J1438 — Etanercept Injection
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Etanercept injection (HCPCS J1438) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/J1438?code_type=HCPCS
MLA (9th ed.)
“Etanercept injection (HCPCS J1438) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/J1438?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Etanercept injection (HCPCS J1438) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/J1438?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $965–$3,302 (25th–75th percentile) across 1,654 hospitals · 3,192 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS J1438 — 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
$965
$1,670 typical
$3,302
The middle 50% of negotiated facility rates for this procedure, measured across 1,654 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $1,670 |
| Likely subtotal | $1,670 |
Facility charge (no separate professional fee)
$1,670
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 $965–$3,302.
- 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 |
|---|---|---|---|---|---|---|---|
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | — | — | — | $753.82 | $376.91 | 2024-12-15 | MRF ↗ |
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | — | — | — | $753.82 | $376.91 | 2024-12-15 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | HEALTHNET TRANSPLANTS [1114] | HEALTH NET COMMERCIAL | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | GLOBAL EXCEL [1036] | GLOBAL EXCEL | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | HEALTH NET [1039] | HEALTH NET COMMERCIAL | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | OPTUM TRANSPLANT [1118] | OPTUM HEALTHCARE SOLUTIONS | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE AETNA [1004] | AETNA | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | UNITED HEALTHCARE [1088] | OPTUM HEALTHCARE SOLUTIONS | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE SHIELD [1014] | BLUE SHIELD OF CA EPN/IFP | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE HEALTHNET [1007] | HEALTH NET COMMERCIAL | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | SHARP HEALTH PLAN [1079] | SHARP HEALTH PLAN | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ETS - LIFETRAC NETWORK [1103] | LIFETRAC | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | AETNA [1003] | AETNA | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE CIGNA [1006] | EVERNORTH (FKA CIGNA) BEHAVIORAL AND EATING DISORDER TREATMENT | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CIGNA [1023] | EVERNORTH (FKA CIGNA) BEHAVIORAL AND EATING DISORDER TREATMENT | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | SAN DIEGO COUNTY [1071] | CMH - COUNTY MENTAL HEALTH [10710005] | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | AETNA [1003] | AETNA MEDI-CAL | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | INTERLINK HEALTH TRANSPLANT [2085] | INTERLINK HEALTH SERVICES INC | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | SAN DIEGO COUNTY [1071] | CMS ADULT TB SERVICES | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE HEALTH NET BH [2059] | HEALTH NET COMMERCIAL | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE CIGNA [1006] | CIGNA HMO | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | USOC - US OLYMPIC COMMITTEE [1123] | USOC VIK (BSC UC CARE) | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE UNITED HEALTHCARE [1008] | OPTUM HEALTHCARE SOLUTIONS | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE SHIELD [1014] | BLUE SHIELD OF CALIFORNIA UC CARE / HSP | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CIGNA [1023] | CIGNA HMO | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | OLYMPUS MANAGED HEALTHCARE INC [1102] | AETNA | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | AETNA TRANSPLANTS [1112] | AETNA | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | INTERLINK HEALTH SERVICES TRANSPLANT [1124] | INTERLINK HEALTH SERVICES INC | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | OLYMPUS MANAGED HEALTHCARE INC [1102] | OLYMPUS MANAGED HEALTHCARE INC [11020001] | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | AETNA [1003] | AETNA BEHAVIORAL EATING DISORDER | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MULTICULTURAL MED GRP [1057] | MULTICULTURAL MED GRP [10570001] | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CIGNA [1023] | CIGNA PPO | $0.03 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | KAISER [1046] | KAISER MEDICARE ADVANTAGE | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE SHIELD TRANSPLANTS [1113] | BLUE SHIELD OF CA PPO AND BARIATRIC | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BLUE SHIELD [1014] | BLUE SHIELD OF CA PPO AND BARIATRIC | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | QUALITY HEALTH [1069] | QUALITY HEALTH MANAGEMENT | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | SD PHYSICIANS MED GRP [1076] | SD PHYSICIANS MED GRP [10760001] | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MERCY PHYSICIANS MED GRP [1052] | MERCY PHYSICIANS MED GRP [10520001] | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE BLUE SHIELD [2002] | BLUE SHIELD OF CA PPO AND BARIATRIC | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CIGNA [1023] | CIGNA LIFESOURCE | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CIGNA LIFESOURCE TRANSPLANT [1117] | CIGNA LIFESOURCE | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CMS - COUNTY MEDICAL SERVICES [1025] | SHERIFF COUNTY CONTRACT # 514250 | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | VANTAGE [1092] | PROSPECT VANTAGE COMMERCIAL [10920001] | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CIGNA [1023] | CIGNA LIFESOURCE [10230006] | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | PACIFIC FOUNDATION [1063] | PACIFIC FOUNDATION FOR MEDICAL CARE | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CASSIDY MED GRP [1019] | PRIMARY CARE ASSOCIATES MEDICAL GROUP | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | HEALTH NET [1039] | HEALTH NET BEHAVIORAL HEALTH COMMERCIAL (FKA:MANAGED HEALTH NETWORK,INC) | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | GRAYBILL MED GRP [1037] | SHARP HEALTH CARE | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE BLUE CROSS [1005] | ANTHEM BLUE CROSS | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | SAN DIEGO COUNTY SHERIFF CUSTODY [2012] | SHERIFF COUNTY CONTRACT # 514250 | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | HEALTH NET [1039] | HEALTH NET MEDI-CAL | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | SHARP HEALTH PLAN [1079] | SHARP HEALTH CARE | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | EMBASSY SPONSORED [1101] | INTERNATIONAL EMBASSY OF KUWAIT | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | HEALTH NET BH (MHN) [1038] | HEALTH NET BEHAVIORAL HEALTH COMMERCIAL (FKA:MANAGED HEALTH NETWORK,INC) | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MGM RESORTS [1053] | MGM RESORT | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | SHARP REES STEALY [1080] | SHARP HEALTH CARE | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | OPTUM CARE NETWORK - PRIMECARE MED GRP [1065] | PRIMECARE MEDICAL NETWORK | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CMN - CANADIAN MEDICAL NETWORK [1024] | CMN GLOBAL INC | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | EMBASSY SPONSORED [1101] | ROYAL EMBASSY | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | OPTUM CARE NETWORK - PCAMG [1064] | PRIMARY CARE ASSOCIATES MEDICAL GROUP | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | NATIONAL HEALTHCARE SOLUTIONS INC [1100] | NATIONAL HEALTHCARE SOLUTIONS INC [11000001] | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | SCRIPPS COASTAL MED GRP [1074] | SCRIPPS COASTAL MED GRP [10740001] | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | SHARP COMMUNITY MED GRP [1078] | SHARP HEALTH CARE | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | EMBASSY SPONSORED [1101] | EMBASSY OF STATE OF KUWAIT [11010001] | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ARCH HEALTH PARTNERS [2000] | ARCH HEALTH PARTNERS [20000001] | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CIGNA LIFESOURCE TRANSPLANT [1117] | CIGNA LIFESOURCE TRANSPLANT [11170001] | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | INTERPLAN [1045] | INTERPLAN | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | UNITED HEALTHCARE [1088] | US BEHAVIORAL MENTAL/EATING DISORDER | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | TRI-CITY [1085] | TRI-CITY [10850001] | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | EMBASSY SPONSORED [1101] | KUWAIT OIL COMPANY [11010005] | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | HEALTH NET BH (MHN) [2010] | HEALTH NET BEHAVIORAL HEALTH COMMERCIAL (FKA:MANAGED HEALTH NETWORK,INC) | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE SHERIFF CUSTODY [1106] | SHERIFF COUNTY CONTRACT # 514250 | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | KAISER [1046] | KAISER | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | AXA ASSISTANCE [1098] | AXA ASSISTANCE USA,INC | $0.04 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | HealthNet of California, Inc. | HMO | — | $1,465.56 | $952.61 | 2025-11-26 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE HUMANA [1120] | HUMANA COMMERCIAL | $0.05 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | MULTIPLAN [1058] | MULTIPLAN | $0.05 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CARNIVAL CRUISES [1018] | CARNIVAL CRUISES [10180001] | $0.05 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | SCRIPPS CLINIC [1073] | SCRIPPS CLINIC HEALTH PLAN SERVICES | $0.05 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | SCRIPPS HEALTH PLAN SERVICES [1075] | SCRIPPS CLINIC HEALTH PLAN SERVICES | $0.05 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BEECH STREET [1012] | CAPPCARE/BEECH STREET | $0.05 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | FIRST HEALTH [1032] | FIRST HEALTH | $0.05 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ADMAR [1001] | MULTIPLAN | $0.05 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | PRIVATE HEALTHCARE SYSTEMS [1067] | PRIVATE HEALTHCARE SYSTEM | $0.05 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | HUMANA [1042] | HUMANA COMMERCIAL | $0.05 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | BPS - BENEFIT PLAN SERVICES [1015] | MULTIPLAN | $0.05 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | PRIVATE HEALTHCARE SYSTEMS [1067] | KAISER RAD ONC | $0.06 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CMS - COUNTY MEDICAL SERVICES [1025] | COUNTY MEDICAL SERVICES | $0.06 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CHARGERS FOOTBALL COMPANY [1109] | CHARGER FOOTBALL COMPANY [11090001] | $0.06 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CHAMPVA [1020] | VETERANS ADMINISTRATION - CHAMPVA | $0.06 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | CALIFORNIA HEALTH & WELLNESS MEDI-CAL [1122] | CALIFORNIA HEALTH AND WELLNESS MEDI-CAL (no longer Medi-Cal plan as of 1/1/24) | $0.06 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | COMMUNITY CARE IPA [1131] | Community Care IPA Medi-Cal Managed Care | $0.06 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | ALTERNATE KAISER RAD ONC [2089] | KAISER RAD ONC | $0.06 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| UC SAN DIEGO HEALTH HILLCREST - HILLCREST MED CTR Outpatient | SHARP HEALTHCARE TRANSPLANT [1119] | SHARP HEALTHCARE TRANSPLANT [11190001] | $0.08 | $0.06 | $0.03 | 2026-04-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $0.29 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $0.29 | — | — | 2026-09-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Medicare | Medicare | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Molina | Molina Medi-Cal | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | United Healthcare | United Healthcare - HMO | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Kaiser | Kaiser - Rehab | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Blue Shield | Blue Shield - Promise | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Managed Health Network | MHN - Medicare | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Health Net | Health Net - HMO/POS/EPO | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Optum Health | Optum Health - Commercial | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Multiplan | Multiplan | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Allianz Global Assistance | AZGA Services Canada | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Community Health Group | Community Health Group - Cal Mediconnect | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Health Net | Health Net Cal MediConnect | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Aetna | First Health - Leased/CCN | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Molina | Molina - Exchange | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Health Net | Health Net - Medi-Cal | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Medi-Cal | Medi-Cal | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Health Net | Health Net Individual - HMO | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $0.60 | — | — | 2026-09-01 | MRF ↗ |
| Vibra Hospital Of Fargo | Medicaid North Dakota 183 | — | $0.64 | $5.00 | — | 2026-07-31 | MRF ↗ |
| Vibra Hospital Of Fargo | Medicaid North Dakota 183 | — | $0.69 | $5.00 | — | 2026-07-31 | MRF ↗ |
| Vibra Hospital Of Fargo | Medicaid North Dakota 183 | — | $0.72 | $5.00 | — | 2026-07-31 | MRF ↗ |
| GROSSMONT HOSPITAL Outpatient | Blue Cross | Blue Cross - Standard | $0.98 | $315.81 | $236.86 | 2026-04-01 | MRF ↗ |
| Vibra Hospital Of Central Dakotas Llc | Medicaid North Dakota 183 | — | $1.00 | $6.70 | — | 2026-08-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | SCAN Health Plan | Medicare Advantage | — | $1,465.56 | $952.61 | 2025-11-26 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Community Health Group | Community Health Group - Medi-Cal | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | San Diego Pace | San Diego Pace | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Medi-Cal | Medi-Cal | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Kaiser | Kaiser - HMO | — | $10,155.53 | $7,616.64 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Community Health Group | Community Health Group - Medi-Cal | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $1,465.56 | $952.61 | 2025-11-26 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Blue Shield | Blue Shield - HMO | — | $10,155.53 | $7,616.64 | 2025-07-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net - PPO | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net - PPO | — | $10,155.53 | $7,616.64 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Aetna | Aetna - HMO/POS | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net - Medi-Cal | — | $10,155.53 | $7,616.64 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Aetna | First Health - Direct | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Aetna | Aetna - PPO | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Aetna | First Health - Leased/CCN | — | $10,155.53 | $7,616.64 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Aetna | First Health Medicare | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Molina | Molina - Exchange | — | $10,155.53 | $7,616.64 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net - HMO/POS/EPO | — | $10,155.53 | $7,616.64 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | United Healthcare | United Healthcare - Medicare | — | $10,155.53 | $7,616.64 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Cigna | Cigna - HMO | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | United Healthcare | United Healthcare - Medicare | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net - Medi-Cal | $1.00 | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Cigna | Cigna - PPO | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | United Healthcare | United Healthcare - HMO | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Molina | Molina Medi-Cal | — | $10,155.53 | $7,616.64 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Interplan | Interplan | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | United Healthcare | United Healthcare - PPO | — | $10,155.53 | $7,616.64 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Multiplan | Multiplan | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Molina | Molina - Cal Medi-Connect | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Blue Cross | Blue Cross - Prudent Buyer | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Optum Health | Optum Health - Commercial | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | County Medical Services | County of San Diego | — | $10,155.53 | $7,616.64 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Optum Health | Optum Health - Medicare | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Blue Cross | Blue Cross - Standard | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Blue Cross | Blue Cross - MCS | — | $10,155.53 | $7,616.64 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | California Health and Wellness | California Health and Wellness | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Epic Americas | AXA Assistance | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Blue Cross | Blue Cross - Standard | — | $10,155.53 | $7,616.64 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Epic Americas | AXA Assistance | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Medicaid | Medicaid | $1.00 | $4,078.80 | $2,039.40 | 2026-07-01 | MRF ↗ |
| The Medical Center at Russellville Outpatient | United Healthcare (Medicare) | All Plans | $1.00 | $3,412.15 | — | 2026-04-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net - Medi-Cal | $1.00 | $17,182.85 | $12,887.14 | 2026-04-01 | MRF ↗ |
| The Medical Center at Russellville Outpatient | Humana (Medicare) | All Plans | $1.00 | $3,412.15 | — | 2026-04-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Humana | Choice Care Network | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Managed Health Network | MHN - Medicare | — | $10,155.53 | $7,616.64 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Blue Cross | Blue Cross - PPO | — | $17,182.85 | $12,887.14 | 2025-07-01 | MRF ↗ |
| The Medical Center at Russellville Outpatient | Molina Healthcare (Medicare) | Passport Health Plan Medicare | $1.00 | $3,412.15 | — | 2026-04-01 | MRF ↗ |
| The Medical Center at Russellville Outpatient | Signature Advantage Plan (Medicare) | Signature Advantage | $1.00 | $3,412.15 | — | 2026-04-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $1.07 | $4,078.80 | $2,039.40 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $1.10 | $4,078.80 | $2,039.40 | 2026-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net Individual - HMO | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net Cal MediConnect | $1.15 | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net - Medicare | $1.15 | $10,155.53 | $7,616.64 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Blue Cross | Blue Cross - HMO | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Community Health Group | Community Health Group - Cal Mediconnect | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Optum Health | Optum Health - Commercial | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Medicare | Medicare | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Blue Cross | Blue Cross - Prudent Buyer | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | California Health and Wellness | California Health and Wellness | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Aetna | Aetna Whole Health | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net Individual - EPO | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net - Medicare | $1.15 | $10,155.53 | $7,616.64 | 2026-04-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Aetna | Aetna - PPO | — | $315.81 | $236.86 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net Cal MediConnect | $1.15 | $315.81 | $236.86 | 2026-04-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $1.18 | $4,078.80 | $2,039.40 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Jefferson Health Plan | Jefferson Health Plan - Managed Medicaid | $1.20 | $4,078.80 | $2,039.40 | 2026-07-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $1.25 | — | — | 2026-04-01 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $1.25 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $1.25 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $1.25 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $1.25 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $1.25 | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $1.25 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $1.25 | — | — | 2026-04-01 | MRF ↗ |
| BOSTON CHILDREN'S HOSPITAL Both | Optum/URN | COMM Inpatient | — | $4,765.46 | $4,765.46 | 2026-04-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - Managed Medicaid | $1.47 | $4,078.80 | $2,039.40 | 2026-07-01 | MRF ↗ |
| ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL OutpatientFacility | Wellpoint | NJ Family Care | $1.51 | — | — | 2026-03-04 | MRF ↗ |
| Vibra Hospital Of Fargo | Sanford Medicaid Expansion (862) | — | $1.65 | $5.00 | — | 2026-07-31 | 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.