Q4038 — Kit Cast Tcc 3in W/2reg Boots Total Contact Cast
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). KIT CAST TCC 3IN W/2REG BOOTS TOTAL CONTACT CAST (HCPCS Q4038) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Q4038?code_type=HCPCS
MLA (9th ed.)
“KIT CAST TCC 3IN W/2REG BOOTS TOTAL CONTACT CAST (HCPCS Q4038) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Q4038?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“KIT CAST TCC 3IN W/2REG BOOTS TOTAL CONTACT CAST (HCPCS Q4038) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Q4038?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $59–$266 (25th–75th percentile) across 1,233 hospitals · 2,352 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS Q4038 — 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
$59
$173 typical
$266
The middle 50% of negotiated facility rates for this procedure, measured across 1,233 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $173 |
| Likely subtotal | $173 |
Facility charge (no separate professional fee)
$173
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 $59–$266.
- 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 |
|---|---|---|---|---|---|---|---|
| ST PETER'S HOSPITAL OutpatientFacility | VNA Homecare Options | Medicaid | — | $293.55 | $249.52 | 2025-01-01 | MRF ↗ |
| SUNNYVIEW HOSPITAL AND REHABILITATION CENTER OutpatientFacility | VNA Homecare Options | Medicaid | — | $293.55 | $249.52 | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | VNA Homecare Options | Medicaid | — | $293.55 | $249.52 | 2025-01-01 | MRF ↗ |
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | — | — | — | $1,285.47 | $642.73 | 2024-12-15 | MRF ↗ |
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | — | — | — | $1,285.47 | $642.73 | 2024-12-15 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Cigna | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Vantage Health Plan Inc. | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | First Choice | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Multiplan/PHCS | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Humana | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Wellcare | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | United Healthcare | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | First Choice | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Cigna | PPO | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Multiplan/PHCS | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Vantage Health Plan Inc. | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | PPOplus Llc | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | PPOplus Llc | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Aetna | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Wellcare | Medicare Advantage | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | Humana | Commercial | — | — | — | 2026-03-05 | MRF ↗ |
| OPELOUSAS GENERAL HEALTH SYSTEM OutpatientFacility | United Healthcare | Commercial | — | — | — | 2026-03-05 | 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 | BCBS PREFERRED BLUE PPO | $0.29 | — | — | 2026-09-01 | MRF ↗ |
| SURGEONS CHOICE MEDICAL CENTER Both | Humana | Default | $0.44 | $1.00 | $1.00 | 2024-08-06 | MRF ↗ |
| SURGEONS CHOICE MEDICAL CENTER Both | Humana | Default | $0.44 | $1.00 | $1.00 | 2024-08-06 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $0.60 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSS AND BLUESHIELD OF NEW MEXICO BLUE SALUD | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Medicaid | Medicaid | $1.00 | $293.00 | $146.50 | 2026-07-01 | 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 ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-05-20 | 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 | BLUE CROSS STATE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECROSSBLUESHIELD MI | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-09-02 | 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 | BLUECHOICE HEALTHPLAN OF SC | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| SIERRA MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW MEXICO MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| THE HOSPITALS OF PROVIDENCE - MEMORIAL CAMPUS OutpatientFacility | UNITED HEALTHCARE | UNITED HEALTHCARE NEW MEXICO MEDICAID | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $1.07 | $293.00 | $146.50 | 2026-07-01 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.08 | $292.00 | $277.40 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $1.08 | $292.00 | $277.40 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.08 | $292.00 | $277.40 | 2026-02-20 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $1.10 | $293.00 | $146.50 | 2026-07-01 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.11 | $292.00 | $277.40 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.14 | $292.00 | $277.40 | 2026-02-20 | MRF ↗ |
| DICKINSON COUNTY MEMORIAL HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $1.17 | $292.00 | $277.40 | 2026-02-20 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | UPMC For You | UPMC For You - Managed Medicaid | $1.18 | $293.00 | $146.50 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Jefferson Health Plan | Jefferson Health Plan - Managed Medicaid | $1.20 | $293.00 | $146.50 | 2026-07-01 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.43 | $292.00 | $277.40 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.43 | $292.00 | $277.40 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.46 | $292.00 | $277.40 | 2026-02-20 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - Managed Medicaid | $1.47 | $293.00 | $146.50 | 2026-07-01 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.52 | $292.00 | $277.40 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $1.58 | $292.00 | $277.40 | 2026-02-20 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | UPMC Health Plan | Managed Medicare | $2.40 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | UPMC Work Partners | Workers Comp | — | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | Highmark Wholecare (prev Gateway) | Medicare | $2.40 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | UPMC Health Plan | Managed Medicare | $2.40 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | Highmark Wholecare (prev Gateway) | Medicare | $2.40 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | UPMC Work Partners | Workers Comp | — | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | AmeriHealth Caritas | Medicare | $2.47 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | AmeriHealth Caritas | Medicare | $2.47 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | United Healthcare | United Healthcare - CHIP - Managed Medicare | $2.50 | $293.00 | $146.50 | 2026-07-01 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | Cigna | Medicare | $2.52 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | Cigna | Medicare | $2.52 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | United Healthcare | Medicare | $2.57 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | United Healthcare | Medicare | $2.57 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2.59 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2.59 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Aetna | Medicare | $2.70 | $15.00 | $12.00 | 2026-03-06 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Hmo | $2.82 | — | — | 2026-09-21 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $2.82 | — | — | 2026-09-21 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Hmo | $2.82 | — | — | 2026-05-06 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $2.82 | — | — | 2026-05-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | UPMC Work Partners | Workers Comp | — | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Aetna | Medicare | $2.88 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Highmark BCBS of PA | Medicare | $3.00 | $15.00 | $12.00 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Highmark Wholecare (prev Gateway) | Medicare | $3.00 | $15.00 | $12.00 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | UPMC Health Plan | Managed Medicare | $3.06 | $15.00 | $12.00 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Cigna | Medicare | $3.15 | $15.00 | $12.00 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Highmark BCBS of PA | Medicare | $3.20 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Highmark Wholecare (prev Gateway) | Medicare | $3.20 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | United Healthcare | Medicare | $3.21 | $15.00 | $12.00 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3.24 | $15.00 | $12.00 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | UPMC Health Plan | Managed Medicare | $3.26 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Cigna | Medicare | $3.36 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | United Healthcare | Medicare | $3.42 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3.46 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | UHC MCR ADV | UHC MCR ADV | $5.44 | $16.00 | $9.60 | 2025-11-18 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | PGT | Medicare|All Plans | $5.74 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | PGT | Medicare|All Plans | $5.74 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | BCBS | Medicare|All Plans | $5.85 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | BCBS | Medicare|All Plans | $5.85 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AETNA | Medicare|All Plans | $5.85 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AETNA | Medicare|All Plans | $5.85 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | UNITED | Medicare|All Plans | $5.97 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | UNITED | Medicare|All Plans | $5.97 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| CONEMAUGH MINERS MEDICAL CENTER Outpatient | Bcbs Of Pa | Highmark Medicare Advantage | $5.98 | $446.00 | $178.40 | 2026-07-18 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Amerigroup | Children's Health Insurance Program | $6.00 | $25.00 | $25.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | ChoiceCare Network | Commercial | $6.00 | $25.00 | $25.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Superior HealthPlan | Commercial | $6.00 | $25.00 | $25.00 | 2025-07-03 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Amerigroup | Medicare Advantage | $6.00 | $25.00 | $25.00 | 2025-07-03 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AMERIVANTAGE | Medicare|All Plans | $6.03 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | AMERIVANTAGE | Medicare|All Plans | $6.03 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | TRICARE - ALL PLANS | TRICARE - ALL PLANS | $6.21 | $16.00 | $9.60 | 2025-11-18 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | SCANHealth | Medicare|All Plans | $6.26 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | SCANHealth | Medicare|All Plans | $6.26 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $6.28 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $6.28 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | UHC VA CCN | UHC VA CCN | $6.40 | $16.00 | $9.60 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | HUMANA MEDICARE-ALL PLANS | HUMANA MEDICARE-ALL PLANS | $6.40 | $16.00 | $9.60 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | MOLINA MCR ADV | MOLINA MCR ADV | $6.40 | $16.00 | $9.60 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | IOWA TOTAL CARE COMM - ALL OTHER PLANS | IOWA TOTAL CARE COMM - ALL OTHER PLANS | $6.40 | $16.00 | $9.60 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | IOWA TOTAL CARE MCR | IOWA TOTAL CARE MCR | $6.40 | $16.00 | $9.60 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | AMERIGROUP MCR ADV | AMERIGROUP MCR ADV | $6.40 | $16.00 | $9.60 | 2025-11-18 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Highmark BCBS of PA | Commercial - Social Mission Indemnity | $6.44 | $15.00 | $12.00 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | Aetna | PEBTF Custom Network | $6.49 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | Aetna | PEBTF Custom Network | $6.49 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | UPMC Health Plan | Commercial | $6.54 | $15.00 | $12.00 | 2026-03-06 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | IOWA TOTAL CARE MCAID | IOWA TOTAL CARE MCAID | $6.72 | $16.00 | $9.60 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | MOLINA MCAID/CHIP | MOLINA MCAID/CHIP | $6.72 | $16.00 | $9.60 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | AMERIGROUP MEDICAID - ALL OTHER PLANS | AMERIGROUP MEDICAID - ALL OTHER PLANS | $6.85 | $16.00 | $9.60 | 2025-11-18 | MRF ↗ |
| UPMC MUNCY InpatientFacility | Aetna | PEBTF Custom Network | $6.85 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY InpatientFacility | Aetna | PEBTF Custom Network | $6.85 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Highmark BCBS of PA | Commercial - Social Mission Indemnity | $6.87 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | UPMC Health Plan | Commercial | $6.98 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | UPMC Health Plan | Commercial | $6.98 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | UPMC Health Plan | Commercial | $6.98 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Amerihealth Caritas Nh | Amerihealth Caritas - Nh Managed Medicaid | $7.14 | $63.00 | $19.28 | 2026-07-18 | MRF ↗ |
| ISLAND HOSPITAL BothFacility | Kaiser | Commercial | $7.28 | $91.00 | $91.00 | 2026-05-04 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | Highmark BCBS of PA | Managed Care - Social Mission | $7.39 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | Highmark BCBS of PA | Managed Care - Social Mission | $7.39 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Highmark BCBS of PA | Commercial | $7.59 | $15.00 | $12.00 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | Aetna | Commercial | $7.63 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | Aetna | Commercial | $7.63 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| BOULDER COMMUNITY HEALTH OutpatientFacility | NE HealthPartners Medicaid (Carelon/Beacon/ValueOptions) | Managed Medicaid | — | $35.00 | $17.50 | 2025-12-23 | MRF ↗ |
| BOULDER COMMUNITY HEALTH OutpatientFacility | Kaiser Public Option | Commercial | $7.67 | $35.00 | $17.50 | 2025-12-23 | MRF ↗ |
| BOULDER COMMUNITY HEALTH OutpatientFacility | Mines and Associates | Commercial | — | $35.00 | $17.50 | 2025-12-23 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Beacon Health Strategies/Carelon | Wellsense - Nh Managed Medicaid Beh Health | $7.69 | $63.00 | $19.28 | 2026-07-18 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Wellsense Health Plan | Wellsense - Nh Managed Medicaid | $7.69 | $63.00 | $19.28 | 2026-07-18 | MRF ↗ |
| CHI ST LUKE'S HEALTH BRAZOSPORT Outpatient | Aetna | Medicare|All Plans | $7.72 | $51.42 | $18.00 | 2026-02-28 | MRF ↗ |
| CHI ST LUKE'S HEALTH BRAZOSPORT Outpatient | Aetna | Medicare|All Plans | $7.72 | $51.42 | $18.00 | 2026-02-28 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | AETNA MCR ADV | AETNA MCR ADV | $7.84 | $16.00 | $9.60 | 2025-11-18 | MRF ↗ |
| JEFFERSON COUNTY HEALTH CENTER Outpatient | COVENTRY MEDICARE | COVENTRY MEDICARE | $7.84 | $16.00 | $9.60 | 2025-11-18 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Aetna | MCR | $7.87 | — | — | 2026-03-01 | MRF ↗ |
| SOUTHERN HILLS HOSPITAL AND MEDICAL CENTER Outpatient | Aetna | MCR | $7.87 | — | — | 2026-03-01 | MRF ↗ |
| SUNRISE HOSPITAL AND MEDICAL CENTER OutpatientFacility | Aetna | MCR | $7.87 | — | — | 2026-03-01 | MRF ↗ |
| MARY HITCHCOCK MEMORIAL HOSPITAL Outpatient | Granite State Health Plan | New Hampshire Healthy Families - Nh Managed Medicaid Beh Health | $7.93 | $63.00 | $19.28 | 2026-07-18 | MRF ↗ |
| GRAHAM REGIONAL MEDICAL CENTER Outpatient | Wellpoint | Commercial | $8.00 | $25.00 | $25.00 | 2025-07-03 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | Coventry/First Health | Commercial | $8.02 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | Coventry/First Health | Commercial | $8.02 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY InpatientFacility | Aetna | Commercial | $8.06 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY InpatientFacility | Aetna | Commercial | $8.06 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Highmark BCBS of PA | Commercial | $8.09 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN Outpatient | UHC MCAID | UHC MCAID | $8.20 | $25.00 | $25.00 | 2026-04-23 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $8.25 | $15.00 | $12.00 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO InpatientFacility | Wirerope Works | Commercial | $8.34 | $15.00 | $12.00 | 2026-03-06 | MRF ↗ |
| TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN Outpatient | TX CHILDRENS HLTH MCAID - ALL PLANS | TX CHILDRENS HLTH MCAID - ALL PLANS | $8.35 | $25.00 | $25.00 | 2026-04-23 | MRF ↗ |
| UPMC MUNCY InpatientFacility | Coventry/First Health | Commercial | $8.46 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY InpatientFacility | Coventry/First Health | Commercial | $8.46 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | Ambetter | Commercial|All Plans | $8.49 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | Ambetter | Commercial|All Plans | $8.49 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| GROVE HILL MEMORIAL HOSPITAL BothFacility | Aetna | Medicare Advantage | $8.54 | $61.00 | $36.60 | 2026-05-28 | MRF ↗ |
| BOULDER COMMUNITY HEALTH OutpatientFacility | Anthem Pathway Essentials | Commercial | $8.63 | $35.00 | $17.50 | 2025-12-23 | MRF ↗ |
| BOULDER COMMUNITY HEALTH OutpatientFacility | Kaiser | Managed Care | $8.75 | $35.00 | $17.50 | 2025-12-23 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | Wellpoint | Commercial|Exchange | $8.78 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| MADISON ST JOSEPH HEALTH CENTER Outpatient | Wellpoint | Commercial|Exchange | $8.78 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| BOULDER COMMUNITY HEALTH OutpatientFacility | Kaiser PPO | Commercial | $8.79 | $35.00 | $17.50 | 2025-12-23 | MRF ↗ |
| BOULDER COMMUNITY HEALTH OutpatientFacility | Cigna Individual | Commercial | $8.79 | $35.00 | $17.50 | 2025-12-23 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $8.80 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $8.80 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY OutpatientFacility | PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $8.80 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY InpatientFacility | Wirerope Works | Commercial | $8.90 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC MUNCY InpatientFacility | Wirerope Works | Commercial | $8.90 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| UPMC WELLSBORO InpatientFacility | Wirerope Works | Commercial | $8.90 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| PENN PRESBYTERIAN MEDICAL CENTER Outpatient | Pa Health And Wellness Medicaid | Pa Health And Wellness Medicaid | $9.00 | $60.00 | $60.00 | 2026-07-15 | MRF ↗ |
| BOULDER COMMUNITY HEALTH OutpatientFacility | Anthem Pathway Essentials Standard | Commercial | $9.50 | $35.00 | $17.50 | 2025-12-23 | MRF ↗ |
| EL PASO CHILDREN'S HOSPITAL Both | El Paso Health Plans | Medicaid | $9.58 | $53.23 | $10.65 | 2026-07-15 | MRF ↗ |
| EL PASO CHILDREN'S HOSPITAL Both | El Paso Health Plans | Medicaid | $9.58 | $53.23 | $10.65 | 2026-07-15 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | BCBS | Medicare|All Plans | $9.90 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | BCBS | Medicare|All Plans | $9.90 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| BOULDER COMMUNITY HEALTH OutpatientFacility | Cigna | Commercial | $9.94 | $35.00 | $17.50 | 2025-12-23 | MRF ↗ |
| UPMC WELLSBORO OutpatientFacility | Geisinger | Commercial | $10.05 | $15.00 | $12.00 | 2026-03-06 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | UNITED | Medicare|All Plans | $10.10 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | UNITED | Medicare|All Plans | $10.10 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| PENN PRESBYTERIAN MEDICAL CENTER Inpatient | Horizon Nj Health | Horizon Nj Health | $10.14 | $60.00 | $60.00 | 2026-07-15 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | AMERIVANTAGE | Medicare|All Plans | $10.20 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| BURLESON ST JOSEPH HEALTH CENTER Outpatient | AMERIVANTAGE | Medicare|All Plans | $10.20 | $45.00 | $7.88 | 2026-02-28 | MRF ↗ |
| BOULDER COMMUNITY HEALTH OutpatientFacility | Anthem Pathway Standard | Commercial | $10.35 | $35.00 | $17.50 | 2025-12-23 | 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.