J9256 — Inj, Nipocalimab-aahu, 3 Mg
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Inj, nipocalimab-aahu, 3 mg (HCPCS J9256) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/J9256?code_type=HCPCS
MLA (9th ed.)
“Inj, nipocalimab-aahu, 3 mg (HCPCS J9256) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/J9256?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Inj, nipocalimab-aahu, 3 mg (HCPCS J9256) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/J9256?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $33–$134 (25th–75th percentile) across 343 hospitals · 706 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS J9256 — 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
$33
$39 typical
$134
The middle 50% of negotiated facility rates for this procedure, measured across 343 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $39 |
| Likely subtotal | $39 |
Facility charge (no separate professional fee)
$39
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 $33–$134.
- 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 |
|---|---|---|---|---|---|---|---|
| FAIRVIEW HOSPITAL OutpatientFacility | AETNA | Asa_Whirlpool_Peia | $2.17 | $6,912.00 | $4,492.80 | 2026-06-15 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | United Healthcare | Managed Medicaid | $4.99 | $124.80 | $124.80 | 2026-06-24 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | Fidelis Managed Medicaid | Managed Medicaid | $5.33 | $124.80 | $124.80 | 2026-06-24 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | Wellpoint | Managed Medicaid | $5.39 | $124.80 | $124.80 | 2026-06-24 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | Aetna Better Health | Managed Medicaid | $6.74 | $124.80 | $124.80 | 2026-06-24 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | Horizon Blue Cross | Omnia | $12.44 | $124.80 | $124.80 | 2026-06-24 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | Horizon Blue Cross | Managed Care | $13.83 | $124.80 | $124.80 | 2026-06-24 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | Horizon Blue Cross | Indemnity | $14.93 | $124.80 | $124.80 | 2026-06-24 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | Horizon Blue Cross | PPO | $14.93 | $124.80 | $124.80 | 2026-06-24 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $17.09 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $17.09 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $17.09 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $17.09 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $17.09 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $17.09 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | McLaren Health Plan | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Meridian | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | United Healthcare | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Priority Health | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Molina | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Blue Cross Complete | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $17.12 | — | — | 2026-04-17 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Aetna Medicare | Medicare | $17.88 | — | — | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Blue Shield | Medicare Advantage | $17.88 | — | — | 2026-03-29 | MRF ↗ |
| Monument Health Orthopedic and Specialty Hospital Outpatient | MEDICA MCR ADV | MEDICA MCR ADV | $17.93 | $72.87 | $58.29 | 2026-09-01 | MRF ↗ |
| Monument Health Orthopedic and Specialty Hospital Outpatient | MEDICA MCAID | MEDICA MCAID | $21.42 | $72.87 | $58.29 | 2026-09-01 | MRF ↗ |
| RHODE ISLAND HOSPITAL OutpatientFacility | Bcbs | Blue Chip Direct Advance Other Commercial Plan | $22.01 | — | — | 2026-04-01 | MRF ↗ |
| PAUL OLIVER MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $23.03 | — | — | 2026-04-17 | MRF ↗ |
| PAUL OLIVER MEMORIAL HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $23.03 | — | — | 2026-04-17 | MRF ↗ |
| PAUL OLIVER MEMORIAL HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $23.03 | — | — | 2026-04-17 | MRF ↗ |
| PAUL OLIVER MEMORIAL HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $23.03 | — | — | 2026-04-17 | MRF ↗ |
| PAUL OLIVER MEMORIAL HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $23.03 | — | — | 2026-04-17 | MRF ↗ |
| PAUL OLIVER MEMORIAL HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $23.03 | — | — | 2026-04-17 | MRF ↗ |
| KALKASKA MEMORIAL HEALTH CENTER OutpatientFacility | United Healthcare | Managed Medicaid | $23.08 | — | — | 2026-04-17 | MRF ↗ |
| KALKASKA MEMORIAL HEALTH CENTER OutpatientFacility | Blue Cross Complete | Managed Medicaid | $23.08 | — | — | 2026-04-17 | MRF ↗ |
| CHARLEVOIX AREA HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $23.08 | — | — | 2026-04-17 | MRF ↗ |
| KALKASKA MEMORIAL HEALTH CENTER OutpatientFacility | Priority Health | Managed Medicaid | $23.08 | — | — | 2026-04-17 | MRF ↗ |
| KALKASKA MEMORIAL HEALTH CENTER OutpatientFacility | Molina | Managed Medicaid | $23.08 | — | — | 2026-04-17 | MRF ↗ |
| CHARLEVOIX AREA HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $23.08 | — | — | 2026-04-17 | MRF ↗ |
| CHARLEVOIX AREA HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $23.08 | — | — | 2026-04-17 | MRF ↗ |
| CHARLEVOIX AREA HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $23.08 | — | — | 2026-04-17 | MRF ↗ |
| CHARLEVOIX AREA HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $23.08 | — | — | 2026-04-17 | MRF ↗ |
| KALKASKA MEMORIAL HEALTH CENTER OutpatientFacility | Meridian | Managed Medicaid | $23.08 | — | — | 2026-04-17 | MRF ↗ |
| KALKASKA MEMORIAL HEALTH CENTER OutpatientFacility | McLaren Health Plan | Managed Medicaid | $23.08 | — | — | 2026-04-17 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UPMC HEALTH PLAN 5138 | UPMC HEALTH PLAN 513801 | $24.10 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UPMC HEALTH PLAN 5138 | UPMC HEALTH PLAN 513801 | $24.10 | — | — | 2026-01-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CAPITAL BLUE CROSS | CHIP | $24.25 | — | — | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CAPITAL BLUE CROSS | CHIP | $24.25 | — | — | 2026-07-01 | MRF ↗ |
| KING'S DAUGHTERS' MEDICAL CENTER OutpatientFacility | Healthsmart | Commercial | $24.43 | — | — | 2026-09-25 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | CAPITAL BLUE CROSS | CHIP | $24.86 | — | — | 2026-07-01 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | Aetna | Commercial | $25.33 | $124.80 | $124.80 | 2026-06-24 | MRF ↗ |
| ASANTE THREE RIVERS MEDICAL CENTER Both | CCO EASTERN OREGON [5023] | CCO EASTERN OREGON PLUS | $26.19 | $10,575.26 | $6,873.92 | 2026-03-25 | MRF ↗ |
| ASANTE THREE RIVERS MEDICAL CENTER Both | CCO JACKSON CARE CONNECT [5005] | Jackson Care Connect CCO Plans | $26.19 | $10,575.26 | $6,873.92 | 2026-03-25 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | MEDICARE BLUE CHOICE 1306 | MEDICARE BLUE CHOICE 130601 | $26.35 | — | — | 2026-01-01 | MRF ↗ |
| PALOMAR HEALTH DOWNTOWN CAMPUS OutpatientFacility | Blue Cross | Anthem Priority Select Other Commercial Plan | $26.52 | — | — | 2026-04-01 | MRF ↗ |
| PALOMAR MEDICAL CENTER POWAY OutpatientFacility | Blue Cross | Anthem Priority Select Other Commercial Plan | $26.52 | — | — | 2026-04-01 | MRF ↗ |
| CAROLINA PINES REGIONAL MEDICAL CENTER OutpatientFacility | BCBS | Blue Preferred | $26.77 | — | — | 2025-01-01 | MRF ↗ |
| INTERMOUNTAIN HEALTH UTAH VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $27.09 | — | — | 2026-08-01 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $27.09 | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH UTAH VALLEY HOSPITAL Outpatient | Molina | Medicaid | $27.09 | — | — | 2026-08-01 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Selecthealth | Medicaid | $27.09 | — | — | 2026-07-15 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Selecthealth | Medicaid | $27.09 | — | — | 2026-07-14 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Health Choice | Medicaid | $27.09 | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH UTAH VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $27.09 | — | — | 2026-08-01 | MRF ↗ |
| INTERMOUNTAIN HEALTH UTAH VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $27.09 | — | — | 2026-08-01 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $27.09 | — | — | 2026-07-15 | MRF ↗ |
| RIVERTON HOSPITAL Outpatient | Selecthealth | Medicaid | $27.09 | — | — | 2026-07-15 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Molina | Medicaid | $27.09 | — | — | 2026-07-15 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $27.09 | — | — | 2026-07-15 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Molina | Medicaid | $27.09 | — | — | 2026-07-15 | MRF ↗ |
| SEVIER VALLEY HOSPITAL Outpatient | Healthy U | Medicaid | $27.09 | — | — | 2026-07-15 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $27.09 | — | — | 2026-07-14 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Healthy U | Medicaid | $27.09 | — | — | 2026-07-14 | MRF ↗ |
| BEAR RIVER VALLEY HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $27.09 | — | — | 2026-07-15 | MRF ↗ |
| RIVERTON HOSPITAL Outpatient | Health Plan Of Nevada | Medicaid | $27.09 | — | — | 2026-07-15 | MRF ↗ |
| CEDAR CITY HOSPITAL Outpatient | Molina | Medicaid | $27.09 | — | — | 2026-07-14 | MRF ↗ |
| RIVERTON HOSPITAL Outpatient | Healthy U | Medicaid | $27.09 | — | — | 2026-07-15 | MRF ↗ |
| ASANTE THREE RIVERS MEDICAL CENTER Both | CCO YAMHILL COMMUNITY CARE ORG [5032] | CCO YAMHILL COMMUNITY CARE | $27.18 | $10,575.26 | $6,873.92 | 2026-03-25 | MRF ↗ |
| ASANTE THREE RIVERS MEDICAL CENTER Both | CCO UMPQUA HEALTH ALLIANCE [5008] | CCO UMPQUA HEALTH ALLIANCE MEDICAID PLANS | $27.18 | $40,310.40 | $26,201.76 | 2026-03-25 | MRF ↗ |
| ASANTE THREE RIVERS MEDICAL CENTER Both | CCO COLUMBIA PACIFIC [5026] | COLUMBIA PACIFIC PLUS | $27.18 | $10,575.26 | $6,873.92 | 2026-03-25 | MRF ↗ |
| ASANTE THREE RIVERS MEDICAL CENTER Both | CCO ADVANCED HEALTH [5027] | ADVANCED HEALTH PLUS | $27.18 | $10,575.26 | $6,873.92 | 2026-03-25 | MRF ↗ |
| ASANTE THREE RIVERS MEDICAL CENTER Both | CCO TRILLIUM COMMUNITY HEALTH PLAN [5011] | CCO TRILLIUM COMMUNITY HEALTH PLAN | $27.18 | $10,575.26 | $6,873.92 | 2026-03-25 | MRF ↗ |
| ASANTE THREE RIVERS MEDICAL CENTER Both | CCO INTERCOMMUNITY HEALTH NETWORK [5010] | CCO INTERCOMMUNITY HEALTH NETWORK MEDICAID PLANS | $27.18 | $10,575.26 | $6,873.92 | 2026-03-25 | MRF ↗ |
| ASANTE THREE RIVERS MEDICAL CENTER Both | CCO HEALTH SHARE KAISER [5031] | CCO HEALTH SHARE KAISER MEDICAID PLANS | $27.18 | $10,575.26 | $6,873.92 | 2026-03-25 | MRF ↗ |
| ASANTE THREE RIVERS MEDICAL CENTER Both | CCO PACIFISOURCE COMMUNITY SOL [5016] | CCO PACIFISOURCE COMMUNITY MEDICAID PLANS | $27.18 | $10,575.26 | $6,873.92 | 2026-03-25 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CIGNA | HEALTHSPRING | $27.77 | — | — | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | CIGNA | HEALTHSPRING | $27.77 | — | — | 2026-07-01 | MRF ↗ |
| ASANTE THREE RIVERS MEDICAL CENTER Both | CCO HEALTH SHARE OREGON [5030] | Health Share CCO Plans | $27.83 | $10,575.26 | $6,873.92 | 2026-03-25 | MRF ↗ |
| ASANTE THREE RIVERS MEDICAL CENTER Both | CCO CASCADE HEALTH ALLIANCE [5006] | Cascade Health Alliance CCO Plans | $27.83 | $10,575.26 | $6,873.92 | 2026-03-25 | MRF ↗ |
| WHITFIELD REGIONAL HOSPITAL OutpatientFacility | WellCare | All Products | $27.83 | — | — | 2026-04-01 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | Aultcare | MEDICARE ADVANTAGE | $27.83 | $6,912.00 | $4,492.80 | 2026-06-15 | MRF ↗ |
| ASANTE THREE RIVERS MEDICAL CENTER Both | CCO CASCADE HEALTH ALLIANCE [5006] | CASCADE HEALTH ALLIANCE BH | $27.83 | $10,575.26 | $6,873.92 | 2026-03-25 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | MEDICARE BLUE CHOICE 1306 | MEDICARE BLUE CHOICE 130601 | $27.96 | — | — | 2026-01-01 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | HealthNet Sante Dual Risk | Medicare Advantage | $29.40 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | HealthNet Sante - Sub Cap Dual Risk | Medicare Advantage | $29.40 | — | — | 2026-06-18 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | McLaren Health Plan | Commercial | $29.47 | — | — | 2026-04-17 | MRF ↗ |
| SIERRA VIEW MEDICAL CENTER OutpatientFacility | HEALTHNET | MEDI-CAL | $29.47 | — | — | 2026-04-01 | MRF ↗ |
| CARSON VALLEY HEALTH OutpatientFacility | Anthem | Managed Medicaid | $29.47 | — | — | 2026-03-27 | MRF ↗ |
| CARSON VALLEY HEALTH OutpatientFacility | Silver Summit | Managed Medicaid | $29.47 | — | — | 2026-03-27 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | McLaren Health Plan | Commercial | $29.47 | — | — | 2026-04-17 | MRF ↗ |
| UNIVERSITY OF VIRGINIA MEDICAL CENTER Both | BLUE RIDGE PACE [10510] | UVAMC - Managed Medicare (Innovage) | $29.47 | $31,200.00 | $18,720.00 | 2026-03-24 | MRF ↗ |
| UNIVERSITY OF VIRGINIA MEDICAL CENTER Both | BLUE RIDGE PACE MEDICAID [20513] | UVAMC - Managed Medicare (Innovage) | $29.47 | $31,200.00 | $18,720.00 | 2026-03-24 | MRF ↗ |
| UNIVERSITY OF VIRGINIA MEDICAL CENTER Both | BLUE RIDGE PACE MEDICAID [20513] | UVAMC - Managed Medicare (Innovage) | $29.47 | $31,200.00 | $18,720.00 | 2026-03-24 | MRF ↗ |
| UNIVERSITY OF VIRGINIA MEDICAL CENTER Both | BLUE RIDGE PACE [10510] | UVAMC - Managed Medicare (Innovage) | $29.47 | $31,200.00 | $18,720.00 | 2026-03-24 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | McLaren Health Plan | Commercial | $29.47 | — | — | 2026-04-17 | MRF ↗ |
| CAROLINA PINES REGIONAL MEDICAL CENTER OutpatientFacility | BCBS | Blue Choice | $30.26 | — | — | 2025-01-01 | MRF ↗ |
| SUMMIT MEDICAL CENTER Outpatient | Medicare | Medicare | $30.44 | — | — | 2026-08-30 | MRF ↗ |
| SUMMIT MEDICAL CENTER Outpatient | MCAdvantage | MCAdvantage | $30.44 | — | — | 2026-08-30 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | Keystone First | JNE001_JNE_002_JNE003 Caid CHIP | $30.72 | — | — | 2026-09-15 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | Keystone First | JNE001_JNE_002_JNE003 Caid MCO | $30.72 | — | — | 2026-09-15 | MRF ↗ |
| Jefferson Methodist Hospital OutpatientFacility | Keystone First | JCC002 Caid CHIP | $30.89 | — | — | 2026-03-18 | MRF ↗ |
| Jefferson Methodist Hospital OutpatientFacility | Keystone First | JCC002 Caid MCO | $30.89 | — | — | 2026-03-18 | MRF ↗ |
| THOMAS JEFFERSON UNIVERSITY HOSPITAL OutpatientFacility | Keystone First | JCC001 Caid CHIP | $30.89 | — | — | 2026-03-18 | MRF ↗ |
| THOMAS JEFFERSON UNIVERSITY HOSPITAL OutpatientFacility | Keystone First | JCC001 Caid MCO | $30.89 | — | — | 2026-03-18 | MRF ↗ |
| METRO NASHVILLE GENERAL HOSPITAL OutpatientFacility | TennCare | Medicaid Managed Care Plan | $30.94 | — | — | 2026-09-01 | MRF ↗ |
| BAPTIST HEALTH FLOYD Outpatient | UHC MCR ADV | UHC MCR ADV | $30.94 | $431.81 | $323.86 | 2026-07-31 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Jefferson Health Plan ACA QHP Exchange | JNJ001_JNJ002_JNJ003 Commercial Exchange | $30.94 | — | — | 2026-09-15 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST InpatientFacility | IBC Medicare | JNE002_JNE003 Medicare Focus | $30.94 | — | — | 2026-09-15 | MRF ↗ |
| JEWISH HOME & REHAB CENTER OutpatientFacility | HealthNet | Medicare Advantage | $31.10 | — | — | 2026-04-30 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Health | Medicare Advantage | $31.10 | — | — | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Health | Medicare Advantage | $31.10 | — | — | 2026-03-31 | MRF ↗ |
| MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL OutpatientFacility | Heritage Provider Network (HPN) | Medicare Advantage | $31.11 | — | — | 2026-03-26 | MRF ↗ |
| MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL OutpatientFacility | Heritage Provider Network (HPN) | Commercial | $31.11 | — | — | 2026-03-26 | MRF ↗ |
| MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL OutpatientFacility | Heritage Provider Network (HPN) | Exchange | $31.11 | — | — | 2026-03-26 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Tricare CHAMPUS | All Products | $31.11 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | Tricare CHAMPUS | All Products | $31.11 | — | — | 2026-04-01 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL OutpatientFacility | Tricare CHAMPUS | All Products | $31.11 | — | — | 2026-04-01 | MRF ↗ |
| SIERRA VIEW MEDICAL CENTER OutpatientFacility | LASALLE | MEDI-CAL | $31.20 | — | — | 2026-04-01 | MRF ↗ |
| SIERRA VIEW MEDICAL CENTER OutpatientFacility | DIGNITY HEALTH | MEDI-CAL | $31.20 | — | — | 2026-04-01 | MRF ↗ |
| SIERRA VIEW MEDICAL CENTER OutpatientFacility | BLUE CROSS | MEDI-CAL | $31.20 | — | — | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Health Net | All Commercial Products | — | — | — | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | AllCare IPA | All Commercial Products | $31.20 | — | — | 2026-04-01 | MRF ↗ |
| DOCTORS HOSPITAL OF MANTECA Outpatient | Humana | TRICARE | $31.69 | — | — | 2026-09-01 | MRF ↗ |
| ATLANTICARE REGIONAL MEDICAL CENTER - CITY CAMPUS OutpatientFacility | AMERIHEALTH | LOCAL VALUE | $31.82 | — | — | 2026-03-18 | MRF ↗ |
| Jefferson Methodist Hospital OutpatientFacility | IBC | JCC002 HMO | $31.82 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON ABINGTON HOSPITAL OutpatientFacility | IBC | JAB001 Indem_Trad | $31.82 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON ABINGTON HOSPITAL OutpatientFacility | IBC | JAB001 PPO | $31.82 | — | — | 2026-03-18 | MRF ↗ |
| ATLANTICARE REGIONAL MEDICAL CENTER - CITY CAMPUS OutpatientFacility | AMERIHEALTH | REGIONAL PREFERRED | $31.82 | — | — | 2026-03-18 | MRF ↗ |
| Jefferson Methodist Hospital OutpatientFacility | IBC | JCC002 PPO | $31.82 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | IBC | JNE01_JNE02_JNE03 PPO | $31.82 | — | — | 2026-09-15 | MRF ↗ |
| JEFFERSON HEALTH- NORTHEAST OutpatientFacility | IBC | JNE01_JNE02_JNE03 HMO | $31.82 | — | — | 2026-09-15 | MRF ↗ |
| JEFFERSON LANSDALE HOSPITAL OutpatientFacility | IBC | JAB002 Indem_Trad | $31.82 | — | — | 2026-09-15 | MRF ↗ |
| JEFFERSON LANSDALE HOSPITAL OutpatientFacility | IBC | JAB002 HMO | $31.82 | — | — | 2026-09-15 | MRF ↗ |
| JEFFERSON LANSDALE HOSPITAL OutpatientFacility | IBC | JAB002 PPO | $31.82 | — | — | 2026-09-15 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE 5158 | UNITED HEALTHCARE 515803 | $31.82 | — | — | 2026-01-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Blue Shield | Value Network | $31.82 | — | — | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Blue Shield | All Commercial Products | $31.82 | — | — | 2026-04-01 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Blue Shield | All Products | $31.82 | — | — | 2026-03-29 | MRF ↗ |
| RONALD REAGAN UCLA MEDICAL CENTER Outpatient | Blue Shield | EPN | $31.82 | — | — | 2026-03-29 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Sheet Metal Workers Union(Smw) | Ucd Hb Blue Shield Referred | $31.82 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Blue Shield | Ucd Hb Blue Shield Calpers | $31.82 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Pipe Trades | Ucd Hb Blue Shield Referred | $31.82 | — | — | 2026-04-01 | MRF ↗ |
| THOMAS JEFFERSON UNIVERSITY HOSPITAL OutpatientFacility | IBC | JCC001 PPO | $31.82 | — | — | 2026-03-18 | MRF ↗ |
| THOMAS JEFFERSON UNIVERSITY HOSPITAL OutpatientFacility | IBC | JCC001 HMO | $31.82 | — | — | 2026-03-18 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Ufcw | Ucd Hb Blue Shield Referred | $31.82 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Blue Shield | Ucd Hb Blue Shield Referred | $31.82 | — | — | 2026-04-01 | MRF ↗ |
| VALLEY CHILDREN'S HOSPITAL OutpatientFacility | Community Care Health Plan | Commercial HMO | $31.82 | — | — | 2026-04-01 | MRF ↗ |
| UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER OutpatientFacility | Blue Shield | Ucd Hb Blue Shield Ifp | $31.82 | — | — | 2026-04-01 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Blue Shield | All Products | $31.82 | — | — | 2026-03-29 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE 5158 | UNITED HEALTHCARE 515803 | $31.82 | — | — | 2026-01-01 | MRF ↗ |
| SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL Outpatient | Blue Shield | EPN | $31.82 | — | — | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Blue Shield | EPN | $31.82 | — | — | 2026-03-29 | MRF ↗ |
| ASANTE THREE RIVERS MEDICAL CENTER Both | TRIWEST [4006] | CCN/COMMUNITY CARE NETWORK PGBA | $31.89 | $10,575.26 | $6,873.92 | 2026-03-25 | MRF ↗ |
| PALOMAR HEALTH DOWNTOWN CAMPUS OutpatientFacility | Patient Centered Community Care | VA Government | $31.92 | — | — | 2026-04-01 | MRF ↗ |
| ADVANCED SURGICAL HOSPITAL Outpatient | Highmark Bcbs | My Direct Blue | $31.99 | — | — | 2026-07-15 | MRF ↗ |
| USA HEALTH CHILDREN'S & WOMEN'S HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Alabama | Medicare Advantage | $32.02 | — | — | 2026-04-30 | MRF ↗ |
| MAIMONIDES MEDICAL CENTER OutpatientFacility | Healthfirst | Medicare Advantage HMO | $32.02 | — | — | 2026-04-01 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Healthfirst | MAP | $32.02 | — | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Healthfirst | Medicare Advantage PPO | $32.02 | — | — | 2026-09-05 | MRF ↗ |
| SOUTH BROOKLYN HEALTH OutpatientFacility | Healthfirst | MEDICARE ADVANTAGE | $32.02 | — | — | 2026-09-05 | MRF ↗ |
| USA HEALTH UNIVERSITY HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Alabama | Medicare Advantage | $32.02 | — | — | 2026-04-30 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE OutpatientFacility | American Health | Medicare Advantage | $32.14 | — | — | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH PRESBYTERIAN HOSPITAL ROCKWALL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $32.14 | — | — | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL STEPHENVILL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $32.14 | — | — | 2026-04-21 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD 5143 | HIGHMARK BCBS 514301 | $32.14 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD 2201, OUT AREA BLUE CROSS BLUE SHIELD, UNIVERA | EXCELLUS 220101, EXCELLUS SIMPLY BLUE 220106, EXCELLUS BLUE CHOICE 220107 | $32.14 | — | — | 2026-01-01 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | UNITED HEALTHCARE MEDICARE 1309 | UNITED HEALTHCARE MEDICARE 130901 | $32.14 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | EXCELLUS BLUE CROSS BLUE SHIELD 2201, OUT AREA BLUE CROSS BLUE SHIELD, UNIVERA | EXCELLUS METAL TIERS 220102 | $32.14 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | FIDELIS MEDICARE 1311 | FIDELIS MEDICARE 131101 | $32.14 | — | — | 2026-01-01 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL ALLIANCE OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $32.14 | — | — | 2026-04-21 | MRF ↗ |
| F F THOMPSON HOSPITAL Outpatient | WELLCARE MEDICARE 1310 | WELLCARE MEDICARE 131001 | $32.14 | — | — | 2026-01-01 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UNITED HEALTHCARE MEDICARE 1309 | UNITED HEALTHCARE MEDICARE 130901 | $32.14 | — | — | 2026-01-01 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | HIGHMARK BLUE CROSS BLUE SHIELD MEDICARE 1301 | HIGHMARK BCBS MEDICARE 130101 | $32.14 | — | — | 2026-01-01 | 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.