L5250 — Hip Canad Sing Axi Cons Fric
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Hip canad sing axi cons fric (HCPCS L5250) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/L5250?code_type=HCPCS
MLA (9th ed.)
“Hip canad sing axi cons fric (HCPCS L5250) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/L5250?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Hip canad sing axi cons fric (HCPCS L5250) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/L5250?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $6,479–$9,526 (25th–75th percentile) across 1,014 hospitals · 1,111 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS L5250 — 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
$6,479
$7,091 typical
$9,526
The middle 50% of negotiated facility rates for this procedure, measured across 1,014 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $7,091 |
| Likely subtotal | $7,091 |
Facility charge (no separate professional fee)
$7,091
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 $6,479–$9,526.
- 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 |
|---|---|---|---|---|---|---|---|
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $0.29 | — | — | 2026-09-01 | 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 | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $0.60 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUE CROSS STATE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| HARPER UNIVERSITY HOSPITAL Outpatient | Hap | HAPHMO | $93.00 | — | — | 2025-01-31 | MRF ↗ |
| Rehabilitation Institute Of Michigan Outpatient | Hap | HAPHMO | $104.79 | — | — | 2025-01-31 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $144.26 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $144.26 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $144.26 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $165.33 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $165.33 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $165.33 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $180.01 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $180.01 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $180.01 | — | — | 2026-03-18 | MRF ↗ |
| ST FRANCIS HOSPITAL - THE HEART CENTER OutpatientFacility | Affinity Health Plan | EP 1&2 | $260.33 | — | — | 2026-02-19 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Hmo | $341.75 | — | — | 2026-09-21 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $341.75 | — | — | 2026-05-06 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Hmo | $341.75 | — | — | 2026-05-06 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $341.75 | — | — | 2026-09-21 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $360.27 | — | — | 2026-03-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Anthem Health Plans Of Nh | Anthem Ppo - Dhp | $380.45 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Anthem Health Plans Of Nh | Anthem Indiv Qhp - Exchange - Dhp | $380.45 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Anthem Health Plans Of Nh | Anthem Shop - Exchange - Dhp | $380.45 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Anthem Health Plans Of Nh | Anthem Hmo/Pos; Individual Non Qhp On Or Off Exch; Shop Off Exch - Dhp | $380.45 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Anthem Health Plans Of Nh | Anthem - Indemnity/Federal Employee Program | $380.45 | — | — | 2026-07-18 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Broward County | Inmates w/o Other Insurance | $682.69 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL PEMBROKE OutpatientFacility | Broward County | Inmates w/o Other Insurance | $682.69 | — | — | 2025-07-30 | MRF ↗ |
| Memorial Regional Hospital South OutpatientFacility | Broward County | Inmates w/o Other Insurance | $682.69 | — | — | 2025-07-30 | MRF ↗ |
| MEMORIAL HOSPITAL WEST OutpatientFacility | Broward County | Inmates w/o Other Insurance | $682.69 | — | — | 2025-07-30 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Aetna | MCR | $1,270.41 | — | — | 2026-03-01 | MRF ↗ |
| SUNRISE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna | MCR | $1,270.41 | — | — | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Aetna | MCR | $1,270.41 | — | — | 2026-03-01 | MRF ↗ |
| RANGE REGIONAL HEALTH SERVICES OutpatientFacility | Blue Cross of Minnesota | PMAP | $1,465.17 | — | — | 2026-01-29 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $1,617.00 | — | — | 2026-07-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $1,617.00 | — | — | 2026-07-01 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $1,617.00 | — | — | 2025-08-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $1,617.00 | — | — | 2026-07-01 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | BCBS - MN | Medicaid|All Plans | $2,024.95 | $6,749.81 | $3,914.89 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Inpatient | BCBS - MN | Medicaid|All Plans | $2,024.95 | $6,749.81 | $3,914.89 | 2026-02-28 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Aetna | Aetna - Hmo/Pos/Ppo | $2,033.61 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Aetna | Aetna Hmo/Pos/Ppo | $2,033.61 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | First Health/Hcvm | First Health/Hcvm - Dhp | — | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Aetna | Aetna Hmo/Pos/Ppo - Arnb | $2,033.61 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Maine Community Health Options | Mcho Indiv - Exchange | — | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Corvel | Corvel - Workers Comp | — | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Ccmsi | Ccmsi - Workers Comp | — | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Coventry | Coventry- Workers Comp | — | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Phcs | Phcs - Ppo | — | — | — | 2026-07-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Generic CCS Other Counties | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Gold Coast Medi-cal | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Medi-Cal Contra Costa Health Plan | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Genetically Handicapped Person | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| HEALTHBRIDGE CHILDREN'S HOSPITAL - ORANGE Outpatient | HealthNet | Managed Medicaid | $2,083.60 | — | — | 2025-12-24 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | CCS Fresno | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | CCS Madera/Sacramento | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Medi-Cal Alameda Alliance for Health | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| HEALTHBRIDGE CHILDREN'S HOSPITAL - ORANGE Outpatient | Molina | Managed Medicaid | $2,083.60 | — | — | 2025-12-24 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Medi-Cal Cencal Health | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL OutpatientFacility | Care1st Health | Managed Medi-Cal | $2,083.60 | — | — | 2026-03-26 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Santa Clara Family Health Plan - Valley Health | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | San Francisco Health Plan Medi-Cal | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | CCS Tulare | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | CCS Merced | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Sante - Blue Cross | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Medi-Cal California Health & Wellness Plan | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Generic Care Out of County | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Medi-Cal LA Care Health | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Medi-Cal Inland Empire Health | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| UCLA WEST VALLEY MEDICAL CENTER Outpatient | LA Care Medi-Cal | MEDI-CAL | $2,083.60 | — | — | 2026-03-29 | MRF ↗ |
| FRESNO SURGICAL HOSPITAL OutpatientFacility | CalViva | Medi-Cal | $2,083.60 | — | $12,541.26 | 2026-04-08 | MRF ↗ |
| HEALTHBRIDGE CHILDREN'S HOSPITAL - ORANGE Outpatient | Medi-Cal | Managed Medicaid | $2,083.60 | — | — | 2025-12-24 | MRF ↗ |
| HEALTHBRIDGE CHILDREN'S HOSPITAL - ORANGE Outpatient | Alameda Alliance | Managed Medicaid | $2,083.60 | — | — | 2025-12-24 | MRF ↗ |
| MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL OutpatientFacility | Brand New Day | Managed Medi-Cal | $2,083.60 | — | — | 2026-03-26 | MRF ↗ |
| ARROWHEAD REGIONAL MEDICAL CENTER OutpatientFacility | LaSalle Medical Associates | Medi-Cal | $2,083.60 | — | — | 2026-02-25 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Fresno County Funded Specialty Care | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Medi-Cal Molina | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| MOUNTAINS COMMUNITY HOSPITAL OutpatientFacility | KAISER | MED ADV | $2,083.60 | — | — | 2026-01-14 | MRF ↗ |
| ARROWHEAD REGIONAL MEDICAL CENTER OutpatientFacility | Physician Health Network | Medi-Cal | $2,083.60 | — | — | 2026-02-25 | MRF ↗ |
| ARROWHEAD REGIONAL MEDICAL CENTER OutpatientFacility | Inland Faculty Medical Group | Managed Medi-Cal | $2,083.60 | — | — | 2026-02-25 | MRF ↗ |
| HEALTHBRIDGE CHILDREN'S HOSPITAL - ORANGE Outpatient | Anthem Blue Cross | Managed Medicaid | $2,083.60 | — | — | 2025-12-24 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Medi-Cal Health Plan of San Mateo | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| ARROWHEAD REGIONAL MEDICAL CENTER OutpatientFacility | Alpha Care | Medi-Cal | $2,083.60 | — | — | 2026-02-25 | MRF ↗ |
| FRESNO SURGICAL HOSPITAL OutpatientFacility | CalViva | Medi-Cal | $2,083.60 | — | $12,541.26 | 2026-04-08 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Medi-Cal Partnership Health Plan of CA | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | CalOptima | Managed Medi-Cal LTC | $2,083.60 | — | — | 2026-03-18 | MRF ↗ |
| SIERRA VIEW MEDICAL CENTER OutpatientFacility | DIGNITY HEALTH | MEDI-CAL | $2,083.60 | — | — | 2026-04-01 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | CCS Kern | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Blue Shield | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL OutpatientFacility | Alta | Managed Medi-Cal | $2,083.60 | — | — | 2026-03-26 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Medi-Cal Blue Shield Promise Health | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield Promise | Medi-Cal | $2,083.60 | — | — | 2026-03-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | CCS Stanislaus | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield Promise | Medi-Cal | $2,083.60 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield Promise | Medi-Cal | $2,083.60 | — | — | 2026-03-18 | MRF ↗ |
| HEALTHBRIDGE CHILDREN'S HOSPITAL - ORANGE Outpatient | Alta Med | Managed Medicaid | $2,083.60 | — | — | 2025-12-24 | MRF ↗ |
| ARROWHEAD REGIONAL MEDICAL CENTER OutpatientFacility | LA Health Care | Medi-Cal | $2,083.60 | — | — | 2026-02-25 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Medi-Cal Community Health Group | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| SIERRA VIEW MEDICAL CENTER OutpatientFacility | LASALLE | MEDI-CAL | $2,083.60 | — | — | 2026-04-01 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Cal Caloptima | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | CHDP | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Medi-Cal Kern Family Health | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | CCS Kings | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| SIERRA VIEW MEDICAL CENTER OutpatientFacility | BLUE CROSS | MEDI-CAL | $2,083.60 | — | — | 2026-04-01 | MRF ↗ |
| UCLA WEST VALLEY MEDICAL CENTER Outpatient | LA Care Medi-Cal | MEDI-CAL | $2,083.60 | — | — | 2026-03-29 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | CCS Mariposa | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| Community Behavioral Health Center OutpatientFacility | Santa Clara Family Health Plan - Premier Health | Managed Medi-Cal | $2,083.60 | — | — | 2026-06-18 | MRF ↗ |
| WOODHULL MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| LINCOLN MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| JACOBI MEDICAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| QUEENS HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| HARLEM HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| METROPOLITAN HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| METROPOLITAN HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| QUEENS HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| WOODHULL MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| KINGS COUNTY HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| ELMHURST HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| KINGS COUNTY HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| BELLEVUE HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| JACOBI MEDICAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $2,104.08 | — | — | 2025-09-05 | MRF ↗ |
| COAST PLAZA HOSPITAL OutpatientFacility | Blue Cross | Medi-Cal | $2,125.27 | — | — | 2026-02-04 | MRF ↗ |
| EAST LOS ANGELES DOCTORS HOSPITAL OutpatientFacility | Blue Cross | Medi-Cal | $2,125.27 | — | — | 2026-02-04 | MRF ↗ |
| COMMUNITY HOSPITAL OF HUNTINGTON PARK OutpatientFacility | Blue Cross | Medi-Cal | $2,125.27 | — | — | 2026-02-04 | MRF ↗ |
| MEMORIAL HOSPITAL OF GARDENA OutpatientFacility | Blue Cross | Medi-Cal | $2,125.27 | — | — | 2026-02-04 | MRF ↗ |
| MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL OutpatientFacility | Molina Healthcare | Managed Medi-Cal | $2,187.78 | — | — | 2026-03-26 | MRF ↗ |
| SIERRA VIEW MEDICAL CENTER OutpatientFacility | HEALTHNET | MEDI-CAL | $2,200.28 | — | — | 2026-04-01 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Unitedhealthcare | Uhc - Tiered Freedom Plan | $2,224.14 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Unitedhealthcare | Uhc - Freedom Plan - Dhp | $2,224.14 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Unitedhealthcare | Uhc - Hmo/Pos/Ppo - Dhp | $2,224.14 | — | — | 2026-07-18 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Health Partners | Medicare|All Plans | $2,227.44 | $6,749.81 | $3,914.89 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Health Partners | Medicare|All Plans | $2,227.44 | $6,749.81 | $3,914.89 | 2026-02-28 | MRF ↗ |
| METROPOLITAN HOSPITAL CENTER OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| WOODHULL MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| ELMHURST HOSPITAL CENTER OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| JACOBI MEDICAL CENTER OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| LINCOLN MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| QUEENS HOSPITAL CENTER OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| HARLEM HOSPITAL CENTER OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| WOODHULL MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| METROPOLITAN HOSPITAL CENTER OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| QUEENS HOSPITAL CENTER OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| JACOBI MEDICAL CENTER OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| KINGS COUNTY HOSPITAL CENTER OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| KINGS COUNTY HOSPITAL CENTER OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| BELLEVUE HOSPITAL CENTER OutpatientFacility | UNITED | Essential Plan 1-4_200-250 | $2,251.37 | — | — | 2025-09-05 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Health Net of California | Managed Medi-Cal | $2,291.96 | — | — | 2026-03-18 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Health Net of California | Managed Medi-Cal | $2,291.96 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Health Net of California | Managed Medi-Cal | $2,291.96 | — | — | 2026-03-18 | MRF ↗ |
| ARROWHEAD REGIONAL MEDICAL CENTER OutpatientFacility | Inland Empire Health Plan | Medi-Cal | $2,291.96 | — | — | 2026-02-25 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan | $2,294.94 | — | — | 2026-03-01 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan – Hmo | $2,294.94 | — | — | 2026-03-01 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WALNUT CREEK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ANTIOCH Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - REDWOOD CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SANTA CLARA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FREMONT Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSP SO SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-15 | MRF ↗ |
| SAN FRANCISCO VA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MANTECA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-18 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-17 | MRF ↗ |
| SANTA ROSA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FRESNO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - VACAVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL AND REHAB CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-17 | MRF ↗ |
| San Leandro Hospital Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MODESTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ROSEVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SAN JOSE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $13,890.00 | $7,778.40 | 2026-07-17 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Medica | Medicare|All Plans | $2,338.81 | $6,749.81 | $3,914.89 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Medica | Medicare|All Plans | $2,338.81 | $6,749.81 | $3,914.89 | 2026-02-28 | MRF ↗ |
| Shirley Ryan Abilitylab Outpatient | Blue Cross And Blue Shield Of Illinois | Blue Community Icp | $2,409.53 | $15,490.00 | $9,294.00 | 2026-07-15 | MRF ↗ |
| Shirley Ryan Abilitylab Outpatient | Aetna Better Health - Medicaid Icp Fhp / Aca | Aetna Better Health Medicaid Icp | $2,409.53 | $15,490.00 | $9,294.00 | 2026-07-15 | MRF ↗ |
| Shirley Ryan Abilitylab Outpatient | Meridian Health Plan | Meridian Icp | $2,409.53 | $15,490.00 | $9,294.00 | 2026-07-15 | MRF ↗ |
| Shirley Ryan Abilitylab Outpatient | County Care | County Care | $2,409.53 | $15,490.00 | $9,294.00 | 2026-07-15 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Humana | Medicare|All Plans | $2,429.94 | $6,749.81 | $3,914.89 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | BCBS - MN | Medicare|All Plans | $2,429.94 | $6,749.81 | $3,914.89 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | Humana | Medicare|All Plans | $2,429.94 | $6,749.81 | $3,914.89 | 2026-02-28 | MRF ↗ |
| ST GABRIELS HOSPITAL Outpatient | BCBS - MN | Medicare|All Plans | $2,429.94 | $6,749.81 | $3,914.89 | 2026-02-28 | 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.