Q0485 — Dme Pos
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). DME POS (HCPCS Q0485) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Q0485?code_type=HCPCS
MLA (9th ed.)
“DME POS (HCPCS Q0485) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Q0485?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“DME POS (HCPCS Q0485) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Q0485?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $422–$633 (25th–75th percentile) across 990 hospitals · 1,333 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS Q0485 — 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
$422
$445 typical
$633
The middle 50% of negotiated facility rates for this procedure, measured across 990 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $445 |
| Likely subtotal | $445 |
Facility charge (no separate professional fee)
$445
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 $422–$633.
- 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 ↗ |
| James Cancer Hospital & Solove Research Institute Outpatient | Cigna | Cigna - Transplant | $0.62 | — | — | 2026-07-01 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW MEXICO MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW MEXICO MEDICAID | $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 ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Aetna | Aetna Hmo/Pos/Ppo - Arnb | $1.35 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Aetna | Aetna - Hmo/Pos/Ppo | $1.35 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Aetna | Aetna Hmo/Pos/Ppo | $1.35 | — | — | 2026-07-18 | MRF ↗ |
| ALBANY MEDICAL CENTER HOSPITAL Both | Blue Cross | Epo/Ppo/Hmo/Indemnity | $2.78 | — | — | 2026-07-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $7.20 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $7.20 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $7.20 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $8.25 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $8.25 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $8.25 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $8.98 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $8.98 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $8.98 | — | — | 2026-03-18 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | United Healthcare MCD | United Healthcare Star Kids MCD/United Healthcare Star MCD/United Healthcare Star Plus MCD | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | First Care Health Plan | First Care CHIP/First Care Star Plus | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | First Care Health Plan | First Care Star MCD | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | United Healthcare CHIP | United Healthcare CHIP | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | First Care Health Plan | First Care CHIP/First Care Star Plus | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | United Healthcare MCD | United Healthcare Star Kids MCD/United Healthcare Star MCD/United Healthcare Star Plus MCD | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | First Care Health Plan | First Care Star MCD | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | First Care Health Plan | First Care CHIP/First Care Star Plus | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | United Healthcare MCD | United Healthcare Star Kids MCD/United Healthcare Star MCD/United Healthcare Star Plus MCD | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | First Care Health Plan | First Care Star MCD | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | United Healthcare CHIP | United Healthcare CHIP | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | First Care Health Plan | First Care CHIP/First Care Star Plus | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | United Healthcare CHIP | United Healthcare CHIP | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | First Care Health Plan | First Care Star MCD | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | United Healthcare CHIP | United Healthcare CHIP | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | United Healthcare MCD | United Healthcare Star Kids MCD/United Healthcare Star MCD/United Healthcare Star Plus MCD | $10.21 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | Molina MCD | Molina CHIP/Molina Star MCD/Molina Star Plus MCD | $11.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Driscoll Children's Health Plan MCD | Driscoll Star MCD | $11.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | Driscoll Children's Health Plan MCD | Driscoll Star MCD | $11.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Driscoll Children's Health Plan MCD | Driscoll CHIP/STAR Kids | $11.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | Driscoll Children's Health Plan MCD | Driscoll CHIP/STAR Kids | $11.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Driscoll Children's Health Plan MCD | Driscoll CHIP/STAR Kids | $11.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | Driscoll Children's Health Plan MCD | Driscoll CHIP/STAR Kids | $11.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | Molina MCD | Molina CHIP/Molina Star MCD/Molina Star Plus MCD | $11.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Molina MCD | Molina CHIP/Molina Star MCD/Molina Star Plus MCD | $11.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Driscoll Children's Health Plan MCD | Driscoll Star MCD | $11.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Molina MCD | Molina CHIP/Molina Star MCD/Molina Star Plus MCD | $11.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | Driscoll Children's Health Plan MCD | Driscoll Star MCD | $11.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Blue Cross Blue Shield MCD | BCBS STAR Kids MCD/BCBS TX STAR MCD/BCBS TX STAR PLUS MCD | $13.23 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | Blue Cross Blue Shield MCD | BCBS STAR Kids MCD/BCBS TX STAR MCD/BCBS TX STAR PLUS MCD | $13.23 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | Blue Cross Blue Shield MCD | BCBS STAR Kids MCD/BCBS TX STAR MCD/BCBS TX STAR PLUS MCD | $13.23 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Blue Cross Blue Shield MCD | BCBS STAR Kids MCD/BCBS TX STAR MCD/BCBS TX STAR PLUS MCD | $13.23 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Community Health Choice | Community HC CHIP/Community HC Star MCD/Community Health Choice Perinate CHIP | $13.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Community Health Choice | Community HC CHIP/Community HC Star MCD/Community Health Choice Perinate CHIP | $13.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | Community Health Choice | Community HC CHIP/Community HC Star MCD/Community Health Choice Perinate CHIP | $13.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | Community Health Choice | Community HC CHIP/Community HC Star MCD/Community Health Choice Perinate CHIP | $13.34 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS InpatientFacility | Cook Children's Health Plan | Cook Children's CHIP/Cook Children's Star/Cook Children's Star Kids MCD | $15.12 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | Community First Health Plan MCD | Community First CHIP/Community First Health Perinate CHIP/Community First Star MCD/Community First Start Kids MCD | $15.12 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | Community First Health Plan MCD | Community First CHIP/Community First Health Perinate CHIP/Community First Star MCD/Community First Start Kids MCD | $15.12 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS InpatientFacility | Interlink Health Svcs | Interlink Health Svcs | — | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus InpatientFacility | Interlink Health Svcs | Interlink Health Svcs | — | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Community First Health Plan MCD | Community First CHIP/Community First Health Perinate CHIP/Community First Star MCD/Community First Start Kids MCD | $15.12 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Cook Children's Health Plan | Cook Children's CHIP/Cook Children's Star/Cook Children's Star Kids MCD | $15.12 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus InpatientFacility | Cook Children's Health Plan | Cook Children's CHIP/Cook Children's Star/Cook Children's Star Kids MCD | $15.12 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Community First Health Plan MCD | Community First CHIP/Community First Health Perinate CHIP/Community First Star MCD/Community First Start Kids MCD | $15.12 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Cook Children's Health Plan | Cook Children's CHIP/Cook Children's Star/Cook Children's Star Kids MCD | $15.12 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Blue Shield of California | Commercial/IFP | $17.97 | — | — | 2026-03-18 | MRF ↗ |
| MACNEAL HOSPITAL BothFacility | Self Pay | Self Pay | $18.62 | $98.00 | — | 2026-03-31 | MRF ↗ |
| MACNEAL HOSPITAL BothFacility | BCBS IL | Blue Precision | $20.22 | $98.00 | — | 2026-03-31 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Anthem Health Plans Of Nh | Anthem - Indemnity/Federal Employee Program | $21.34 | — | — | 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 | $21.34 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Anthem Health Plans Of Nh | Anthem Indiv Qhp - Exchange - Dhp | $21.34 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Anthem Health Plans Of Nh | Anthem Shop - Exchange - Dhp | $21.34 | — | — | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Anthem Health Plans Of Nh | Anthem Ppo - Dhp | $21.34 | — | — | 2026-07-18 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Cigna | Cigna TCH Employee Plan | $21.55 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus InpatientFacility | Cigna | Cigna TCH Employee Plan | $21.55 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Cigna | Cigna TCH Employee Plan | $21.55 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS InpatientFacility | Cigna | Cigna TCH Employee Plan | $21.55 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| MACNEAL HOSPITAL BothFacility | BCBS IL | PPO | $21.74 | $98.00 | — | 2026-03-31 | MRF ↗ |
| MACNEAL HOSPITAL BothFacility | BCBS IL | HMO | $21.74 | $98.00 | — | 2026-03-31 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Cigna | Cigna Local Plus/Cigna Sure Fit HMO | $21.92 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Cigna | Cigna Local Plus/Cigna Sure Fit HMO | $21.92 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS InpatientFacility | Cigna | Cigna Local Plus/Cigna Sure Fit HMO | $21.92 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus InpatientFacility | Cigna | Cigna Local Plus/Cigna Sure Fit HMO | $21.92 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Interlink Health Svcs | Interlink Health Svcs | $22.68 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Interlink Health Svcs | Interlink Health Svcs | $22.68 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $23.42 | — | — | 2026-09-21 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Hmo | $23.42 | — | — | 2026-09-21 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Hmo | $23.42 | — | — | 2026-05-06 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $23.42 | — | — | 2026-05-06 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Blue Cross Blue Shield | BCBS HMO Blue Essentials TX | $23.81 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | Blue Cross Blue Shield | BCBS PPO | $23.81 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | Blue Cross Blue Shield | BCBS HMO Blue Essentials TX | $23.81 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | Blue Cross Blue Shield | BCBS Traditional | $23.81 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | Blue Cross Blue Shield | BCBS Traditional | $23.81 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | Blue Cross Blue Shield | BCBS HMO Blue Essentials TX | $23.81 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Blue Cross Blue Shield | BCBS PPO | $23.81 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Blue Cross Blue Shield | BCBS PPO | $23.81 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | Blue Cross Blue Shield | BCBS PPO | $23.81 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Blue Cross Blue Shield | BCBS Traditional | $23.81 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Blue Cross Blue Shield | BCBS Traditional | $23.81 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Blue Cross Blue Shield | BCBS HMO Blue Essentials TX | $23.81 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus InpatientFacility | Cigna | Cigna Harris County PPO/HMO/Cigna PPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS InpatientFacility | Community Health Choice | Community HC Marketplace | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Community Health Choice | Community HC Marketplace | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | Aetna | Aetna HMO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | United Healthcare | Golden Rule/UMR/United Healthcare International/United Healthcare POS/EPO/United Healthcare PPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS InpatientFacility | First Care Health Plan | First Care HMO/PPO/EPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | United Healthcare | Golden Rule/UMR/United Healthcare International/United Healthcare POS/EPO/United Healthcare PPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Aetna | Aetna EPO/Aetna POS/Aetna PPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | First Care Health Plan | First Care HMO/PPO/EPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS InpatientFacility | Cigna | Cigna Harris County PPO/HMO/Cigna PPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | Aetna | Aetna EPO/Aetna POS/Aetna PPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Cigna | Cigna Harris County PPO/HMO/Cigna PPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Community Health Choice | Community HC Marketplace | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | United Healthcare | Golden Rule/UMR/United Healthcare International/United Healthcare POS/EPO/United Healthcare PPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | Aetna | Aetna HMO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus InpatientFacility | Community Health Choice | Community HC Marketplace | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus InpatientFacility | First Care Health Plan | First Care HMO/PPO/EPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Cigna | Cigna Harris County PPO/HMO/Cigna PPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Aetna | Aetna HMO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | Aetna | Aetna EPO/Aetna POS/Aetna PPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Aetna | Aetna EPO/Aetna POS/Aetna PPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | United Healthcare | Golden Rule/UMR/United Healthcare International/United Healthcare POS/EPO/United Healthcare PPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | Aetna | Aetna HMO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | First Care Health Plan | First Care HMO/PPO/EPO | $24.19 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | KelseyCare | KelseyCare | $24.57 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | KelseyCare | KelseyCare | $24.57 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | KelseyCare | KelseyCare | $24.57 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | KelseyCare | KelseyCare | $24.57 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | HealthSmart | HealthSmart Other | $26.46 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus InpatientFacility | HealthSmart | HealthSmart Other | $26.46 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS InpatientFacility | HealthSmart | HealthSmart Other | $26.46 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | HealthSmart | HealthSmart Other | $26.46 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus InpatientFacility | Evolutions Healthcare | Evolutions PPO | $28.35 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Evolutions Healthcare | Evolutions PPO | $28.35 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Evolutions Healthcare | Evolutions PPO | $28.35 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS InpatientFacility | Evolutions Healthcare | Evolutions PPO | $28.35 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| MACNEAL HOSPITAL BothFacility | BCBS IL | Blue Choice | $28.81 | $98.00 | — | 2026-03-31 | MRF ↗ |
| LOYOLA GOTTLIEB MEMORIAL HOSPITAL OutpatientFacility | Cigna | HMO | $29.50 | $98.00 | $18.62 | 2026-03-31 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior Health | STARPLUS | $31.08 | $518.00 | $518.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior Health | CHIP | $31.08 | $518.00 | $518.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior Health | STARKids | $31.08 | $518.00 | $518.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior Health | STAR | $31.08 | $518.00 | $518.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL Outpatient | Superior Health | CHPFC | $31.08 | $518.00 | $518.00 | 2025-01-01 | MRF ↗ |
| MACNEAL HOSPITAL OutpatientFacility | Cigna | PPO | $32.14 | $98.00 | — | 2026-03-31 | 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 ↗ |
| Texas Children's Hospital West Campus OutpatientFacility | First Health | Commercial | $33.26 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | First Health | Commercial | $33.26 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL OutpatientFacility | First Health | Commercial | $33.26 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS OutpatientFacility | First Health | Commercial | $33.26 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| GILLETTE CHILDRENS SPECIALTY HOSPITAL Outpatient | Bcbs | Managed Medicaid | $33.44 | — | — | 2026-07-15 | MRF ↗ |
| LOYOLA UNIVERSITY MEDICAL CENTER OutpatientFacility | Cigna | HMO | $34.01 | $98.00 | $22.54 | 2026-03-31 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS InpatientFacility | Multiplan | Multiplan Other | $34.02 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Multiplan | Multiplan Other | $34.02 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | First Health | Commercial | $34.02 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus InpatientFacility | First Health | Commercial | $34.02 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | First Health | Commercial | $34.02 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Multiplan | Multiplan Other | $34.02 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus InpatientFacility | Multiplan | Multiplan Other | $34.02 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS InpatientFacility | First Health | Commercial | $34.02 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| VIDANT EDGECOMBE HOSPITAL Both | BCBS MEDICAID - HEALTHY BLUE [1318] | NCHC BCBS MEDICAID - HEALTHY BLUE [406] | $35.00 | $207.00 | $115.92 | 2026-03-24 | MRF ↗ |
| VIDANT EDGECOMBE HOSPITAL Both | BCBS MEDICAID - HEALTHY BLUE [1318] | BCBS MEDICAID - HEALTHY BLUE [378] | $35.00 | $207.00 | $115.92 | 2026-03-24 | MRF ↗ |
| VIDANT EDGECOMBE HOSPITAL Both | CAROLINA COMPLETE HEALTH [1317] | CAROLINA COMPLETE [377] | $35.36 | $207.00 | $115.92 | 2026-03-24 | MRF ↗ |
| VIDANT EDGECOMBE HOSPITAL Both | WELLCARE [1320] | WELLCARE [380] | $35.52 | $207.00 | $115.92 | 2026-03-24 | MRF ↗ |
| VIDANT EDGECOMBE HOSPITAL Both | AMERIHEALTH MCAID ADV [1316] | AMERIHEALTH [376] | $35.71 | $207.00 | $115.92 | 2026-03-24 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS InpatientFacility | First Health | CCN Network | $35.91 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Galaxy Health Network | Galaxy Health Network | $35.91 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | First Health | CCN Network | $35.91 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus InpatientFacility | Galaxy Health Network | Galaxy Health Network | $35.91 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| Texas Children's Hospital West Campus InpatientFacility | First Health | CCN Network | $35.91 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | Galaxy Health Network | Galaxy Health Network | $35.91 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL NORTH AUSTIN CAMPUS InpatientFacility | Galaxy Health Network | Galaxy Health Network | $35.91 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| TEXAS CHILDRENS HOSPITAL InpatientFacility | First Health | CCN Network | $35.91 | $37.80 | $25.33 | 2026-03-05 | MRF ↗ |
| St Luke's Hospital Of Kansas City Both | HUMANA [7500] | ZZZHUMANA KANSAS CITY PPOX [75002] | $36.16 | $113.00 | $67.80 | 2025-12-31 | MRF ↗ |
| St Luke's Hospital Of Kansas City Both | CIGNA [7000] | CIGNA CONNECT EPO EXCHANGE [70015] | $36.39 | $113.00 | $67.80 | 2025-12-31 | MRF ↗ |
| St Luke's Hospital Of Kansas City Both | COMMERCIAL-CONTRACTED [8000] | CHILDRENS SPOT FOUNDATION [80018] | $37.29 | $113.00 | $67.80 | 2025-12-31 | MRF ↗ |
| MACNEAL HOSPITAL InpatientFacility | BCBS IL | Blue Precision | $37.36 | $98.00 | — | 2026-03-31 | MRF ↗ |
| MACNEAL HOSPITAL InpatientFacility | BCBS IL | HMO | $37.36 | $98.00 | — | 2026-03-31 | MRF ↗ |
| MACNEAL HOSPITAL InpatientFacility | BCBS IL | PPO | $37.36 | $98.00 | — | 2026-03-31 | MRF ↗ |
| St Luke's Hospital Of Kansas City Both | CIGNA [7000] | ZZZCIGNA BJC [70010] | $38.42 | $113.00 | $67.80 | 2025-12-31 | MRF ↗ |
| ECU HEALTH NORTH HOSPITAL Both | TRILLIUM [1296] | TRILLIUM [1575] | $39.33 | $207.00 | $115.92 | 2026-03-24 | MRF ↗ |
| ECU HEALTH NORTH HOSPITAL Both | TRILLIUM [1296] | TRILLIUM [1575] | $39.33 | $207.00 | $115.92 | 2026-03-24 | MRF ↗ |
| GILLETTE CHILDRENS SPECIALTY HOSPITAL Outpatient | Bcbs | Commercial | $39.37 | — | — | 2026-07-15 | MRF ↗ |
| St Luke's Hospital Of Kansas City Both | TRANSPLANTS-CASE RATES [5750] | OPTUM MA HEART E&P [57512] | $39.55 | $113.00 | $67.80 | 2025-12-31 | MRF ↗ |
| St Luke's Hospital Of Kansas City Both | TRANSPLANTS-CASE RATES [5750] | OPTUM COMMERCIAL HEART E&P [57501] | $39.55 | $113.00 | $67.80 | 2025-12-31 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| St Luke's Hospital Of Kansas City Both | CIGNA [7000] | CIGNA BJC FLEX OR HDHP [70017] | $41.25 | $113.00 | $67.80 | 2025-12-31 | MRF ↗ |
| LOYOLA GOTTLIEB MEMORIAL HOSPITAL OutpatientFacility | Cigna | PPO | $41.75 | $98.00 | $18.62 | 2026-03-31 | MRF ↗ |
| HEDRICK MEDICAL CENTER Both | MEDICARE REPLACEMENT PLAN [1250] | ZZZBC KC MEDICARE ADVANTAGE [12517] | $42.34 | $132.30 | $79.38 | 2025-12-31 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.