDCARE | MOLINA KIDCARE | $208.11 | $1,230.00 | — | 2026-03-26 | MRF ↗ |
| JACKSON HEALTH SYSTEM Outpatient | MOLINA MCAID | MOLINA MCAID | $208.11 | $1,230.00 | — | 2026-04-01 | MRF ↗ |
| JACKSON HEALTH SYSTEM Outpatient | MOLINA KIDCARE | MOLINA KIDCARE | $208.11 | $1,230.00 | — | 2026-04-01 | MRF ↗ |
| JUPITER MEDICAL CENTER Outpatient | MOLINA MCAID | MOLINA MCAID | $208.11 | $1,230.00 | — | 2026-03-26 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Sunshine State | Medicaid HMO | $208.11 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL Outpatient | Simply Healthcare | Medicaid HMO | $208.11 | — | — | 2025-08-01 | MRF ↗ |
| SARASOTA MEMORIAL HOSPITAL - VENICE Outpatient | Sunshine State | Medicaid HMO | $208.11 | — | — | 2025-08-01 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Sunshine | MEDICAID | $208.69 | — | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | Sunshine | MEDICAID | $208.69 | — | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | Sunshine | Child Welfare Program | $208.69 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Sunshine | Child Welfare Program | $208.69 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Sunshine | MEDICAID | $208.69 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Sunshine | Child Welfare Program | $208.69 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL REGIONAL HOSPITAL OutpatientFacility | Sunshine | Child Welfare Program | $208.69 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Sunshine | MEDICAID | $208.69 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL MIRAMAR OutpatientFacility | Sunshine | MEDICAID | $208.69 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Sunshine | Child Welfare Program | $208.69 | — | — | 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.