G0169 — Pt Wound Care Mngmt G0169
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PT WOUND CARE MNGMT G0169 (HCPCS G0169) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/G0169?code_type=HCPCS
MLA (9th ed.)
“PT WOUND CARE MNGMT G0169 (HCPCS G0169) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/G0169?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“PT WOUND CARE MNGMT G0169 (HCPCS G0169) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/G0169?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $28–$70 (25th–75th percentile) across 17 hospitals · 40 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS G0169 — 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 | Access All Commercial Plans | $20.73 | — | — | 2026-04-01 | MRF ↗ |
| KALEIDA HEALTH OutpatientFacility | Univera | Access Other Commercial Plan | $21.35 | — | — | 2026-04-01 | MRF ↗ |
| KALEIDA HEALTH OutpatientFacility | Univera - Wchob | Access Other Commercial Plan | $21.35 | — | — | 2026-04-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Metra Comp | Wc | $22.34 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Metra Comp | Wc | $22.34 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Metra Comp | Wc | $22.34 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Metra Comp | Wc | $22.34 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Metra Comp | Wc | $22.34 | $55.00 | — | 2026-07-15 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Univera | All Commercial Plans | $24.39 | — | — | 2026-04-01 | MRF ↗ |
| CUBA MEMORIAL HOSPITAL, INC OutpatientFacility | Univera | All Commercial Plans | $24.39 | — | — | 2026-04-01 | MRF ↗ |
| CUBA MEMORIAL HOSPITAL, INC OutpatientFacility | Univera | Medicare Managed Care Plan | $24.39 | — | — | 2026-04-01 | MRF ↗ |
| BROOKS-TLC HOSPITAL SYSTEM, INC OutpatientFacility | Univera | All Commercial Plans | $24.39 | — | — | 2026-04-01 | MRF ↗ |
| Bradford Regional Medical Center OutpatientFacility | Univera | Essential Other Commercial Plan | $24.39 | — | — | 2026-04-01 | MRF ↗ |
| Roswell Park Cancer Institute OutpatientFacility | Univera | All Commercial Plans | $24.39 | — | — | 2026-04-01 | MRF ↗ |
| KALEIDA HEALTH OutpatientFacility | Univera - Wchob | Medicare Managed Care Plan | $25.12 | — | — | 2026-04-01 | MRF ↗ |
| KALEIDA HEALTH OutpatientFacility | Univera | Medicare Managed Care Plan | $25.12 | — | — | 2026-04-01 | MRF ↗ |
| KALEIDA HEALTH OutpatientFacility | Univera | Other Commercial Plan | $25.12 | — | — | 2026-04-01 | MRF ↗ |
| KALEIDA HEALTH OutpatientFacility | Univera - Wchob | All Commercial Plans | $25.12 | — | — | 2026-04-01 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Medin-Crease Health Plan | — | $25.78 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Integrated Health | Wc | $25.78 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Integrated Health | Wc | $25.78 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Integrated Health | Wc | $25.78 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Integrated Health | Wc | $25.78 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Medin-Crease Health Plan | — | $25.78 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Medin-Crease Health Plan | — | $25.78 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Medin-Crease Health Plan | — | $25.78 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Medin-Crease Health Plan | — | $25.78 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Integrated Health | Wc | $25.78 | $55.00 | — | 2026-08-01 | MRF ↗ |
| Roswell Park Cancer Institute OutpatientFacility | Univera | Medicare Managed Care Plan | $26.10 | — | — | 2026-04-01 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Rockport | — | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Positive | Hc Ma | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Coventry | Hp Hmo | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Positive | Hc Ma | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Humana | Ma | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Humana | Ppo | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Humana | Hmo | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Humana | Ma | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Humana | Ppo | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Humana | Hc | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Humana | Hc | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Coventry | Hp Ma | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Humana | Ppo | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Humana | Hmo | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Rockport | — | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Positive | Hc Ma | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Positive | Hc Ma | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Humana | Hmo | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Humana | Hc | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Coventry | Hp Ma | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Coventry | Hp Hmo | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Coventry | Hp Hmo | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Rockport | — | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Humana | Ma | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Humana | Ma | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Humana | Hmo | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Humana | Hc | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Humana | Mma | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Conventry | Hp Ma | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Coventry | Hp Ma | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Coventry | Hp Hmo | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Rockport | — | $27.50 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Humana | Hmo | $27.50 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Positive | Hc Ma | $27.50 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Humana | Ma | $27.50 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Conventry | Hp Ma | $27.50 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Rockport | — | $27.50 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Humana | Ppo | $27.50 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Coventry | Hp Hmo | $27.50 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Humana | Hc | $27.50 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Medin-Crease Health Plan | Wc | $29.21 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Medin-Crease Health Plan | Wc | $29.21 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Medin-Crease Health Plan | Wc | $29.21 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Medin-Crease Health Plan | Wc | $29.21 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Medin-Crease Health Plan | Wc | $29.21 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Rockport | Wc | $30.93 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Rockport | Wc | $30.93 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Rockport | Wc | $30.93 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Rockport | Wc | $30.93 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Rockport | Wc | $30.93 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Concordia | Care Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Dimension Health | Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Dimension Health | Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Wellcare | Fl Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Wellcare | Fl Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Uhc | Hmo Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Uhc | Ppo | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Uhc | Ma Cmg | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Uhc | Hmo | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Uhc | Ppo | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Uhc | Hmo Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Uhc | Hmo | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Uhc | Ma Cmg | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Preferred Care Partners | Wellmed | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Preferred Care Partners | Hp Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Preferred Care Partners | Pso Hp | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Preferred Care Partners | Hp Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Preferred Care Partners | Wellmed | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Preferred Care Partners | Pso Hp | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Prime Health Care Partners | Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Prime Health Care Partners | Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Concordia | Care Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Uhc | Hmo Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Dimension Health | Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Dimension Health | Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Preferred Care Partners | Hp Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Preferred Care Partners | Pso Hp | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Preferred Care Partners | Wellmed | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Preferred Care Partners | Hp Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Preferred Care Partners | Pso Hp | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Preferred Care Partners | Wellmed | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Prime Health Care Partners | Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Prime Health Care Partners | Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Concordia | Care Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Wellcare | Fl Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Concordia | Care Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Dimension Health | Ma | $34.37 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Preferred Care Partners | Hp Ma | $34.37 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Uhc | Ma Cmg | $34.37 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Uhc | Hmo | $34.37 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Uhc | Ppo | $34.37 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Uhc | Hmo Ma | $34.37 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Preferred Care Partners | Pso Hp | $34.37 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Wellcare | Fl Ma | $34.37 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Preferred Care Partners | Wellmed | $34.37 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Prime Health Care Partners | Ma | $34.37 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Concordia | Care Ma | $34.37 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Wellcare | Fl Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Uhc | Hmo Ma | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Uhc | Ppo | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Uhc | Hmo | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Uhc | Ma Cmg | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Uhc | Hmo | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Uhc | Ppo | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Uhc | Ma Cmg | $34.37 | $55.00 | — | 2026-07-15 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Corvel | Corvel - Workers Comp | — | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Ccmsi | Ccmsi - Workers Comp | — | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Coventry | Coventry- Workers Comp | — | — | — | 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 | First Health/Hcvm | First Health/Hcvm - Dhp | — | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Phcs | Phcs - Ppo | — | — | — | 2026-07-18 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Avmed | Hp | $60.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Avmed | Hp Ma | $60.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Avmed | Hp | $60.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Avmed | Hp Ma | $60.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Avmed | Hp | $60.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Avmed | Hp | $60.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Avmed | Hp | $60.00 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Avmed | Hp Ma | $60.00 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Avmed | Hp Ma | $60.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Avmed | Hp Ma | $60.00 | $55.00 | — | 2026-07-15 | 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 ↗ |
| St Catherine's Rehabilitation Hospital Both | Doctors | Hc Ma | $70.00 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Doctors | Hc Ma | $70.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Doctors | Hc Ma | $70.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Doctors | Hc Ma | $70.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Doctors | Hc Ma | $70.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Simply | Ma | $75.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Simply | Ma | $75.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Simply | Ma | $75.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Simply | Ma | $75.00 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Simply | Ma | $75.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| STEPHENS COUNTY HOSPITAL Outpatient | Amerigroup | Medicaid | $78.25 | $243.40 | $146.04 | 2026-07-15 | MRF ↗ |
| STEPHENS COUNTY HOSPITAL Outpatient | Medicaid | Medicaid | $78.25 | $243.40 | $146.04 | 2026-07-15 | MRF ↗ |
| STEPHENS COUNTY HOSPITAL Outpatient | Peachstate Medicaid | Medicaid | $78.25 | $243.40 | $146.04 | 2026-07-15 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Doctors | Hc Ma | $80.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Doctors | Hc Ma | $80.00 | $55.00 | — | 2026-08-01 | MRF ↗ |
| St Anthony's Rehabilitation Hospital Both | Doctors | Hc Ma | $80.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Doctors | Hc Ma | $80.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| St Catherine's Rehabilitation Hospital Both | Doctors | Hc Ma | $80.00 | $55.00 | — | 2026-07-15 | MRF ↗ |
| STEPHENS COUNTY HOSPITAL Outpatient | Wellcare Medicaid | Medicaid | $80.59 | $243.40 | $146.04 | 2026-07-15 | MRF ↗ |
| CHESHIRE MEDICAL CENTER Outpatient | Phcs | Phcs | — | — | — | 2026-07-15 | MRF ↗ |
| CHESHIRE MEDICAL CENTER Outpatient | First Health/Hcvm | First Health/Hcvm | — | — | — | 2026-07-15 | MRF ↗ |
| MAURY REGIONAL HOSPITAL Outpatient | Humana | Commercial | — | — | — | 2026-07-15 | MRF ↗ |
| Wayne Medical Center Outpatient | Humana | Commercial | — | — | — | 2026-05-13 | MRF ↗ |
| Wayne Medical Center Outpatient | Humana | Commercial | — | — | — | 2026-05-23 | MRF ↗ |
| MARSHALL MEDICAL CENTER Outpatient | Humana | Commercial | — | — | — | 2026-05-08 | MRF ↗ |
| CABELL HUNTINGTON HOSPITAL, INC Outpatient | Caresource | Wv Marketplace | — | — | — | 2026-07-15 | MRF ↗ |
| ST MARYS MEDICAL CENTER Outpatient | Caresource | Wv Marketplace | — | — | — | 2026-05-06 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Medicare B MS JH | Default | $99.11 | $187.00 | $140.25 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Primewell Vantage Health Plan | Default | $130.90 | $187.00 | $140.25 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | GEHA Multiplan Network | Default | $140.25 | $187.00 | $140.25 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Private Healthcare Systems PHCS | Default | $140.25 | $187.00 | $140.25 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Advanced Health | Default | $149.60 | $187.00 | $140.25 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | First Choice Health Network | Default | $149.60 | $187.00 | $140.25 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Mississippi Physicians Care Network | Default | $149.60 | $187.00 | $140.25 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Mississippi Select Health Care | Default | $168.30 | $187.00 | $140.25 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Blue Cross Blue Shield of MS INST | Default | $170.00 | $187.00 | $140.25 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Multiplan Inc. for American Family | Default | $177.65 | $187.00 | $140.25 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | UHC Community Plan MS | Default | $187.00 | $187.00 | $140.25 | 2026-07-01 | MRF ↗ |
| FIELD HEALTH SYSTEM Both | Magnolia Health Plan MCD Rep | Default | $187.00 | $187.00 | $140.25 | 2026-07-01 | MRF ↗ |
| STEPHENS COUNTY HOSPITAL Outpatient | Bcbs | Commercial | $194.79 | $243.40 | $146.04 | 2026-07-15 | MRF ↗ |
| STEPHENS COUNTY HOSPITAL Outpatient | Aetna | Commercial | $206.89 | $243.40 | $146.04 | 2026-07-15 | MRF ↗ |
| STEPHENS COUNTY HOSPITAL Outpatient | Uhc | Commercial | $214.19 | $243.40 | $146.04 | 2026-07-15 | MRF ↗ |
| STEPHENS COUNTY HOSPITAL Outpatient | Cigna | Commercial | $219.06 | $243.40 | $146.04 | 2026-07-15 | MRF ↗ |
| STEPHENS COUNTY HOSPITAL Outpatient | Caresource | Medicare | $243.40 | $243.40 | $146.04 | 2026-07-15 | MRF ↗ |
| STEPHENS COUNTY HOSPITAL Outpatient | Medicare | Medicare | $243.40 | $243.40 | $146.04 | 2026-07-15 | MRF ↗ |