L5331 — Dme Pos
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). DME POS (HCPCS L5331) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/L5331?code_type=HCPCS
MLA (9th ed.)
“DME POS (HCPCS L5331) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/L5331?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“DME POS (HCPCS L5331) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/L5331?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $6,110–$8,804 (25th–75th percentile) across 1,005 hospitals · 1,194 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS L5331 — 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
$6,110
$6,950 typical
$8,804
The middle 50% of negotiated facility rates for this procedure, measured across 1,005 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $6,950 |
| Likely subtotal | $6,950 |
Facility charge (no separate professional fee)
$6,950
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 $6,110–$8,804.
- 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 | 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 ↗ |
| 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 | BLUECHOICE HEALTHPLAN OF SC | $1.00 | — | — | 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 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 ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $13.31 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $13.31 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $13.63 | $7,570.00 | — | 2025-12-31 | 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 ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| SARATOGA HOSPITAL OutpatientFacility | — | — | — | — | — | 2025-01-01 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Brighton Health Plan | All Products | $82.15 | $7,393.00 | — | 2024-12-31 | 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 ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Corvel | Corvel Acc And Health | $114.50 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $121.44 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $121.44 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $121.44 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $139.18 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $139.18 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $139.18 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $151.54 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $151.54 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $151.54 | — | — | 2026-03-18 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Alamed | Alamed Work Comp Al | $171.75 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Self Pay | Self Pay | $171.75 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Uhc Iex | Uhc Iex | $172.90 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | United Healthcare | Uhc Apa | $196.94 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| ST FRANCIS HOSPITAL - THE HEART CENTER OutpatientFacility | Affinity Health Plan | EP 1&2 | $260.33 | — | — | 2026-02-19 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Self Pay | Self Pay | $274.80 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Bp Health Advocate | Bp Health Advocate | $286.25 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Viva Health | Viva New | $286.25 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $303.28 | — | — | 2026-03-18 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Hmo | $334.64 | — | — | 2026-09-21 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $334.64 | — | — | 2026-05-06 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Hmo | $334.64 | — | — | 2026-05-06 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $334.64 | — | — | 2026-09-21 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Anthem Health Plans Of Nh | Anthem Indiv Qhp - Exchange - Dhp | $364.40 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Anthem Health Plans Of Nh | Anthem - Indemnity/Federal Employee Program | $364.40 | — | — | 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 | $364.40 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Anthem Health Plans Of Nh | Anthem Ppo - Dhp | $364.40 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Anthem Health Plans Of Nh | Anthem Shop - Exchange - Dhp | $364.40 | — | — | 2026-07-18 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Choicecare | Choicecare Ppo | $400.75 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Drummond | Drummond Work Comp Al | $400.75 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Viva Health | Viva Existing | $435.10 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | American Employee Alliance | American Employee Alliance | $458.00 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Aetna | Aetna - Hmo/Pos/Ppo | $478.38 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Aetna | Aetna Hmo/Pos/Ppo - Arnb | $478.38 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Aetna | Aetna Hmo/Pos/Ppo | $478.38 | — | — | 2026-07-18 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Optum Health | Optum Health | $515.25 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Coventry Work Comp Al | Coventry Work Comp Al | $526.70 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | First Health | First Health Work Comp Al | $526.70 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Novanet | Novanet Work Comp Al | $543.88 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Healthchoice | Healthchoice Non Standard 1 | $572.50 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Alabama Wc | Al Work Comp | $572.50 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Value Options | Value Options Non Hmo | $572.50 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Healthchoice | Healthchoice Non Standard 2 | $629.75 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| MEMORIAL HOSPITAL WEST 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 ↗ |
| Memorial Regional Hospital South 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 ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Healthchoice | Healthchoice Standard | $687.00 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | First Health | First Health | $687.00 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Ag Administrators | Ag Administrators | $687.00 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Multiplan | Multiplan Primary | $698.45 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Multiplan | Multiplan Primary | $709.90 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Blue Bell Creameries | Blue Bell Creameries | $801.50 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Multiplan | Multiplan Complementary | $801.50 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Natl Comp Care | Ncc Work Comp Al | $858.75 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Usa Ppo | Usa Ppo | $858.75 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Node Tricare | Node Tricare | $916.00 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Cal-Med | Cal Med | $973.25 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Inpatient | Associated Admin | Associated Admin | $1,030.50 | $1,145.00 | $274.80 | 2026-07-15 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Aetna | MCR | $1,069.44 | — | — | 2026-03-01 | MRF ↗ |
| SUNRISE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna | MCR | $1,069.44 | — | — | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Aetna | MCR | $1,069.44 | — | — | 2026-03-01 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Node Medicare Non Par | Node Medicare Non Par | $1,126.68 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Humana | Node Humana Mcr Adv | $1,126.68 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Node Aetna Mcr Adv | Node Aetna Mcr Adv | $1,126.68 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Node Medicare Traditional | Node Medicare Traditional | $1,126.68 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Blue Advantage | Node Bcbs Al Mcr Adv | $1,126.68 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Viva Health | Node Viva Mcr Adv | $1,126.68 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Select Health | Node Select Health Mcr Adv | $1,137.95 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Node Va | Node Va | $1,145.00 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Hospice | Node Hospice Non Par | $1,145.00 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Blue Cross Blue Shield Of Alabama | Bcbs Al All | $1,145.00 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Node Champva | Node Champva | $1,145.00 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Node United Optum Va Ccn | Node United Optum Va Ccn | $1,145.00 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Cigna | Cigna All | $1,145.00 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $1,145.91 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Node Cigna Healthspring Mcr Adv | Node Cigna Healthspring Mcr Adv | $1,149.21 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Node Devoted Health Mcr Adv | Node Devoted Health Mcr Adv | $1,149.21 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Node Clover Health Mcr Adv | Node Clover Health Mcr Adv | $1,156.45 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Node Wellcare Mcr Adv | Node Wellcare Mcr Adv | $1,167.90 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,173.35 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicaid | $1,190.27 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MANAGED MEDICAID | $1,218.77 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | United | Managed Medicaid | $1,270.86 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | MANAGED MEDICAID | $1,301.28 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $1,330.74 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $1,330.74 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $1,330.74 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $1,330.74 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $1,362.60 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $1,362.60 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $1,362.60 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $1,362.60 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $1,362.60 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $1,362.60 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $1,362.60 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $1,362.60 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $1,362.60 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $1,362.60 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $1,362.60 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $1,362.60 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $1,362.60 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,370.17 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| RANGE REGIONAL HEALTH SERVICES OutpatientFacility | Blue Cross of Minnesota | PMAP | $1,371.18 | — | — | 2026-01-29 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $1,508.17 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $1,522.96 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $1,522.96 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,544.28 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $1,552.53 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,559.42 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,559.42 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,559.42 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Horizon | Managed Medicaid | $1,562.88 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $1,567.32 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,582.13 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,582.13 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,589.70 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,589.70 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,604.84 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1,604.84 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO Outpatient | Medicare | Medicare | $1,604.97 | $9,441.00 | $6,608.70 | 2026-04-01 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Amerigroup | Medicare Advantage | $1,611.67 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | Horizon Braven | Managed Medicare | $1,611.67 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| LEHIGH VALLEY HOSPITAL - DICKSON CITY Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $1,617.00 | — | — | 2025-08-01 | MRF ↗ |
| SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $1,617.00 | — | — | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $1,617.00 | — | — | 2026-07-01 | MRF ↗ |
| CHP-LVHN JV, LLC d/b/a Lehigh Valley Hospital - Gilbertsville Outpatient | AMERIHEALTH CARITAS | MANAGED MEDICAID | $1,617.00 | — | — | 2026-07-01 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,650.26 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,650.26 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | OPTUM HEALTH | MANAGED MEDICAID | $1,665.40 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | OPTUM HEALTH | MANAGED MEDICAID | $1,665.40 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Horizon Braven | Managed Medicare | $1,715.18 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| GRANDVIEW MEDICAL CENTER Outpatient | Node Wellcare Ambetter Marketplace | Node Wellcare Ambetter Marketplace | $1,717.50 | $1,145.00 | $171.75 | 2026-07-15 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,756.24 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $1,756.24 | $7,570.00 | — | 2025-12-31 | MRF ↗ |
| LOMA LINDA UNIVERSITY MEDICAL CENTER InpatientFacility | LLUH Dept of Risk Management | WC | $1,868.20 | $9,341.00 | $4,203.45 | 2026-02-19 | MRF ↗ |
| LOMA LINDA UNIVERSITY CHILDREN'S HOSPITAL InpatientFacility | Adventist Health | Commercial | $1,868.20 | $9,341.00 | $4,203.45 | 2026-02-19 | MRF ↗ |
| LOMA LINDA UNIVERSITY CHILDREN'S HOSPITAL InpatientFacility | Adventist Health | Commercial | $1,868.20 | $9,341.00 | $4,203.45 | 2026-02-19 | MRF ↗ |
| LOMA LINDA UNIVERSITY MEDICAL CENTER InpatientFacility | Adventist Health | Commercial | $1,868.20 | $9,341.00 | $4,203.45 | 2026-02-19 | MRF ↗ |
| METROPOLITAN HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| LINCOLN MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| BELLEVUE HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| KINGS COUNTY HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| KINGS COUNTY HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| WOODHULL MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| ELMHURST HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| JACOBI MEDICAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| JACOBI MEDICAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| WOODHULL MEDICAL & MENTAL HEALTH CENTER OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| HARLEM HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| North Central Bronx Hospital OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| QUEENS HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| METROPOLITAN HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| QUEENS HOSPITAL CENTER OutpatientFacility | UNITED | Managed Medicaid | $1,886.12 | — | — | 2025-09-05 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Amerigroup | Medicare Advantage | $1,936.97 | $7,393.00 | — | 2024-12-31 | MRF ↗ |
| San Leandro Hospital Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SAN JOSE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ROSEVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL AND REHAB CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FRESNO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MANTECA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - VACAVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSP SO SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MODESTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - REDWOOD CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-15 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SANTA CLARA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-15 | MRF ↗ |
| SANTA ROSA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FREMONT Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-15 | MRF ↗ |
| SAN FRANCISCO VA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WALNUT CREEK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $11,695.00 | $6,549.20 | 2026-07-15 | 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.