Q4107 — Graftjacket 1sqcm
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). GRAFTJACKET 1SQCM (HCPCS Q4107) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Q4107?code_type=HCPCS
MLA (9th ed.)
“GRAFTJACKET 1SQCM (HCPCS Q4107) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Q4107?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“GRAFTJACKET 1SQCM (HCPCS Q4107) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Q4107?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $168–$3,192 (25th–75th percentile) across 1,641 hospitals · 4,295 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS Q4107 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
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 | — | $4,247.50 | $3,610.38 | 2025-01-01 | MRF ↗ |
| SAMARITAN HOSPITAL OF TROY, NEW YORK OutpatientFacility | VNA Homecare Options | Medicaid | — | $4,247.50 | $3,610.38 | 2025-01-01 | MRF ↗ |
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | None | — | — | $730.08 | $365.04 | 2024-12-15 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | None | — | — | $9,867.92 | $986.79 | 2026-06-01 | MRF ↗ |
| WEST JERSEY HOSPITAL Outpatient | None | — | — | $9,867.92 | $986.79 | 2026-04-01 | MRF ↗ |
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | None | — | — | $730.08 | $365.04 | 2024-12-15 | MRF ↗ |
| VIRTUA OUR LADY OF LOURDES HOSPITAL Outpatient | None | — | — | $9,867.92 | $986.79 | 2026-04-01 | MRF ↗ |
| SUNNYVIEW HOSPITAL AND REHABILITATION CENTER OutpatientFacility | VNA Homecare Options | Medicaid | — | $4,247.50 | $3,610.38 | 2025-01-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | POS | — | $263.00 | $215.66 | 2025-11-26 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.23 | $127.72 | — | 2024-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.25 | $141.63 | — | 2024-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.28 | $153.14 | — | 2024-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.34 | $188.28 | — | 2024-12-31 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Kaiser Foundation Hospitals | Medicare Advantage | — | $435.00 | $356.70 | 2025-11-26 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.37 | $208.00 | — | 2024-12-31 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | UHC | ALL PRODUCTS | $0.38 | $9,930.00 | — | 2025-06-28 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.40 | $223.20 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $0.40 | $223.20 | — | 2025-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.40 | $221.12 | — | 2024-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.41 | $229.03 | — | 2024-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.42 | $234.76 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $0.42 | $234.76 | — | 2025-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $0.43 | $237.00 | — | 2025-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.43 | $238.23 | — | 2024-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.43 | $237.00 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $0.44 | $245.07 | — | 2025-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.45 | $251.10 | — | 2024-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.48 | $266.67 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $0.48 | $266.67 | — | 2025-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $0.49 | $273.52 | — | 2025-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.49 | $273.52 | — | 2024-12-31 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | Medicare Advantage | — | $716.00 | $587.12 | 2025-11-26 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.62 | $346.73 | — | 2024-12-31 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | HMO | — | $716.00 | $587.12 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Alignment Health Plan | Medicare Advantage | — | $435.00 | $356.70 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | PPO | — | $263.00 | $215.66 | 2025-11-26 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $0.76 | $419.49 | — | 2025-12-31 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | EPO | — | $435.00 | $356.70 | 2025-11-26 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $0.91 | $503.51 | — | 2025-12-31 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $716.00 | $587.12 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $263.00 | $215.66 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | HMO | — | $263.00 | $215.66 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Health Net of California, Inc. | Medicare Advantage | — | $716.00 | $587.12 | 2025-11-26 | MRF ↗ |
| ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| ESSENTIA HEALTH OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | United Healthcare | Medicare Advantage | — | $435.00 | $356.70 | 2025-11-26 | MRF ↗ |
| ESSENTIA HEALTH DULUTH OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| ESSENTIA HEALTH OutpatientFacility | BCBS PLUS PMAP PCC PRIME | Medicaid | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Outpatient | Aetna Health of California, Inc. and Aetna Health Management LLC | Medicare Advantage | — | $263.00 | $215.66 | 2025-11-26 | MRF ↗ |
| ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER OutpatientFacility | BLUE PLUS PMAP PCC PRIME | Medicaid | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| WYANDOTTE HOSPITAL AND MEDICAL CENTER OutpatientFacility | HAP | Self Insured | $2.10 | $146.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | Self Insured | $2.10 | $146.00 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | HAP | Self Insured | $2.10 | $146.00 | — | 2025-06-28 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.21 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.21 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $2.21 | — | — | 2026-03-18 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | Aetna | MCR | $2.36 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | Aetna | MCR | $2.36 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| LAKEVIEW HOSPITAL BothFacility | HP MEDICAID REPLACEMENT [950307] | HP CARE PMAP [50327] | $2.45 | $2,550.00 | $943.50 | 2026-03-31 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $2.53 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $2.53 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $2.53 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $2.75 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $2.75 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $2.75 | — | — | 2026-03-18 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | MBN | $3.01 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | SBN | $3.01 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | MBN | $3.01 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | SBN | $3.01 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | BSL | $3.01 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | BSL | $3.01 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | HMO | $3.94 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | HMO | $3.94 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $4.13 | $2,294.00 | — | 2024-12-31 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $4.13 | $2,294.00 | — | 2024-12-31 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | NWB | $4.31 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | PPO | $4.31 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | PPO | $4.31 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | NWB | $4.31 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | Aetna | MCR | $4.62 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | Aetna | MCR | $4.62 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $4.87 | $2,708.16 | — | 2025-12-31 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $4.87 | $2,708.16 | — | 2024-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $4.87 | $2,708.16 | — | 2024-12-31 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | Simply Healthcare | MGMCR | $5.27 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | Simply Healthcare | MGMCR | $5.27 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | United | OptionsPPO | $5.61 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | United | OptionsPPO | $5.61 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | MBN | $5.90 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | MBN | $5.90 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | BSL | $5.90 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | SBN | $5.90 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | SBN | $5.90 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | BSL | $5.90 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $6.00 | $3,332.92 | — | 2025-12-31 | MRF ↗ |
| OVIEDO MEDICAL CENTER Outpatient | AvMed | HIX | $6.66 | $74.00 | $74.00 | 2024-10-01 | MRF ↗ |
| OVIEDO MEDICAL CENTER Outpatient | BCBS | BSL | $6.81 | $74.00 | $74.00 | 2024-10-01 | MRF ↗ |
| OVIEDO MEDICAL CENTER Outpatient | BCBS | SBN | $6.81 | $74.00 | $74.00 | 2024-10-01 | MRF ↗ |
| OVIEDO MEDICAL CENTER Outpatient | BCBS | MBN | $6.81 | $74.00 | $74.00 | 2024-10-01 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | HUMANA | HUMANA MEDICARE | $6.90 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | BLUE CROSS TN | BLUE ADVANTAGE TN | $6.90 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | VIVA | VIVA MEDICARE | $6.90 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | MEDICARE | MEDICARE ADVANTAGE | $6.90 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | VIVA | VIVA MEDICARE | $6.90 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | MEDICARE | MEDICARE ADVANTAGE | $6.90 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | HUMANA | HUMANA MEDICARE | $6.90 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | BLUE CROSS OF AL | BLUE ADVANTAGE | $6.90 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | BLUE CROSS TN | BLUE ADVANTAGE TN | $6.90 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | BLUE CROSS OF AL | BLUE ADVANTAGE | $6.90 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | PHS | $6.95 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | PHS | $6.95 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | CIGNA | CIGNA MEDICARE | $6.97 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | CIGNA | CIGNA MEDICARE | $6.97 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | AETNA | AETNA MEDICARE | $7.04 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | AETNA | AETNA MEDICARE | $7.04 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | UNITED HEALTHCARE | UNITED MEDICARE | $7.07 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | UNITED HEALTHCARE | UNITED MEDICARE | $7.07 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | DEVOTED | DEVOTED MEDICARE | $7.10 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | DEVOTED | DEVOTED MEDICARE | $7.10 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $7.14 | $3,968.00 | — | 2024-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $7.14 | $3,968.00 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $7.14 | $3,968.00 | — | 2025-12-31 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | HUMANA | HUMANA MEDICARE | $7.28 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | BLUE CROSS TN | BLUE ADVANTAGE TN | $7.28 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | MEDICARE | MEDICARE ADVANTAGE | $7.28 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | BLUE CROSS OF AL | BLUE ADVANTAGE | $7.28 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | VIVA | VIVA MEDICARE | $7.28 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | VIVA | VIVA MEDICARE | $7.28 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | BLUE CROSS OF AL | BLUE ADVANTAGE | $7.28 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | MEDICARE | MEDICARE ADVANTAGE | $7.28 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | BLUE CROSS TN | BLUE ADVANTAGE TN | $7.28 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | HUMANA | HUMANA MEDICARE | $7.28 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | CIGNA | CIGNA MEDICARE | $7.35 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | CIGNA | CIGNA MEDICARE | $7.35 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | AETNA | AETNA MEDICARE | $7.42 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | AETNA | AETNA MEDICARE | $7.42 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | UNITED HEALTHCARE | UNITED MEDICARE | $7.46 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | UNITED HEALTHCARE | UNITED MEDICARE | $7.46 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | DEVOTED | DEVOTED MEDICARE | $7.49 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | DEVOTED | DEVOTED MEDICARE | $7.49 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | WELLCARE | WELLCARE MEDICARE | $7.59 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | WELLCARE | WELLCARE MEDICARE | $7.59 | $28.57 | $28.57 | 2026-03-27 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | HMO | $7.70 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | HMO | $7.70 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | WELLCARE | WELLCARE MEDICARE | $8.00 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| HELEN KELLER HOSPITAL Both | WELLCARE | WELLCARE MEDICARE | $8.00 | $41.79 | $41.79 | 2026-03-27 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $8.02 | $4,456.56 | — | 2025-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $8.02 | $4,456.56 | — | 2024-12-31 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $8.02 | $4,456.56 | — | 2024-12-31 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Aetna | Commercial | — | $7,639.98 | $7,639.98 | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusCentralHMO | $8.36 | $3,533.07 | $3,533.07 | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Cigna | Commercial | — | $7,639.98 | $7,639.98 | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Aetna | MedicareAdvantage | — | $3,533.07 | $3,533.07 | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | United Healthcare | CommercialAllPlans | — | $7,639.98 | $7,639.98 | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusHMO | $8.36 | $3,533.07 | $3,533.07 | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusHMO | $8.36 | $3,533.07 | $3,533.07 | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Health New England | Commercial | — | $7,639.98 | $7,639.98 | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusCentralHMO | $8.36 | $3,533.07 | $3,533.07 | 2025-04-16 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | NWB | $8.44 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | PPO | $8.44 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | NWB | $8.44 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | BCBS | PPO | $8.44 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $8.47 | $4,704.56 | — | 2024-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $8.47 | $4,704.56 | — | 2024-12-31 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Community Health Group | Community Health Group - Cal Mediconnect | $9.02 | $142.76 | $107.07 | 2026-04-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Community Health Group | Community Health Group - Medi-Cal | $9.02 | $142.76 | $107.07 | 2026-04-01 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Inpatient | Aetna | Aetna - HMO/POS | $9.02 | $142.76 | $107.07 | 2026-04-01 | MRF ↗ |
| OVIEDO MEDICAL CENTER Outpatient | Truli for Health | COMMHMO | $9.32 | $74.00 | $74.00 | 2024-10-01 | MRF ↗ |
| OVIEDO MEDICAL CENTER Outpatient | BCBS | PPO | $9.62 | $74.00 | $74.00 | 2024-10-01 | MRF ↗ |
| OVIEDO MEDICAL CENTER Outpatient | BCBS | NWB | $9.62 | $74.00 | $74.00 | 2024-10-01 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST F OutpatientFacility | Cook Childrens | Managed Medicaid | $9.63 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST F OutpatientFacility | Blue Cross Blue Shield | Managed Medicaid | $9.63 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST F OutpatientFacility | Amerigroup | Managed Medicaid | $9.63 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST F OutpatientFacility | United Healthcare | Managed Medicaid | $9.63 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| Hospital Of The Fox Chase Cancer Center OutpatientFacility | Keystone First | CHIP | $9.85 | $114.00 | — | 2026-04-08 | MRF ↗ |
| Hospital Of The Fox Chase Cancer Center OutpatientFacility | Keystone First | Community HealthChoices | $9.85 | $114.00 | — | 2026-04-08 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST F OutpatientFacility | Superior Wellcare | Managed Medicaid | $10.11 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| OVIEDO MEDICAL CENTER Outpatient | BCBS | HMO | $10.14 | $74.00 | $74.00 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | Aetna | ASA | $10.27 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | Aetna | ASA | $10.27 | $34.23 | $34.23 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | Simply Healthcare | MGMCR | $10.32 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| HCA FLORIDA LEHIGH REGIONAL MEDICAL CENTER Outpatient | Simply Healthcare | MGMCR | $10.32 | $66.99 | $66.99 | 2026-03-01 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST F OutpatientFacility | Molina | Managed Medicaid | $10.40 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HEART & VASCULAR HOSPITAL ARLINGTON OutpatientFacility | Blue Cross Blue Shield | Managed Medicaid | $10.44 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HEART & VASCULAR HOSPITAL ARLINGTON OutpatientFacility | Amerigroup | Managed Medicaid | $10.44 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HEART & VASCULAR HOSPITAL ARLINGTON OutpatientFacility | United Healthcare | Managed Medicaid | $10.44 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HEART & VASCULAR HOSPITAL ARLINGTON OutpatientFacility | Cook Childrens | Managed Medicaid | $10.44 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST F OutpatientFacility | Aetna | Managed Medicaid | $10.59 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| Hospital Of The Fox Chase Cancer Center OutpatientFacility | Pennsylvania Health and Wellness | Community HealthChoices | $10.90 | $114.00 | — | 2026-04-08 | MRF ↗ |
| TEXAS HEALTH HEART & VASCULAR HOSPITAL ARLINGTON OutpatientFacility | Superior Wellcare | Managed Medicaid | $10.96 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN OutpatientFacility | Blue Cross Blue Shield | Managed Medicaid | $10.98 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS OutpatientFacility | Amerigroup | Managed Medicaid | $10.98 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON OutpatientFacility | Cook Childrens | Managed Medicaid | $10.98 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS OutpatientFacility | Blue Cross Blue Shield | Managed Medicaid | $10.98 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN OutpatientFacility | Amerigroup | Managed Medicaid | $10.98 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON OutpatientFacility | Blue Cross Blue Shield | Managed Medicaid | $10.98 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH PRESBYTERIAN HOSPITAL DENTON OutpatientFacility | Amerigroup | Managed Medicaid | $10.98 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN OutpatientFacility | Parkland | Managed Medicaid | $10.98 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS OutpatientFacility | Parkland | Managed Medicaid | $10.98 | $117.26 | $70.36 | 2026-04-21 | MRF ↗ |
| TEXAS HEALTH PRESBYTERIAN HOSPITAL KAUFMAN OutpatientFacility | United Healthcare | Managed Medicaid | $10.98 | $117.26 | $70.36 | 2026-04-21 | 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.