J0739 — HIV Prep, Inj, Cabotegravir
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Hiv prep, inj, cabotegravir (HCPCS J0739) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/J0739?code_type=HCPCS
MLA (9th ed.)
“Hiv prep, inj, cabotegravir (HCPCS J0739) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/J0739?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Hiv prep, inj, cabotegravir (HCPCS J0739) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/J0739?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $7–$5,889 (25th–75th percentile) across 1,500 hospitals · 2,795 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS J0739 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Estimated complete episode
What this costs at this hospital
The hospital facility charge for this code — an actual negotiated rate from our data. A separate professional fee isn’t separately estimable for this code (see the note below).
What hospitals actually negotiate
Measured
$7
$14 typical
$5,889
The middle 50% of negotiated facility rates for this procedure, measured across 1,500 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $14 |
| Likely subtotal | $14 |
Facility charge (no separate professional fee)
$14
Not included in this estimate:
- Rehab, physical therapy, and other post-acute care after discharge
- Complications, revisions, or readmissions
- Out-of-network provider choices you make yourself (the No Surprises Act only covers providers you can't choose)
The biggest swing: which insurer's rate applies — negotiated prices here run $7–$5,889.
- This is a drug/supply code billed by the facility; there is no separate professional fee to estimate — the figure above is the facility charge only.
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
Estimates use CMS Medicare Physician Fee Schedule reference data (RVU × GPCI × conversion factor; anesthesia base+time × CF) scaled by a sourced commercial multiplier, weighted by how often each component is billed. See the methodology. Your real total appears on your insurer’s Explanation of Benefits (EOB).
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 |
|---|---|---|---|---|---|---|---|
| SAINT ALPHONSUS MEDICAL CENTER ONTARIO OutpatientFacility | Molina | Medicaid | — | $19,345.05 | $13,541.54 | 2025-01-01 | MRF ↗ |
| SAINT ALPHONSUS MEDICAL CENTER ONTARIO OutpatientFacility | Molina | Medicaid | — | $19,345.05 | $13,541.54 | 2025-01-01 | MRF ↗ |
| SKAGIT VALLEY HOSPITAL Both | Regence | Commercial | — | $0.01 | $0.01 | 2026-03-26 | MRF ↗ |
| CASCADE VALLEY HOSPITAL Both | Regence | Commercial | — | $0.01 | $0.01 | 2026-03-26 | MRF ↗ |
| SKAGIT VALLEY HOSPITAL Both | United Healthcare | Commercial | — | $0.01 | $0.01 | 2026-03-26 | MRF ↗ |
| CASCADE VALLEY HOSPITAL Both | United Healthcare | Commercial | — | $0.01 | $0.01 | 2026-03-26 | MRF ↗ |
| CASCADE VALLEY HOSPITAL Both | Kaiser | Medicare | — | $0.01 | $0.01 | 2026-03-26 | MRF ↗ |
| SKAGIT VALLEY HOSPITAL Both | Kaiser | Medicare | — | $0.01 | $0.01 | 2026-03-26 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | VNA Homecare Options | Medicaid | — | $11,607.03 | $9,865.98 | 2025-01-01 | MRF ↗ |
| UNC HOSPITALS Outpatient | Contigo | — | $0.11 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Serenity Pace | Medicare Managed Care | $0.13 | $26.05 | $26.05 | 2026-06-05 | MRF ↗ |
| UNC HOSPITALS Outpatient | Medcost | — | $0.13 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Medcost | Ultra | $0.13 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Medcost | Ppo | $0.14 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | First Carolina Care | — | $0.15 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Wellpoint | All Commercial | $0.17 | $26.05 | $26.05 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Multiplan | All Commercial Plans | $0.18 | $26.05 | $26.05 | 2026-06-05 | MRF ↗ |
| UNC HOSPITALS Outpatient | Aetna | Choice Pos | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | First Medicare Direct | Medicare Advantage | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Bcbs | Medicare Advantage | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Cigna | Choice | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Bcbs | Option Ppo | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Nalc Health Benefit Plan | Hmo/Ppo | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | First Health Network | — | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | United Healthcare | Medicare Advantage | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Wellcare | Medicare Advantage | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Surest | — | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Optum Health | Behavioral Health | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Cigna | Medicare Advantage | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Amerihealth Caritas North Carolina | Managed Medicaid | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Alignment | Preferred Plus Hmo | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Humana | Medicare Advantage Gold Plus | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Partners | Managed Medicaid | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | United Healthcare | Managed Medicaid | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Trillium | Managed Medicaid | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Wellcare | Managed Medicaid | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Alignment | Medicare Advantage | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Aetna | Medicare Advantage | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | Indemnity Commercial | $0.20 | $26.05 | $26.05 | 2026-06-05 | MRF ↗ |
| UNC HOSPITALS Outpatient | Umr | — | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | United Healthcare | Exchange | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Liberty | Medicare Advantage | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Tricare | Hmo | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Alliance | Managed Medicaid | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | PPO Commercial | $0.20 | $26.05 | $26.05 | 2026-06-05 | MRF ↗ |
| UNC HOSPITALS Outpatient | Vaya Health | Managed Medicaid | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Humana | Medicare Advantage State Health Plan | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Aetna | State Health Plan | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | United Healthcare | — | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Healthy Blue North Carolina | Managed Medicaid | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Health Team Advantage | Medicare Advantage | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Bcbs | Blue Home | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| UNC HOSPITALS Outpatient | Cigna | Behavioral Health | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | HMO Commercial | $0.20 | $26.05 | $26.05 | 2026-06-05 | MRF ↗ |
| UNC HOSPITALS Outpatient | Carolina Complete Health | Managed Medicaid | $0.20 | $0.20 | $0.12 | 2026-07-15 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Connecticare | CBI Other Commercial Plan | $0.22 | $26.05 | $26.05 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | First Health | PPO | $0.22 | $26.05 | $26.05 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Connecticare | All Commercial Plans | $0.22 | $26.05 | $26.05 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Aetna | All Commercial Plans | $0.22 | $26.05 | $26.05 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Coventry | Health Care Workers Comp | $0.26 | $26.05 | $26.05 | 2026-06-05 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Fidelis Care | Essential Plan | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Aetna | Medicare Advantage | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | EmblemHealth | Commercial | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Anthem Blue Cross and Blue Shield (FKA Empire) | Managed Medicaid | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | EmblemHealth | Medicare Advantage | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Centers Plan for Healthy Living | Medicare Advantage | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | 1199SEIU National Benefit Funds | Commercial | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Fidelis Care | Child Health Plus | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Fidelis Care | Managed Medicaid | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Molina Healthcare (FKA Affinity) | Essential Plan 3 & 4 | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Anthem Blue Cross and Blue Shield (FKA Empire) | Essential | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Molina Healthcare (FKA Affinity) | Behavioral Health | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | EmblemHealth | Managed Medicaid | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Healthfirst | Managed Medicaid | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | ValueOptions | Managed Medicaid | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Molina Healthcare (FKA Affinity) | Essential Plan 1 & 2 | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Fidelis Care | Health Benefit Exchange | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Blue Cross Blue Shield | Medicare Advantage | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Fidelis Care | Medicare Advantage | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | ValueOptions | Commercial | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | United Healthcare | Medicare Advantage | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | United Healthcare | Managed Medicaid | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | United Healthcare | VACCN | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Humana | Medicare Advantage | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| NASSAU UNIVERSITY MEDICAL CENTER InpatientFacility | Molina Healthcare (FKA Affinity) | Managed Medicaid | — | $1.24 | $0.87 | 2025-10-28 | MRF ↗ |
| James Cancer Hospital & Solove Research Institute Outpatient | Cigna | Cigna - Transplant | $0.62 | $37.00 | — | 2026-07-01 | MRF ↗ |
| BERKSHIRE MEDICAL CENTER Outpatient | Commcare Alliance | Mcrmanaged Cca One Care | $0.70 | $11,779.71 | $11,190.72 | 2026-07-15 | MRF ↗ |
| SAVANNAH HEALTH SERVICES LLC DBA MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER Outpatient | Peach State | MGMCD | $0.83 | — | — | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Peach State | MGMCD | $0.83 | — | — | 2024-10-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW MEXICO MEDICAID | $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 ↗ |
| 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 ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW MEXICO MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | FACEY MEDICAL GROUP | COMM | $1.00 | — | — | 2024-10-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | FACEY MEDICAL GROUP | COMM | $1.00 | — | — | 2026-03-01 | MRF ↗ |
| Thousand Oaks Surgical Hospital Outpatient | FACEY MEDICAL GROUP | MGMCR | $1.00 | — | — | 2026-03-01 | MRF ↗ |
| LOS ROBLES HOSPITAL & MEDICAL CENTER Outpatient | FACEY MEDICAL GROUP | MGMCR | $1.00 | — | — | 2024-10-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| ROBERT PACKER HOSPITAL Outpatient | Amerihealth | Managed Medicaid | $1.18 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| ROBERT PACKER HOSPITAL Outpatient | Amerihealth | Caritas Chc | $1.18 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| ROBERT PACKER HOSPITAL Outpatient | Freedom Blue | Medicare Advantage | $1.21 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| ROBERT PACKER HOSPITAL Outpatient | Bcbs | Blue Medicare Hmo/Ppo | $1.21 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| Guthrie Towanda Memorial Hospital Outpatient | Bcbs | Blue Medicare Hmo/Ppo | $1.21 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| Guthrie Towanda Memorial Hospital Outpatient | Freedom Blue | Medicare Advantage | $1.21 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| MACNEAL HOSPITAL OutpatientFacility | BCBS IL | PPO | $1.21 | — | — | 2026-03-31 | MRF ↗ |
| CORNING HOSPITAL Outpatient | Amerihealth | Managed Medicaid | $1.32 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| GUTHRIE CORTLAND REGIONAL MEDICAL CENTER Outpatient | Amerihealth | Managed Medicaid | $1.32 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| GUTHRIE CORTLAND REGIONAL MEDICAL CENTER Outpatient | Amerihealth | Caritas Chc | $1.32 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| CORNING HOSPITAL Outpatient | Amerihealth | Caritas Chc | $1.32 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Aetna | Medicare Advantage | $1.44 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Both | Amerihealth | Managed Medicaid | — | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Both | Emblem | Medicare Advantage | $1.44 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Health Partners | Medicare Advantage | $1.44 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Tricare | Medicare Advantage | $1.44 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | United Healthcare | Medicare Advantage | $1.44 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Cdphp | Medicare Advantage | $1.44 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Both | Health Partners | Managed Medicaid | — | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Mvp | Medicare Advantage | $1.44 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Geisinger | Medicare Advantage | $1.46 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Humana | Medicare Advantage | $1.49 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Upmc | Medicare Advantage | $1.51 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | WELLCARE | MCARE HMO DUAL PLAN | $1.55 | — | — | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | WELLCARE | MCARE HMO | $1.55 | — | — | 2025-12-23 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Freedom Blue | Medicare Advantage | $1.58 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Bcbs | Blue Medicare Hmo/Ppo | $1.58 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Bcbs | Medicare Advantage | $1.58 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Wellcare | Medicare Advantage | $1.68 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Icircle | Medicare Advantage | $1.68 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Bcbs | Highmark Wholecare Medicare Advantage | $1.68 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| SOUTHWEST HEALTH CENTER OutpatientFacility | ANTHEM BLUE CROSS | MEDICARE ADVANTAGE | $2.05 | $6.83 | $5.12 | 2026-03-27 | MRF ↗ |
| SOUTHWEST HEALTH CENTER OutpatientFacility | CARE WISCONSIN | MEDICARE ADVANTAGE | $2.05 | $6.83 | $5.12 | 2026-03-27 | MRF ↗ |
| SOUTHWEST HEALTH CENTER OutpatientFacility | UNITED HEALTHCARE | MEDICARE ADVANTAGE | $2.12 | $6.83 | $5.12 | 2026-03-27 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | AETNA | Asa_Whirlpool_Peia | $2.17 | $5,074.80 | $3,298.62 | 2026-06-15 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR InpatientFacility | Humana Military | TRICARE | $2.22 | $7.94 | $7.94 | 2026-10-12 | MRF ↗ |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CTR OutpatientFacility | Excellus BlueCross BlueShield | Medicare Advantage | $2.22 | $7.94 | $7.94 | 2026-10-12 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan | $2.34 | — | — | 2026-03-01 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan – Hmo | $2.34 | — | — | 2026-03-01 | MRF ↗ |
| Guthrie Towanda Memorial Hospital Both | Health Partners | Managed Medicaid | — | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| Guthrie Towanda Memorial Hospital Both | Geisinger | Managed Medicaid | $2.39 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| CORNING HOSPITAL Both | Health Partners | Managed Medicaid | — | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| CORNING HOSPITAL Both | Geisinger | Managed Medicaid | $2.39 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| ROBERT PACKER HOSPITAL Both | Geisinger | Managed Medicaid | $2.39 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Pa Health And Wellness | — | $2.43 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Both | Geisinger | Managed Medicaid | $2.44 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| GUTHRIE CORTLAND REGIONAL MEDICAL CENTER Outpatient | Geisinger | Managed Medicaid | $2.44 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| OCHSNER UNIVERSITY HOSPITAL AND CLINICS Outpatient | Louisiana Healthcare Connections (Healthy Louisiana) | All Plans | $2.58 | $12.00 | $3.00 | 2026-07-15 | MRF ↗ |
| OCHSNER UNIVERSITY HOSPITAL AND CLINICS Outpatient | United Healthcare Community Plan (Healthy Louisiana) | All Plans | $2.58 | $12.00 | $3.00 | 2026-07-15 | MRF ↗ |
| OCHSNER UNIVERSITY HOSPITAL AND CLINICS Outpatient | Healthy Blue (Healthy Louisiana) | All Plans | $2.58 | $12.00 | $3.00 | 2026-07-15 | MRF ↗ |
| OCHSNER UNIVERSITY HOSPITAL AND CLINICS Outpatient | Amerihealth Caritas Louisiana (Healthy Louisiana) | All Plans | $2.58 | $12.00 | $3.00 | 2026-07-15 | MRF ↗ |
| OCHSNER UNIVERSITY HOSPITAL AND CLINICS Outpatient | Aetna Better Health (Healthy Louisiana) | All Plans | $2.58 | $12.00 | $3.00 | 2026-07-15 | MRF ↗ |
| OCHSNER UNIVERSITY HOSPITAL AND CLINICS Outpatient | Humana Managed Medicaid (Healthy Louisiana) | All Plans | $2.58 | $12.00 | $3.00 | 2026-07-15 | MRF ↗ |
| TROY COMMUNITY HOSPITAL Outpatient | Wellcare | Fidelis Medicare Advantage | $2.72 | $8.00 | $6.40 | 2026-07-15 | MRF ↗ |
| OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC Both | Geisinger | Managed Medicaid | — | $8.00 | $4.00 | 2026-07-15 | MRF ↗ |
| OUR LADY OF LOURDES MEMORIAL HOSPITAL, INC Both | Cigna | — | $2.79 | $8.00 | $4.00 | 2026-07-15 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $2.83 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $2.83 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $2.83 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $2.83 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $2.83 | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $2.83 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $2.83 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $2.83 | — | — | 2026-04-01 | MRF ↗ |
| HARTFORD HOSPITAL Outpatient | MOLINA dba CONNECTICARE | MOLINA dba CONNECTICARE MEDICARE | $2.86 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| HARTFORD HOSPITAL Outpatient | HEALTH NEW ENGLAND | HEALTH NEW ENGLAND MEDICARE | $2.86 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| HARTFORD HOSPITAL Outpatient | UNITED | UNITED MEDICARE | $2.86 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| HARTFORD HOSPITAL Outpatient | TUFTS | TUFTS MEDICARE | $2.86 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| HARTFORD HOSPITAL Outpatient | ANTHEM | ANTHEM MEDICARE | $2.86 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| THE HOSPITAL OF CENTRAL CONNECTICUT Outpatient | HEALTH NEW ENGLAND | HEALTH NEW ENGLAND MEDICARE | $2.86 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| THE HOSPITAL OF CENTRAL CONNECTICUT Outpatient | TUFTS | TUFTS MEDICARE | $2.86 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| THE HOSPITAL OF CENTRAL CONNECTICUT Outpatient | UNITED | UNITED MEDICARE | $2.86 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| THE HOSPITAL OF CENTRAL CONNECTICUT Outpatient | ANTHEM | ANTHEM MEDICARE | $2.86 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| THE HOSPITAL OF CENTRAL CONNECTICUT Outpatient | MOLINA dba CONNECTICARE | MOLINA dba CONNECTICARE MEDICARE | $2.86 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| MIDSTATE MEDICAL CENTER Outpatient | UNITED | UNITED MEDICARE | $2.86 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| MIDSTATE MEDICAL CENTER Outpatient | HEALTH NEW ENGLAND | HEALTH NEW ENGLAND MEDICARE | $2.86 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| MIDSTATE MEDICAL CENTER Outpatient | ANTHEM | ANTHEM MEDICARE | $2.86 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| MIDSTATE MEDICAL CENTER Outpatient | MOLINA dba CONNECTICARE | MOLINA dba CONNECTICARE MEDICARE | $2.86 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| MIDSTATE MEDICAL CENTER Outpatient | TUFTS | TUFTS MEDICARE | $2.86 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| HARTFORD HOSPITAL Outpatient | WELLCARE | WELLCARE MEDICARE | $2.92 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| THE HOSPITAL OF CENTRAL CONNECTICUT Outpatient | WELLCARE | WELLCARE MEDICARE | $2.92 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| MIDSTATE MEDICAL CENTER Outpatient | WELLCARE | WELLCARE MEDICARE | $2.92 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| HARTFORD HOSPITAL Outpatient | AETNA | AETNA MEDICARE | $2.93 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| THE HOSPITAL OF CENTRAL CONNECTICUT Outpatient | AETNA | AETNA MEDICARE | $2.93 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| MIDSTATE MEDICAL CENTER Outpatient | AETNA | AETNA MEDICARE | $2.93 | $1,474.30 | $1,474.30 | 2026-04-01 | MRF ↗ |
| SOUTHWEST GENERAL HEALTH CENTER OutpatientFacility | Medical Mutual | ACA Exchange | $2.93 | — | — | 2026-07-01 | MRF ↗ |
| SOUTHWEST GENERAL HEALTH CENTER OutpatientFacility | MEDICAL MUTUAL-OHIO | All Products | $2.93 | — | — | 2026-07-01 | MRF ↗ |
| MAURY REGIONAL HOSPITAL Outpatient | Unitedhealthcare | Medicaid | $2.96 | — | — | 2026-07-15 | MRF ↗ |
| CENTRAL VERMONT MEDICAL CENTER InpatientFacility | Humana Military | TRICARE | $3.16 | $7.94 | $7.94 | 2026-10-01 | MRF ↗ |
| SOUTHWEST GENERAL HEALTH CENTER OutpatientFacility | Medical Mutual | All Products | $3.27 | — | — | 2026-07-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MC AETNA HMO [164001] | UC MANAGED CARE | $3.30 | $27.54 | $15.15 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MC UHC HARMONY HMO [164026] | UC MANAGED CARE | $3.30 | $27.54 | $15.15 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MC SCAN HMO [164035] | UC MANAGED CARE | $3.30 | $27.54 | $15.15 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MC UHC VEBA HMO [164033] | UC MANAGED CARE | $3.30 | $27.54 | $15.15 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MC HEALTHNET GENERIC PAYOR [164010] | UC MANAGED CARE | $3.30 | $27.54 | $15.15 | 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.