J3403 — Revakinagene, Per Implant
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Revakinagene, per implant (HCPCS J3403) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/J3403?code_type=HCPCS
MLA (9th ed.)
“Revakinagene, per implant (HCPCS J3403) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/J3403?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Revakinagene, per implant (HCPCS J3403) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/J3403?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $257,500–$287,499 (25th–75th percentile) across 367 hospitals · 484 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS J3403 — 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
$257,500
$265,000 typical
$287,499
The middle 50% of negotiated facility rates for this procedure, measured across 367 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $265,000 |
| Likely subtotal | $265,000 |
Facility charge (no separate professional fee)
$265,000
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: your remaining deductible and out-of-pocket max — enter your own plan terms to tighten this.
- 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 |
|---|---|---|---|---|---|---|---|
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $61.30 | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $61.30 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $61.30 | — | — | 2026-04-01 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $61.30 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $61.30 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $61.30 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $61.30 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $61.30 | — | — | 2026-04-01 | MRF ↗ |
| NICKLAUS CHILDREN'S HOSPITAL OutpatientFacility | Cigna | Surfit/Local Plus | $2,408.00 | — | — | 2026-04-01 | MRF ↗ |
| NICKLAUS CHILDREN'S HOSPITAL OutpatientFacility | Cigna | Hmo/Ppo | $2,675.00 | — | — | 2026-04-01 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Anthem | Anthemmedicaid | $6,881.22 | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Caresource | Caresourcemedicaid | $6,881.22 | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | United Healthcare | Unitedmedicaid | $7,087.65 | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Molina | Molinamedicaid | $7,087.65 | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Buckeye | Buckeyemedicaid | $7,087.65 | — | — | 2026-07-31 | MRF ↗ |
| FISHER-TITUS HOSPITAL Outpatient | Amerihealth | Amerihealthmedicaid | $7,087.65 | — | — | 2026-07-31 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | OPTUM | Managed Medicaid Transplant | $9,152.59 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $9,509.28 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $9,509.28 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $9,509.28 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $9,690.41 | — | — | 2026-06-15 | MRF ↗ |
| CLEVELAND CLINIC AVON HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $9,690.41 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | Paramount | Managed Medicaid | $9,923.33 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $10,116.02 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $10,116.02 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $10,116.02 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | United BH | Managed Medicaid | $10,212.36 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $10,308.70 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $10,308.70 | — | — | 2026-06-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | AMERIHEALTH | Managed Medicaid | $10,597.73 | — | — | 2026-06-15 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | Buckeye | Managed Medicaid | $11,989.56 | — | — | 2026-06-15 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | ANTHEM | Managed Medicaid | $12,589.04 | — | — | 2026-06-15 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | MOLINA | Managed Medicaid | $12,589.04 | — | — | 2026-06-15 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Molina | Managed Medicaid - Non-Cap | $12,628.82 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | UHC | Managed Medicaid | $12,628.82 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | Molina | Managed Medicaid - Non-Cap | $12,628.82 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | UHC | Managed Medicaid | $12,628.82 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Anthem | Managed Medicaid - Non-Cap | $12,750.26 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Amerihealth | Managed Medicaid - Non-Cap | $12,750.26 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | Amerihealth | Managed Medicaid - Non-Cap | $12,750.26 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | Anthem | Managed Medicaid - Non-Cap | $12,750.26 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | Humana | Managed Medicaid | $12,750.26 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | BCHP | Managed Medicaid - Non-Cap | $12,750.26 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | BCHP | Managed Medicaid - Non-Cap | $12,750.26 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Humana | Managed Medicaid | $12,750.26 | — | — | 2026-04-01 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | CARESOURCE | Managed Medicaid | $12,828.83 | — | — | 2026-06-15 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | UNITED | Managed Medicaid | $12,828.83 | — | — | 2026-06-15 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | AMERIHEALTH | Managed Medicaid | $13,188.52 | — | — | 2026-06-15 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Caresource | Managed Medicaid - Non-Cap | $17,159.44 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Amerihealth | Managed Medicaid - Non-Cap | $17,159.44 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Anthem | Managed Medicaid - Non-Cap | $17,159.44 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Humana | Managed Medicaid - Non-Cap | $17,159.44 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Molina | Managed Medicaid - Non-Cap | $17,159.44 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | UHC | Managed Medicaid - Non-Cap | $17,159.44 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | BCHP | Managed Medicaid - Non-Cap | $17,159.44 | — | — | 2026-04-01 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Daniel Memorial | Managed Medicaid | $25,395.70 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Amerigroup of Georgia | Managed Medicaid OOS | $25,395.70 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Humana | Managed Medicaid | $25,395.70 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Amerigroup of Georgia | Managed Medicaid OOS | $25,395.70 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Nassaua County Sheriff's Office | Managed Medicaid | $25,395.70 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Daniel Memorial | Managed Medicaid | $25,395.70 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Amerigroup of Georgia | Managed Medicaid OOS | $25,395.70 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Daniel Memorial | Managed Medicaid | $25,395.70 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Simply Healthcare Plans | Managed Medicaid | $26,665.49 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Simply Healthcare Plans - CHA | Managed Medicaid | $26,665.49 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Simply Healthcare Plans - CHA | Managed Medicaid | $26,665.49 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Simply Healthcare Plans | Managed Medicaid | $26,665.49 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Simply Healthcare Plans - CHA | Managed Medicaid | $26,665.49 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Simply Healthcare Plans | Managed Medicaid | $26,665.49 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Humana | Managed Medicaid | $27,935.27 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | United Community Plan | Managed Medicaid | $27,935.27 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Florida Community Care | Managed Medicaid | $27,935.27 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $27,935.27 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Florida Community Care | Managed Medicaid | $27,935.27 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | United Community Plan | Managed Medicaid | $27,935.27 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $27,935.27 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Vivida Health | Managed Medicaid | $27,935.27 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | United Community Plan | Managed Medicaid | $27,935.27 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Amerihealth Caritas | Managed Medicaid | $27,935.27 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Florida Community Care | Managed Medicaid | $27,935.27 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Vivida Health | Managed Medicaid | $27,935.27 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Vivida Health | Managed Medicaid | $27,935.27 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Sunshine State Health Plan | Managed Medicaid | $27,935.28 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Sunshine State Health Plan | Managed Medicaid | $27,935.28 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Sunshine State Health Plan | Managed Medicaid | $27,935.28 | — | — | 2026-02-06 | MRF ↗ |
| BEAVER COUNTY MEMORIAL HOSPITAL OutpatientFacility | BCBS | MEDICARE ADVANTAGE | $29,350.36 | — | — | 2025-12-30 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Molina Healthcare of Florida | Managed Medicaid | $30,220.88 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Molina Healthcare of Florida | Managed Medicaid | $30,220.88 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Molina Healthcare of Florida | Managed Medicaid | $30,220.88 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Simply Healthcare Plans | Florida Healthy Kids | $30,474.84 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Aetna Better Health | Healthy Kids | $30,474.84 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER BEACHES OutpatientFacility | Aetna Better Health | Managed Medicaid | $30,474.84 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Aetna Better Health | Healthy Kids | $30,474.84 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Simply Healthcare Plans | Florida Healthy Kids | $30,474.84 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST MEDICAL CENTER - NASSAU OutpatientFacility | Aetna Better Health | Managed Medicaid | $30,474.84 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Simply Healthcare Plans | Florida Healthy Kids | $30,474.84 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Aetna Better Health | Healthy Kids | $30,474.84 | — | — | 2026-02-06 | MRF ↗ |
| BAPTIST HEALTH MEDICAL CENTER - JACKSONVILLE OutpatientFacility | Aetna Better Health | Managed Medicaid | $30,474.84 | — | — | 2026-02-06 | MRF ↗ |
| BEAVER COUNTY MEMORIAL HOSPITAL OutpatientFacility | BCBS | PREFERRED | $33,774.87 | — | — | 2025-12-30 | MRF ↗ |
| BEAVER COUNTY MEMORIAL HOSPITAL OutpatientFacility | BCBS | BLUE CHOICE | $40,124.55 | — | — | 2025-12-30 | MRF ↗ |
| BEAVER COUNTY MEMORIAL HOSPITAL OutpatientFacility | BCBS | ALL PRODUCTS | $45,427.20 | — | — | 2025-12-30 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Aetna | Managed Medicaid | $51,775.08 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Molina | Managed Medicaid | $51,775.08 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | United Healthcare | Managed Medicaid | $51,775.08 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Aetna | Managed Medicaid | $51,775.08 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE WALTER REED HOSPITAL Outpatient | Aetna | Managed Medicaid | $51,775.08 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE WALTER REED HOSPITAL Outpatient | United Healthcare | Managed Medicaid | $51,775.08 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE WALTER REED HOSPITAL Outpatient | Anthem | Managed Medicaid | $51,775.08 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE REGIONAL MEDICAL CENTER Outpatient | Aetna | Managed Medicaid | $51,775.08 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Molina | Managed Medicaid | $51,775.08 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | United Healthcare | Managed Medicaid | $51,775.08 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE REGIONAL MEDICAL CENTER Outpatient | United Healthcare | Managed Medicaid | $51,775.08 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE REGIONAL MEDICAL CENTER Outpatient | Molina | Managed Medicaid | $51,775.08 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | United Healthcare | Managed Medicaid | $52,100.68 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Aetna | Managed Medicaid | $52,100.68 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Anthem | Managed Medicaid | $52,100.68 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Aetna | Managed Medicaid | $52,100.68 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | United Healthcare | Managed Medicaid | $52,100.68 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Anthem | Managed Medicaid | $52,100.68 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Sentara Health Plans | Managed Medicaid | $53,079.81 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Sentara Health Plans | Managed Medicaid | $53,079.81 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE WALTER REED HOSPITAL Outpatient | Sentara Health Plans | Managed Medicaid | $53,079.81 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE REGIONAL MEDICAL CENTER Outpatient | Sentara Health Plans | Managed Medicaid | $53,079.81 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Sentara Health Plans | Managed Medicaid | $53,413.62 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Sentara Health Plans | Managed Medicaid | $53,413.62 | — | — | 2026-01-02 | MRF ↗ |
| UPLAND HILLS HEALTH OutpatientFacility | GHC OF SC WI | POS | $53,727.15 | — | — | 2026-03-20 | MRF ↗ |
| UPLAND HILLS HEALTH OutpatientFacility | MHS | MANAGED MEDICAID | $53,727.15 | — | — | 2026-03-20 | MRF ↗ |
| UPLAND HILLS HEALTH OutpatientFacility | GHC OF EAU CLAIRE | MANAGED MEDICAID | $53,727.15 | — | — | 2026-03-20 | MRF ↗ |
| UPLAND HILLS HEALTH OutpatientFacility | GHC OF SC WI | POS | $53,727.15 | — | — | 2026-03-20 | MRF ↗ |
| UPLAND HILLS HEALTH OutpatientFacility | GHC OF EAU CLAIRE | MANAGED MEDICAID | $53,727.15 | — | — | 2026-03-20 | MRF ↗ |
| UPLAND HILLS HEALTH OutpatientFacility | MHS | MANAGED MEDICAID | $53,727.15 | — | — | 2026-03-20 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Humana | Managed Medicaid | $54,363.83 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE DOCTORS' HOSPITAL OF WILLIAMSBURG Outpatient | Humana | Managed Medicaid | $54,363.83 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE WALTER REED HOSPITAL Outpatient | Humana | Managed Medicaid | $54,363.83 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE REGIONAL MEDICAL CENTER Outpatient | Humana | Managed Medicaid | $54,363.83 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Humana | Managed Medicaid | $54,705.71 | — | — | 2026-01-02 | MRF ↗ |
| RIVERSIDE SHORE MEMORIAL HOSPITAL Outpatient | Humana | Managed Medicaid | $54,705.71 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | ANTHEM | MANAGED MEDICAID | $56,052.70 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | SENTARA | MANAGED MEDICAID | $56,052.70 | — | — | 2026-01-02 | MRF ↗ |
| VCU HEALTH TAPPAHANNOCK HOSPITAL Outpatient | ANTHEM | MANAGED MEDICAID | $56,052.70 | — | — | 2026-01-02 | MRF ↗ |
| VCU HEALTH TAPPAHANNOCK HOSPITAL Outpatient | AETNA | MANAGED MEDICAID | $56,052.70 | — | — | 2026-01-02 | MRF ↗ |
| VCU HEALTH TAPPAHANNOCK HOSPITAL Outpatient | SENTARA | MANAGED MEDICAID | $56,052.70 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | AETNA | MANAGED MEDICAID | $56,613.23 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | ANTHEM | MANAGED MEDICAID | $57,139.93 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | SENTARA | MANAGED MEDICAID | $57,139.93 | — | — | 2026-01-02 | MRF ↗ |
| VCU HEALTH TAPPAHANNOCK HOSPITAL Outpatient | UNITED | MANAGED MEDICAID | $57,173.75 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | UNITED | MANAGED MEDICAID | $57,173.75 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | AETNA | MANAGED MEDICAID | $57,711.33 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | UNITED | MANAGED MEDICAID | $58,282.73 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | MOLINA | MANAGED MEDICAID | $58,855.34 | — | — | 2026-01-02 | MRF ↗ |
| VCU HEALTH TAPPAHANNOCK HOSPITAL Outpatient | MOLINA | MANAGED MEDICAID | $58,855.34 | — | — | 2026-01-02 | MRF ↗ |
| MEDICAL COLLEGE OF VIRGINIA HOSPITALS Outpatient | MOLINA | MANAGED MEDICAID | $59,996.93 | — | — | 2026-01-02 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | AllCare IPA | All Commercial Products | $83,333.33 | — | — | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Health Net | All Commercial Products | — | — | — | 2026-04-01 | MRF ↗ |
| SIERRA VIEW MEDICAL CENTER OutpatientFacility | LASALLE | MEDI-CAL | $83,333.33 | — | — | 2026-04-01 | MRF ↗ |
| SIERRA VIEW MEDICAL CENTER OutpatientFacility | DIGNITY HEALTH | MEDI-CAL | $83,333.33 | — | — | 2026-04-01 | MRF ↗ |
| SIERRA VIEW MEDICAL CENTER OutpatientFacility | BLUE CROSS | MEDI-CAL | $83,333.33 | — | — | 2026-04-01 | MRF ↗ |
| CHILDREN'S NEBRASKA OutpatientFacility | Nebraska Medicaid | Managed Medicaid Community Plan | $90,961.76 | — | — | 2026-03-31 | MRF ↗ |
| CHILDREN'S NEBRASKA OutpatientFacility | Nebraska Medicaid | Community Plan - All Products | $90,961.76 | — | — | 2026-03-31 | MRF ↗ |
| CHILDREN'S NEBRASKA OutpatientFacility | Nebraska Medicaid | Total Care | $93,690.61 | — | — | 2026-03-31 | MRF ↗ |
| CHILDREN'S NEBRASKA OutpatientFacility | Molina (Nebraska) | Managed Medicaid | $97,329.08 | — | — | 2026-03-31 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Central California Alliance for Health | Managed Medicaid | $112,275.00 | — | — | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Dignity IPA_Formerly IMG | Managed Medicaid | $116,666.66 | — | — | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | La Salle IPA | Managed Medicaid | $116,666.66 | — | — | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Sante IPA | All Commercial Products | $116,666.66 | — | — | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Kaiser | Managed Medicaid | $120,833.33 | — | — | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Univseral Healthcare IPA | Managed Medicaid | $125,000.00 | — | — | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Central Valley Medical Providers IPA | Managed Medicaid | $125,000.00 | — | — | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Sequoia Health IPA | Managed Medicaid | $125,000.00 | — | — | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | United Physicians Network IPA | Managed Medicaid | $129,166.66 | — | — | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Community Care IPA | Managed Medicaid | $131,666.66 | — | — | 2026-04-01 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $137,148.26 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $137,148.26 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $137,148.26 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $137,148.26 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $137,148.26 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $137,148.26 | — | — | 2026-04-17 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | Aetna | Mi Medicaid | $138,020.00 | — | — | 2026-05-13 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | Mclaren | Mi Medicaid | $138,020.00 | — | — | 2026-05-13 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | Uhc | Mi Medicaid | $138,020.00 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mclaren (Mi | Mi Medicaid | $138,020.00 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Uhc | Mi Medicaid | $138,020.00 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Uhc | Mi Medicaid | $138,020.00 | — | — | 2026-09-21 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | Molina | Mi Medicaid | $138,020.00 | — | — | 2026-05-13 | MRF ↗ |
| THREE RIVERS HEALTH Outpatient | Priority Health | Mi Medicaid | $138,020.00 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mclaren | Mi Medicaid | $138,020.00 | — | — | 2026-09-21 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $138,595.00 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $138,595.00 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $138,595.00 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $138,595.00 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $138,595.00 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Molina | Managed Medicaid | $138,595.00 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Priority Health | Managed Medicaid | $138,595.00 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | United Healthcare | Managed Medicaid | $138,595.00 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Blue Cross Complete | Managed Medicaid | $138,595.00 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | McLaren Health Plan | Managed Medicaid | $138,595.00 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $138,595.00 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $138,595.00 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $138,595.00 | — | — | 2026-04-17 | 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.