G0463 — Hospital Outpatient Clinic Visit For Assessment And Management Of A Patient
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). HOSPITAL OUTPATIENT CLINIC VISIT FOR ASSESSMENT AND MANAGEMENT OF A PATIENT (HCPCS G0463) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/G0463?code_type=HCPCS
MLA (9th ed.)
“HOSPITAL OUTPATIENT CLINIC VISIT FOR ASSESSMENT AND MANAGEMENT OF A PATIENT (HCPCS G0463) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/G0463?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“HOSPITAL OUTPATIENT CLINIC VISIT FOR ASSESSMENT AND MANAGEMENT OF A PATIENT (HCPCS G0463) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/G0463?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $117–$285 (25th–75th percentile) across 2,029 hospitals · 6,480 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS G0463 — 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 |
|---|---|---|---|---|---|---|---|
| ST MARY MEDICAL CENTER OutpatientFacility | Cigna | Individual Family Plan | — | $527.00 | $333.06 | 2025-01-01 | MRF ↗ |
| HOLY CROSS HOSPITAL OutpatientFacility | AvMed | Select | — | $372.00 | $241.80 | 2025-01-01 | MRF ↗ |
| ST MARY MEDICAL CENTER OutpatientFacility | Cigna | Open Access_Network Benefit | — | $527.00 | $333.06 | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | VNA Homecare Options | Medicaid | — | $105.00 | $89.25 | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | VNA Homecare Options | Medicaid | — | $336.00 | $285.60 | 2025-01-01 | MRF ↗ |
| SUNNYVIEW HOSPITAL AND REHABILITATION CENTER OutpatientFacility | VNA Homecare Options | Medicaid | — | $284.00 | $241.40 | 2025-01-01 | MRF ↗ |
| HOLY CROSS HOSPITAL OutpatientFacility | AvMed | Select | — | $372.00 | $241.80 | 2025-01-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Anthem BCBS | All Products | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children's Hospital OutpatientFacility | Anthem BCBS | All Products | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| SKAGIT VALLEY HOSPITAL Outpatient | Coordinated Care | Medicaid | $0.20 | $539.00 | $431.20 | 2026-03-26 | MRF ↗ |
| LUCILE SALTER PACKARD CHILDREN'S HSP AT STANFORD Outpatient | CIGNA | CIGNA COM ALT HMO PLAN | $0.42 | $1.00 | $0.50 | 2026-03-31 | MRF ↗ |
| LUCILE SALTER PACKARD CHILDREN'S HSP AT STANFORD Outpatient | BLUE SHIELD | STANFORD HEALTHCARE ALLIANCE PLAN | $0.49 | $1.00 | $0.50 | 2026-03-31 | MRF ↗ |
| LUCILE SALTER PACKARD CHILDREN'S HSP AT STANFORD Outpatient | BLUE SHIELD OUT OF STATE | STANFORD HEALTHCARE ALLIANCE PLAN | $0.49 | $1.00 | $0.50 | 2026-03-31 | MRF ↗ |
| LUCILE SALTER PACKARD CHILDREN'S HSP AT STANFORD Outpatient | AETNA | AETNA ALL OTHER PLANS | $0.52 | $1.00 | $0.50 | 2026-03-31 | MRF ↗ |
| LUCILE SALTER PACKARD CHILDREN'S HSP AT STANFORD Outpatient | MERITAIN HEALTH | AETNA ALL OTHER PLANS | $0.52 | $1.00 | $0.50 | 2026-03-31 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | CIGNA | CIGNA COMMERCIAL-PPO | $0.68 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | CIGNA | CIGNA COMMERCIAL-PPO | $0.68 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | CIGNA | CIGNA COMMERCIAL-ALLEG | $0.68 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | CIGNA | CIGNA COMMERCIAL-ALLEG | $0.68 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $374.00 | $306.68 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | California Physicians' Service dba Blue Shield of California | Covered | — | $374.00 | $306.68 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | HMO | — | $471.00 | $386.22 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | United Healthcare | HMO | — | $374.00 | $306.68 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $374.00 | $306.68 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $471.00 | $386.22 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $471.00 | $386.22 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | California Physicians' Service dba Blue Shield of California | Medicare Advantage | — | $471.00 | $386.22 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | United Healthcare | POS | — | $374.00 | $306.68 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | California Physicians' Service dba Blue Shield of California | HMO | — | $374.00 | $306.68 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $471.00 | $386.22 | 2025-11-26 | MRF ↗ |
| ST VINCENT'S MEDICAL CENTER Outpatient | AETNA | AETNA MANAGED CARE | — | $337.04 | $337.04 | 2026-04-01 | MRF ↗ |
| Saint Mary's Health Care BothFacility | ACCESS HEALTH | ACCESS HEALTH | $1.07 | $27.60 | $17.94 | 2026-03-31 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | UNITED HEALTHCARE | UNITED COMMERCIAL | $1.22 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | HUMANA | HUMANA COMMERCIALEXCHHMO | $1.22 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | HUMANA | HUMANA COMMERCIALEXCHPPO | $1.22 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | HUMANA | HUMANA COMMERCIALEXCHHMO | $1.22 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | UNITED HEALTHCARE | UNITED COMMERCIAL | $1.22 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | HUMANA | HUMANA COMMERCIALEXCHPPO | $1.22 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | CIGNA | CIGNA COMMERCIAL | $1.30 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | CIGNA | CIGNA_COMMERCIAL-GOOD | $1.30 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | CIGNA | CIGNA COMMERCIAL | $1.30 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | CIGNA | CIGNA_COMMERCIAL-GOOD | $1.30 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | VIVA | VIVA HEALTH | $1.35 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | VIVA | VIVA HEALTH | $1.35 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| BAPTIST HEALTH PADUCAH Outpatient | UHC MCAID | UHC MCAID | $1.49 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH PADUCAH Outpatient | AETNA BETTER HLTH MCAID | AETNA BETTER HLTH MCAID | $1.49 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH PADUCAH Outpatient | ANTHEM MCAID | ANTHEM MCAID | $1.49 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH PADUCAH Outpatient | MOLINA MCAID - ALL PLANS | MOLINA MCAID - ALL PLANS | $1.49 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH CORBIN Outpatient | WELLCARE MCAID | WELLCARE MCAID | $1.49 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH PADUCAH Outpatient | HUMANA MCAID | HUMANA MCAID | $1.49 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH CORBIN Outpatient | HUMANA MCAID | HUMANA MCAID | $1.49 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH CORBIN Outpatient | MOLINA MCAID - ALL PLANS | MOLINA MCAID - ALL PLANS | $1.49 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH CORBIN Outpatient | UHC MCAID | UHC MCAID | $1.49 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH CORBIN Outpatient | ANTHEM MCAID | ANTHEM MCAID | $1.49 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH PADUCAH Outpatient | WELLCARE MCAID | WELLCARE MCAID | $1.49 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH CORBIN Outpatient | AETNA BETTER HLTH MCAID | AETNA BETTER HLTH MCAID | $1.49 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| Saint Mary's Health Care BothFacility | CORRECTIONAL RECOVERY | CORRECTIONAL RECOVERY | $1.52 | $27.60 | $17.94 | 2026-03-31 | MRF ↗ |
| Saint Mary's Health Care BothFacility | OSCAR | OSCAR EPO | $1.52 | $27.60 | $17.94 | 2026-03-31 | MRF ↗ |
| Saint Mary's Health Care BothFacility | HOSPICE FAITH | HOSPICE FAITH | $1.52 | $27.60 | $17.94 | 2026-03-31 | MRF ↗ |
| Saint Mary's Health Care BothFacility | HOSPICE OF HOLLAND | HOSPICE OF HOLLAND | $1.52 | $27.60 | $17.94 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH LEXINGTON Outpatient | MOLINA MCAID - ALL PLANS | MOLINA MCAID - ALL PLANS | $1.67 | $18.60 | $13.95 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH LEXINGTON Outpatient | ANTHEM MCAID | ANTHEM MCAID | $1.67 | $18.60 | $13.95 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH LEXINGTON Outpatient | UHC MCAID | UHC MCAID | $1.67 | $18.60 | $13.95 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH RICHMOND Outpatient | AETNA BETTER HLTH MCAID | AETNA BETTER HLTH MCAID | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH HARDIN Outpatient | MOLINA MEDICAID - ALL PLANS | MOLINA MEDICAID - ALL PLANS | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LAGRANGE Outpatient | MOLINA MCAID - ALL PLANS | MOLINA MCAID - ALL PLANS | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH HARDIN Outpatient | UHC MEDICAID | UHC MEDICAID | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LAGRANGE Outpatient | ANTHEM MCAID | ANTHEM MCAID | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LEXINGTON Outpatient | HUMANA MCAID HMO | HUMANA MCAID HMO | $1.67 | $18.60 | $13.95 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH RICHMOND Outpatient | UHC MCAID | UHC MCAID | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LAGRANGE Outpatient | HUMANA MCAID | HUMANA MCAID | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH RICHMOND Outpatient | HUMANA MCAID | HUMANA MCAID | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH RICHMOND Outpatient | ANTHEM MCAID | ANTHEM MCAID | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH HARDIN Outpatient | AETNA BETTER HLTH MCAID | AETNA BETTER HLTH MCAID | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LAGRANGE Outpatient | UHC MCAID | UHC MCAID | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LAGRANGE Outpatient | WELLCARE MCAID | WELLCARE MCAID | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LEXINGTON Outpatient | AETNA BETTER HLTH MCAID | AETNA BETTER HLTH MCAID | $1.67 | $18.60 | $13.95 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH LEXINGTON Outpatient | WELLCARE MCAID | WELLCARE MCAID | $1.67 | $18.60 | $13.95 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH HARDIN Outpatient | WELLCARE MEDICAID | WELLCARE MEDICAID | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH RICHMOND Outpatient | WELLCARE MCAID | WELLCARE MCAID | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LAGRANGE Outpatient | AETNA BETTER HLTH MCAID | AETNA BETTER HLTH MCAID | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH HARDIN Outpatient | ANTHEM MEDICAID | ANTHEM MEDICAID | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH RICHMOND Outpatient | MOLINA MCAID-ALL PLANS | MOLINA MCAID-ALL PLANS | $1.67 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH HARDIN Outpatient | HUMANA MCAID | HUMANA MCAID | $1.71 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | AETNA | AETNA COMMERCIAL | $1.76 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | AETNA | AETNA COMMERCIAL | $1.76 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MISC MEDICAID GET NAME | $1.88 | $94.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | UHC COMMUNITY PLAN | UHC COMMUNITY PLAN | $1.88 | $94.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID COLORADO | $1.88 | $94.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | WELLPOINT (AMGRP) | WELLPOINT (AMGRP) | $1.88 | $94.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | MEDICAID | MEDICAID BEACON HEALTH | $1.88 | $94.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | DENVER HEALTH MED PLAN | DENVER HEALTH MED PLAN | $1.88 | $94.00 | — | 2026-03-31 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | COLORADO ACCESS | COLORADO ACCESS | $1.88 | $94.00 | — | 2026-03-31 | MRF ↗ |
| Saint Mary's Health Care BothFacility | MOLINA MARKETPLACE | MOLINA HMO MARKETPLACE | $1.98 | $27.60 | $17.94 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH LOUISVILLE Outpatient | UHC MCAID | UHC MCAID | $2.05 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LOUISVILLE Outpatient | AETNA MCAID | AETNA MCAID | $2.05 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LOUISVILLE Outpatient | HUMANA MCAID | HUMANA MCAID | $2.05 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LOUISVILLE Outpatient | ANTHEM MCAID | ANTHEM MCAID | $2.05 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LOUISVILLE Outpatient | WELLCARE MCAID | WELLCARE MCAID | $2.05 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LOUISVILLE Outpatient | MOLINA MCAID - ALL PLANS | MOLINA MCAID - ALL PLANS | $2.05 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| Saint Mary's Health Care BothFacility | WELLPATH | WELLPATH | $2.36 | $27.60 | $17.94 | 2026-03-31 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.43 | — | — | 2026-03-18 | MRF ↗ |
| NEWARK BETH ISRAEL MEDICAL CENTER OutpatientFacility | Cigna | HMO | — | — | — | 2026-03-04 | MRF ↗ |
| CHARLOTTE HUNGERFORD HOSPITAL Outpatient | AETNA | AETNA MANAGED CARE | — | $337.04 | $337.04 | 2026-04-01 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | DEVOTED | DEVOTED MEDICARE | $2.70 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | BLUE CROSS OF AL | BLUE ADVANTAGE | $2.70 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | UNITED HEALTHCARE | UNITED MEDICARE | $2.70 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | UNITED HEALTHCARE | UNITED MEDICARE | $2.70 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | HUMANA | HUMANA MEDICARE | $2.70 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | BLUE CROSS OF AL | BLUE ADVANTAGE | $2.70 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | HUMANA | HUMANA MEDICARE | $2.70 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| HUNTSVILLE HOSPITAL Both | DEVOTED | DEVOTED MEDICARE | $2.70 | $2.70 | $2.70 | 2026-03-27 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $2.79 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $2.81 | $490.11 | $490.11 | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $2.81 | $4,243.33 | $4,243.33 | 2026-03-18 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $3.32 | $420.00 | $155.40 | 2026-03-31 | MRF ↗ |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER OutpatientFacility | BLUE SHIELD - ID (REGENCE) | REGENCE BS IND FAM | $3.69 | — | $211.25 | 2026-03-31 | MRF ↗ |
| Duke Health Raleigh Hospital Inpatient | DUKE PLUS | DUKE PLUS | $3.84 | $12.00 | $3.00 | 2025-03-27 | MRF ↗ |
| DUKE UNIVERSITY HOSPITAL Inpatient | DUKE PLUS | DUKE PLUS | $3.84 | $12.00 | $3.00 | 2025-03-14 | MRF ↗ |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER OutpatientFacility | BLUE SHIELD - ID (REGENCE) | REGENCE BS ACCORD | $3.91 | — | $211.25 | 2026-03-31 | MRF ↗ |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER OutpatientFacility | BLUE SHIELD - ID (REGENCE) | REGENCE BS ACCORD EXCLUSIVE | $3.91 | — | $211.25 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH HARDIN Outpatient | AETNA NEW BUS | AETNA NEW BUS | $3.94 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | ALBANY COUNTY CORRECTIONAL FACILITY | ALBANY CORRECTIONAL FACILITY | $3.95 | — | $184.60 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (EXCELLUS) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $4.19 | — | $184.60 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center OutpatientFacility | BLUE CROSS - NY (ANTHEM) MEDICAID ADVANTAGE | EMPIRE MEDICAID | $4.19 | — | $184.60 | 2026-03-31 | MRF ↗ |
| WILLIAM W BACKUS HOSPITAL Outpatient | MOLINA dba CONNECTICARE | MOLINA MANAGED CARE | — | $337.00 | $337.00 | 2026-04-01 | MRF ↗ |
| WINDHAM COMMUNITY MEMORIAL HOSPITAL Outpatient | CIGNA | CIGNA MANAGED CARE | — | $337.00 | $337.00 | 2026-04-01 | MRF ↗ |
| Saint Mary's Health Care BothFacility | ACCESS HEALTH | ACCESS HEALTH | $4.32 | $29.80 | $19.37 | 2026-03-31 | MRF ↗ |
| UPMC GREENE OutpatientFacility | Aetna | Advantra Washington Prime | $4.32 | $10.80 | $7.56 | 2026-03-06 | MRF ↗ |
| UPMC GREENE OutpatientFacility | Aetna | Advantra Washington Prime | $4.32 | $10.80 | $7.56 | 2026-03-06 | MRF ↗ |
| BAPTIST HEALTH LOUISVILLE Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $4.35 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| KOOTENAI HEALTH OutpatientFacility | Blue Cross of Idaho | All Commercial Plans | $4.39 | — | — | 2026-03-27 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Meridian | Medicare Advantage | $4.39 | $12.20 | $6.10 | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Health Alliance | Medicare Advantage | $4.39 | $12.20 | $6.10 | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Health Alliance | Medicare Advantage | $4.39 | $12.20 | $6.10 | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | UHC | Medicare Advantage | $4.39 | $12.20 | $6.10 | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Meridian | Medicare Advantage | $4.39 | $12.20 | $6.10 | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Wellcare | Medicare Advantage | $4.39 | $12.20 | $6.10 | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Molina | Medicare Advantage | $4.39 | $12.20 | $6.10 | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | UHC | Medicare Advantage | $4.39 | $12.20 | $6.10 | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Molina | Medicare Advantage | $4.39 | $12.20 | $6.10 | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Aetna | Medicare Advantage | $4.39 | $12.20 | $6.10 | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Aetna | Medicare Advantage | $4.39 | $12.20 | $6.10 | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Wellcare | Medicare Advantage | $4.39 | $12.20 | $6.10 | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Clear Spring Health | Medicare Advantage | $4.52 | $12.20 | $6.10 | 2025-01-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF STAUNTON OutpatientFacility | Clear Spring Health | Medicare Advantage | $4.52 | $12.20 | $6.10 | 2025-01-21 | MRF ↗ |
| BAPTIST HEALTH FLOYD Outpatient | ANTHEM BHS1 | ANTHEM BHS1 | $4.58 | $18.60 | $13.95 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH FLOYD Outpatient | ANTHEM BHS1 | ANTHEM BHS1 | $4.58 | $18.60 | $13.95 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH RICHMOND Outpatient | ANTHEM BHS1 | ANTHEM BHS1 | $4.58 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LOUISVILLE Outpatient | ANTHEM BHS1 | ANTHEM BHS1 | $4.58 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LAGRANGE Outpatient | ANTHEM BHS1 | ANTHEM BHS1 | $4.58 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH PADUCAH Outpatient | ANTHEM BHS1 | ANTHEM BHS1 | $4.58 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH CORBIN Outpatient | ANTHEM BHS1 | ANTHEM BHS1 | $4.58 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LEXINGTON Outpatient | ANTHEM BHS1 | ANTHEM BHS1 | $4.58 | $18.60 | $13.95 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH FLOYD Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $4.89 | $18.60 | $13.95 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH FLOYD Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $4.89 | $18.60 | $13.95 | 2026-03-31 | MRF ↗ |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER OutpatientFacility | BLUE SHIELD - ID (REGENCE) | REGENCE BS ALL NETWORK | $4.92 | — | $211.25 | 2026-03-31 | MRF ↗ |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER OutpatientFacility | BLUE SHIELD - WA (REGENCE) | REGENCE BS ALL NETWORK | $4.92 | — | $211.25 | 2026-03-31 | MRF ↗ |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER OutpatientFacility | ASURIS NORTHWEST HEALTH | REGENCE BS ALL NETWORK | $4.92 | — | $211.25 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH HARDIN Outpatient | HUMANA - ALL OTHER PLANS | HUMANA - ALL OTHER PLANS | $4.92 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER OutpatientFacility | BLUE SHIELD - ID (REGENCE) | REGENCE BS PPO 2 | $4.92 | — | $211.25 | 2026-03-31 | MRF ↗ |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER OutpatientFacility | BLUE SHIELD - ID (REGENCE) | REGENCE BS PPO | $4.92 | — | $211.25 | 2026-03-31 | MRF ↗ |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER OutpatientFacility | HEALTHCARE MANAGEMENT ADMIN | REGENCE BS ALL NETWORK | $4.92 | — | $211.25 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH HARDIN Outpatient | AETNA COMM -ALL OTHER PLANS | AETNA COMM -ALL OTHER PLANS | $5.00 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LOUISVILLE Outpatient | ANTHEM PATH HPN | ANTHEM PATH HPN | $5.07 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH PADUCAH Outpatient | ANTHEM PATH HMO | ANTHEM PATH HMO | $5.09 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER BothFacility | ADA COUNTY JAIL INMATE INS | MEDICAID COUNTY | $5.30 | $157.00 | $102.05 | 2026-03-31 | MRF ↗ |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER BothFacility | ID COUNTY ADA | MEDICAID COUNTY | $5.30 | $157.00 | $102.05 | 2026-03-31 | MRF ↗ |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER BothFacility | ID COUNTY CANYON | MEDICAID COUNTY | $5.30 | $157.00 | $102.05 | 2026-03-31 | MRF ↗ |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER BothFacility | CENTURION OF IDAHO | MEDICAID COUNTY | $5.30 | $157.00 | $102.05 | 2026-03-31 | MRF ↗ |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER BothFacility | ID COUNTY PAYETTE | MEDICAID COUNTY | $5.30 | $157.00 | $102.05 | 2026-03-31 | MRF ↗ |
| SAINT ALPHONSUS REGIONAL MEDICAL CENTER BothFacility | ID COUNTY CAT FUND | MEDICAID COUNTY | $5.30 | $157.00 | $102.05 | 2026-03-31 | MRF ↗ |
| Saint Mary's Health Care BothFacility | ACCESS HEALTH | ACCESS HEALTH | $5.33 | $138.00 | $89.70 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH FLOYD Outpatient | AETNA NEW BUSINESS | AETNA NEW BUSINESS | $5.36 | $18.60 | $13.95 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH FLOYD Outpatient | AETNA NEW BUSINESS | AETNA NEW BUSINESS | $5.36 | $18.60 | $13.95 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH LOUISVILLE Outpatient | HEALTHLINK-ALL PLANS | HEALTHLINK-ALL PLANS | $5.42 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| Duke Health Raleigh Hospital Inpatient | DUKE PLUS | DUKE PLUS | $5.44 | $17.00 | — | 2025-03-27 | MRF ↗ |
| DUKE UNIVERSITY HOSPITAL Inpatient | DUKE PLUS | DUKE PLUS | $5.44 | $17.00 | — | 2025-03-14 | MRF ↗ |
| BAPTIST HEALTH FLOYD Outpatient | ANTHEM PATH/HPN | ANTHEM PATH/HPN | $5.48 | $18.60 | $13.95 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH FLOYD Outpatient | ANTHEM PATH/HPN | ANTHEM PATH/HPN | $5.48 | $18.60 | $13.95 | 2026-03-31 | MRF ↗ |
| UPMC GREENE OutpatientFacility | Aetna | Advantra Washington Prime | $5.52 | $13.80 | $9.66 | 2026-03-06 | MRF ↗ |
| UPMC GREENE OutpatientFacility | Aetna | Advantra Washington Prime | $5.52 | $13.80 | $9.66 | 2026-03-06 | MRF ↗ |
| BAPTIST HEALTH RICHMOND Outpatient | UHC ALL PAYER-ALL OTHER PLANS | UHC ALL PAYER-ALL OTHER PLANS | $5.62 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LOUISVILLE Outpatient | ANTHEM BLUE PREF HMO/HIC | ANTHEM BLUE PREF HMO/HIC | $5.63 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LOUISVILLE Outpatient | ANTHEM PATH HMO | ANTHEM PATH HMO | $5.63 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LOUISVILLE Outpatient | ANTHEM BLUE ACCESS PPO | ANTHEM BLUE ACCESS PPO | $5.63 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LAGRANGE Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $5.65 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH HARDIN Outpatient | CENTER CARE-ALL PLANS | CENTER CARE-ALL PLANS | $5.65 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| BAPTIST HEALTH LOUISVILLE Outpatient | UHC ALL PAYER NEW - ALL OTHER PLANS | UHC ALL PAYER NEW - ALL OTHER PLANS | $5.69 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| Saint Mary's Health Care BothFacility | ACCESS HEALTH | ACCESS HEALTH | $5.70 | $25.60 | $16.64 | 2026-03-31 | MRF ↗ |
| BAPTIST HEALTH RICHMOND Outpatient | AETNA NEW BUS | AETNA NEW BUS | $5.73 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| PERRY COUNTY MEMORIAL HOSPITAL Both | KENTUCKY MEDICAID | KY MEDI MOLINA PSPRT IP | $5.75 | $25.00 | $17.50 | 2026-01-02 | MRF ↗ |
| PERRY COUNTY MEMORIAL HOSPITAL Both | KENTUCKY MEDICAID | KY MEDI BC KMA IP | $5.75 | $25.00 | $17.50 | 2026-01-02 | MRF ↗ |
| PERRY COUNTY MEMORIAL HOSPITAL Both | KENTUCKY MEDICAID | KY MEDI BC KMA OP | $5.75 | $25.00 | $17.50 | 2026-01-02 | MRF ↗ |
| PERRY COUNTY MEMORIAL HOSPITAL Both | KENTUCKY MEDICAID | KY MEDI UNITEDHEALTH IP | $5.75 | $25.00 | $17.50 | 2026-01-02 | MRF ↗ |
| UPMC GREENE OutpatientFacility | Aetna of PA | Auto/Workers Compensation | $5.76 | $10.80 | $7.56 | 2026-03-06 | MRF ↗ |
| UPMC GREENE OutpatientFacility | Aetna of PA | Auto/Workers Compensation | $5.76 | $10.80 | $7.56 | 2026-03-06 | MRF ↗ |
| BAPTIST HEALTH HARDIN Outpatient | UHC ALL PAYER -ALL OTHER PLANS | UHC ALL PAYER -ALL OTHER PLANS | $5.82 | $18.60 | $13.95 | 2026-04-01 | MRF ↗ |
| HENDRICK MEDICAL CENTER BROWNWOOD OutpatientFacility | Superior Health Plan | Managed Medicaid/CHIP | — | $739.00 | $739.00 | 2025-12-08 | MRF ↗ |
| BAPTIST HEALTH LAGRANGE Outpatient | HUMANA-ALL OTHER PLANS | HUMANA-ALL OTHER PLANS | $5.84 | $18.60 | $13.95 | 2026-04-01 | 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.