Q4113 — Graftjacket Xpress
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). GRAFTJACKET XPRESS (CPT Q4113) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Q4113?code_type=CPT
MLA (9th ed.)
“GRAFTJACKET XPRESS (CPT Q4113) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Q4113?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“GRAFTJACKET XPRESS (CPT Q4113) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Q4113?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,216–$2,948 (25th–75th percentile) across 1,039 hospitals · 1,363 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS Q4113 — 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
$1,216
$1,916 typical
$2,948
The middle 50% of negotiated facility rates for this procedure, measured across 1,039 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $1,916 |
| Likely subtotal | $1,916 |
Facility charge (no separate professional fee)
$1,916
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 $1,216–$2,948.
- 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 |
|---|---|---|---|---|---|---|---|
| ESSENTIA HEALTH OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER OutpatientFacility | BLUE PLUS PMAP PCC PRIME | Medicaid | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | 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 ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.94 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.94 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | Covered California/IFP/PPO | $3.94 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | HMO | $4.51 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | HMO | $4.51 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | HMO | $4.51 | — | — | 2026-03-18 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $4.91 | — | — | 2026-03-18 | MRF ↗ |
| FOOTHILL REGIONAL MEDICAL CENTER OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $4.91 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Blue Shield of California | EPO/PPO/Out of State | $4.91 | — | — | 2026-03-18 | MRF ↗ |
| ST JOE MERCY HOSPITAL SYSTEM LIVONIA OutpatientFacility | VACCN United | Veterans Affairs | $20.50 | $2,120.00 | $1,378.00 | 2025-01-01 | MRF ↗ |
| ST JOE MERCY HOSPITAL SYSTEM LIVONIA OutpatientFacility | VACCN United | Veterans Affairs | $20.50 | $2,120.00 | $1,378.00 | 2025-01-01 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCPreferredBlue | $33.10 | — | — | 2024-12-08 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $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 ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $37.56 | $6,060.00 | $3,636.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $37.56 | $8,337.00 | $5,002.20 | 2026-01-01 | MRF ↗ |
| GLENDALE MEM HOSPITAL & HLTH CENTER Outpatient | SCAN | Medicare|All Plans | $40.00 | $10,435.00 | $3,401.81 | 2026-02-28 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusCentralHMO | $44.39 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusHMO | $44.39 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusCentralHMO | $44.39 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusHMO | $44.39 | — | — | 2025-04-16 | MRF ↗ |
| REID HEALTH OutpatientFacility | MDWise | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | CareSource Indiana Healthy Indiana Plan (HIP) | Managed Medicaid | $47.71 | — | — | 2025-03-27 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Humana | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| REID HEALTH OutpatientFacility | MHS | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | Managed Health Services (MHS) | Managed Medicaid | $47.71 | — | — | 2025-03-27 | MRF ↗ |
| REID HEALTH OutpatientFacility | Humana of Indiana | Pathways for Aging/Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| REID HEALTH OutpatientFacility | Anthem Blue Cross Blue Shield | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | CareSource Indiana Healthy Indiana Plan (HIP) | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Healthwise (HHW) | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2025-03-27 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | United Healthcare of Indiana | Managed Medicaid | $47.71 | — | — | 2025-03-27 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Anthem Blue Cross Blue Shield | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | Anthem | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | MDWise | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| REID HEALTH OutpatientFacility | Anthem Blue Cross Blue Shield | Pathways for Aging/Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| REID HEALTH OutpatientFacility | Caresource of Indiana | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | MHS Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | CareSource Indiana Hoosier Healthwise (HHW) | Managed Medicaid | $48.19 | — | — | 2025-03-27 | MRF ↗ |
| REID HEALTH OutpatientFacility | United Healthcare | Pathways for Aging/Managed Medicaid | $48.66 | — | — | 2025-07-21 | MRF ↗ |
| REID HEALTH OutpatientFacility | United Healthcare | Managed Medicaid | $48.66 | — | — | 2025-07-21 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.68 | $8,337.00 | $5,002.20 | 2026-01-01 | MRF ↗ |
| TERRE HAUTE REGIONAL HOSPITAL Outpatient | Hospice of Bloomington Hospital | MCR | $48.68 | — | — | 2024-10-01 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Anthem IN Pathways for Aging | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Anthem IN | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.68 | $8,337.00 | $5,002.20 | 2026-01-01 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Anthem HIP | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Caresource IN | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| NORTON-KING'S DAUGHTERS' HEALTH OutpatientFacility | Anthem of Indiana | Managed Medicaid | $48.68 | — | — | 2026-05-05 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.68 | $8,337.00 | $5,002.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.68 | $8,337.00 | $5,002.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $48.68 | $8,337.00 | $5,002.20 | 2026-01-01 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | United Healthcare IN | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | MDWise HIP | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.68 | $6,060.00 | $3,636.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.68 | $8,337.00 | $5,002.20 | 2026-01-01 | MRF ↗ |
| TERRE HAUTE REGIONAL HOSPITAL Outpatient | Hospice of Bloomington Hospital | MCR | $48.68 | — | — | 2024-10-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.68 | $6,060.00 | $3,636.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | MHS CARE CONNECT | 8257_MHS CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.68 | $6,060.00 | $3,636.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | 9365_MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.68 | $6,060.00 | $3,636.00 | 2026-01-01 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | MHS Behavioral | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | ANTHEM CARE CONNECT | 8255_ANTHEM CONNECT MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.68 | $6,060.00 | $3,636.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | MHS CARE CONNECT | 8877_MHS CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.68 | $6,060.00 | $3,636.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | MEDICAID ADVANTAGE | 8723_MEDICAID REPLACEMENT OUTPATIENT 20240401 | $48.68 | $6,060.00 | $3,636.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 9347_MDWISE MEDICAID REPLACEMENT ASC OUTPATIENT 20250101 | $48.68 | $8,337.00 | $5,002.20 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT KOKOMO Outpatient | ANTHEM CARE CONNECT | 8879_ANTHEM CONNECT MEDICAID REPLACEMENT ASC OUTPATIENT 20240401 | $48.68 | $6,060.00 | $3,636.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | MDWISE HOOSIER ALLIANCE MEDICAID | 8256_MDWISE MEDICAID REPLACEMENT OUTPATIENT 20240101 | $48.68 | $8,337.00 | $5,002.20 | 2026-01-01 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Caresource HIP | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $49.14 | — | — | 2025-04-24 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | CareSource Indiana Hoosier Healthwise (HHW) | Managed Medicaid | $49.14 | — | — | 2025-04-24 | MRF ↗ |
| TERRE HAUTE REGIONAL HOSPITAL Outpatient | CareSource | MCD | $49.65 | — | — | 2024-10-01 | MRF ↗ |
| TERRE HAUTE REGIONAL HOSPITAL Outpatient | CareSource | MCD | $49.65 | — | — | 2024-10-01 | MRF ↗ |
| HILTON HEAD REGIONAL MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Mdwise Hoosier Healthwise (HHW) | Managed Medicaid | $50.10 | — | — | 2025-04-24 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | MDwise Hoosier Healthwise (HHW) | Managed Medicaid | $50.10 | — | — | 2025-03-27 | MRF ↗ |
| TERRE HAUTE REGIONAL HOSPITAL Outpatient | MDwise Hoosier Alliance | HoosierCareConnect | $50.14 | — | — | 2024-10-01 | MRF ↗ |
| TERRE HAUTE REGIONAL HOSPITAL Outpatient | MDwise Hoosier Alliance | HoosierHealthwise | $50.14 | — | — | 2024-10-01 | MRF ↗ |
| TERRE HAUTE REGIONAL HOSPITAL Outpatient | MDwise Hoosier Alliance | HoosierHealthwise | $50.14 | — | — | 2024-10-01 | MRF ↗ |
| TERRE HAUTE REGIONAL HOSPITAL Outpatient | MDwise Hoosier Alliance | HoosierCareConnect | $50.14 | — | — | 2024-10-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID ANTHEM MAGELLAN HLT [212] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID PATHWAYS [270] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | FRANCISCAN ACO [236] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID MDWISE ST MARG BHS [224] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID MD WISE HIP STC BHS [231] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID PRESUMPTIVE [250] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID MDWISE CARE SELECT [221] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID CENPATICO BHS [211] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID MDWISE STC BHS [222] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID [200] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | CARESOURCE HOOSIER HEALTHWISE [233] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| HANCOCK REGIONAL HOSPITAL Outpatient | ANTHEM BC MCAID | ANTHEM BC MCAID | $50.55 | $5,517.60 | $4,414.08 | 2026-04-28 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | FRANCISCAN ACO [236] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID MDWISE HOOSIER BHS [223] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID MDWISE STC BHS [222] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID MDWISE ST MARG BHS [224] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID MDWISE [220] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID ANTHEM MAGELLAN HLT [212] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID MDWISE CARE SELECT [221] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID MDWISE HOOSIER BHS [223] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID HIP [230] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID ADVANTAGED HEALTH [201] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID PRESUMPTIVE [250] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID PATHWAYS [270] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID ADVANTAGED HEALTH [201] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID MANAGED HEALTH [210] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID ANTHEM MAGELLAN HLT [212] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID MDWISE [220] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID [200] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID HIP [230] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | CARETAKER HIP [232] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | CARESOURCE HOOSIER HEALTHWISE [233] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID MANAGED HEALTH [210] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID CENPATICO BHS [211] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| HANCOCK REGIONAL HOSPITAL Outpatient | UHC MCAID | UHC MCAID | $50.55 | $5,517.60 | $4,414.08 | 2026-04-28 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID MD WISE HIP STC BHS [231] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | CARETAKER HIP [232] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID MANAGED HEALTH [210] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID MDWISE ST MARG BHS [224] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID PATHWAYS [270] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | FRANCISCAN ACO [236] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID MDWISE HOOSIER BHS [223] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID PATHWAYS [270] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | CARETAKER HIP [232] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | FRANCISCAN ACO [236] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID HIP [230] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MDWISE ST MARG BHS [224] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MD WISE HIP STC BHS [231] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID PRESUMPTIVE [250] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MDWISE CARE SELECT [221] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MDWISE [220] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MDWISE STC BHS [222] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MDWISE HOOSIER BHS [223] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID CENPATICO BHS [211] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID ANTHEM MAGELLAN HLT [212] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| HANCOCK REGIONAL HOSPITAL Outpatient | MHS/MDWISE MCAID-ALL PLANS | MHS/MDWISE MCAID-ALL PLANS | $50.55 | $5,517.60 | $4,414.08 | 2026-04-28 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID [200] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID ADVANTAGED HEALTH [201] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID MDWISE STC BHS [222] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | CARESOURCE HOOSIER HEALTHWISE [233] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID PRESUMPTIVE [250] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID HIP [230] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | CARETAKER HIP [232] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID MDWISE CARE SELECT [221] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID ADVANTAGED HEALTH [201] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID MD WISE HIP STC BHS [231] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID CENPATICO BHS [211] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID [200] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | CARESOURCE HOOSIER HEALTHWISE [233] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MANAGED HEALTH [210] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID MDWISE [220] | Indiana Medicaid | $50.55 | — | — | 2026-04-01 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Molina Healthcare of Indiana | Managed Medicaid | $50.57 | — | — | 2025-04-24 | MRF ↗ |
| TERRE HAUTE REGIONAL HOSPITAL Outpatient | Molina | MCD | $53.55 | — | — | 2024-10-01 | MRF ↗ |
| TERRE HAUTE REGIONAL HOSPITAL Outpatient | Molina | MCD | $53.55 | — | — | 2024-10-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Humana | HumanaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Centene | AmbetterHIX | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Humana | HumanaCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Centene | CenteneHNWellcareMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Prime Health Services | PrimeHealthServicesMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Zing Health | ZingHealthMedicareNonNarrow | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Provider Partners Health Plan | ProviderPartnersHealthPlanMedicareAdvantage | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Prime Health Services | PrimeHealthServicesWC | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Prime Health Services | PrimeHealthServicesMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Mclaren Health Plan | McLarenMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Mclaren Health Plan | McLarenAdvantagePPO | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Oscar Health | OscarHealthPlanHIX | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Mclaren Health Plan | McLarenMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Corvel | CorvelWC | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Aetna | AetnaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Mclaren Health Plan | McLarenCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Mclaren Health Plan | McLarenMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Aetna | AetnaMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Mclaren Health Plan | McLarenMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Mclaren Health Plan | McLarenAdvantagePPO | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Multiplan | MultiplanWC | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Aetna | AetnaExistingBusiness | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | American Health Plan | AmericanHealthPlanMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Molina Healthcare Of Texas (Claims Only) | MolinaHIX | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Longevity Health Plan | LongevityHealthPlan | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Mclaren Health Plan | McLarenCommercial | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Naphcare Inc. | NaphCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Community Care | CommunityCareComm | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Amerihealth | AmerihealthCaritasMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Americas Choice Provider Network | AmericasChoiceProviderNetworkWC | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | AllyAlign Health | AllyAlignHealthMgdMCare | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Employers Choice Network | EmployersChoiceNetworkWC | — | — | — | 2025-01-31 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL Outpatient | Amerihealth | BlueCrossCompleteMgdMCaid | — | — | — | 2025-01-31 | MRF ↗ |
| Harper University Hospital Outpatient | Prime Health Services | PrimeHealthServicesWC | — | — | — | 2025-01-31 | 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.