Q4150 — Allowrap Ds Or Dry 1 Sq Cm
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Allowrap ds or dry 1 sq cm (HCPCS Q4150) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Q4150?code_type=HCPCS
MLA (9th ed.)
“Allowrap ds or dry 1 sq cm (HCPCS Q4150) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Q4150?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Allowrap ds or dry 1 sq cm (HCPCS Q4150) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Q4150?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $188–$2,442 (25th–75th percentile) across 1,426 hospitals · 2,181 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS Q4150 — 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
$188
$545 typical
$2,442
The middle 50% of negotiated facility rates for this procedure, measured across 1,426 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $545 |
| Likely subtotal | $545 |
Facility charge (no separate professional fee)
$545
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 $188–$2,442.
- 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 |
|---|---|---|---|---|---|---|---|
| SAINT AGNES MEDICAL CENTER OutpatientFacility | UHC | All products | — | $6,604.20 | $4,622.94 | 2025-01-01 | MRF ↗ |
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | — | — | — | $1,316.25 | $658.12 | 2024-12-15 | MRF ↗ |
| SAINT AGNES MEDICAL CENTER BothFacility | BSCA | EPN | — | $6,604.20 | $4,622.94 | 2025-01-01 | MRF ↗ |
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | — | — | — | $1,316.25 | $658.12 | 2024-12-15 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Both | SCAN | Medicare Advantage | — | $610.00 | $500.20 | 2025-11-26 | MRF ↗ |
| TORRANCE MEMORIAL MEDICAL CENTER Inpatient | Health Net of California, Inc. | HMO | — | $263.00 | $215.66 | 2025-11-26 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | Indemnity | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Cigna | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | United Healthcare | CommercialAllPlans | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | HMO | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Cigna | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Aetna | MedicareAdvantage | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | Indemnity | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Aetna | MedicareAdvantage | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | United Healthcare | CommercialAllPlans | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Aetna | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Aetna | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | HMO | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | PPA | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Health New England | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | BCBS-MA | PPA | — | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Health New England | Commercial | — | — | — | 2025-04-16 | MRF ↗ |
| Lake City Medical Center Suwannee Campus Outpatient | BCBS | MCRPPO | $32.42 | $579.00 | $579.00 | 2026-03-01 | MRF ↗ |
| Lake City Medical Center Suwannee Campus Outpatient | BCBS | MCRHMO | $32.54 | $579.00 | $579.00 | 2026-03-01 | 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 ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | CORVEL | Worker's Compensation | $33.27 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | Prime Health Services | Worker's Compensation | $33.27 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | American Health Plan | Medicare Advantage | $33.35 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | HealthSpring | Medicare Advantage | $33.35 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | ProCare Advantage | Medicare Advantage | $33.35 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | Superior Health Plan | Medicare HMO/Medicare PPO | $33.35 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $33.35 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE HEART & VASCULAR HOSPITAL - DALLAS OutpatientFacility | Superior Health Plan | Medicaid | $33.75 | $421.93 | $253.16 | 2026-02-21 | MRF ↗ |
| Baylor Scott & White Medical Center - Frisco at PGA Parkway OutpatientFacility | Superior Health Plan | Medicaid | $34.20 | $244.30 | $146.58 | 2026-02-23 | MRF ↗ |
| BAYLOR SCOTT AND WHITE MEDICAL CENTER MCKINNEY OutpatientFacility | Superior Health Plan | Medicaid | $34.20 | $244.30 | $146.58 | 2026-02-19 | MRF ↗ |
| Lake City Medical Center Suwannee Campus Outpatient | Aetna | MCR | $34.26 | $496.50 | $496.50 | 2026-03-01 | 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 ↗ |
| Lake City Medical Center Suwannee Campus Outpatient | BCBS | SBN | $36.41 | $331.00 | $331.00 | 2026-03-01 | MRF ↗ |
| Lake City Medical Center Suwannee Campus Outpatient | BCBS | BSL | $36.41 | $331.00 | $331.00 | 2026-03-01 | MRF ↗ |
| Lake City Medical Center Suwannee Campus Outpatient | BCBS | MBN | $36.41 | $331.00 | $331.00 | 2026-03-01 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - TEMPLE OutpatientFacility | Superior Health Plan | Medicaid | $36.65 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| Baylor Scott & White McLane Children's Medical Center - Temple OutpatientFacility | Superior Health Plan | Medicaid | $36.65 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Caresource | Commercial | $37.56 | — | — | 2026-07-17 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $37.56 | $9,660.00 | $5,796.00 | 2026-01-01 | MRF ↗ |
| ASCENSION ST VINCENT HOSPITAL Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $37.56 | $9,660.00 | $5,796.00 | 2026-01-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Anthem | Medicaid | $37.56 | — | — | 2026-07-17 | MRF ↗ |
| ASCENSION ST VINCENT CARMEL Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $37.56 | $9,660.00 | $5,796.00 | 2026-01-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Mdwise | Medicaid | $37.56 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Mdwise | Hip | $37.56 | — | — | 2026-07-17 | MRF ↗ |
| MERCY MEDICAL CTR BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $37.70 | $137.58 | $89.43 | 2026-03-31 | MRF ↗ |
| MERCY MEDICAL CTR BothFacility | HEALTH NEW ENGLAND MEDICARE ADVANTAGE | HEALTH NEW ENGLAND MEDICARE ADVANTAGE | $37.70 | $137.58 | $89.43 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | IOWA TOTAL CARE | IOWA TOTAL CARE MEDICAID | $37.83 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | IOWA TOTAL CARE | IOWA TOTAL CARE MEDICAID | $37.83 | $231.82 | $231.82 | 2026-03-31 | MRF ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | Baylor Scott & White Health Plan | BSW Premier - Small Group | $38.11 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | MOLINA MEDICAID | MOLINA MEDICAID | $38.20 | $231.82 | $231.82 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | MOLINA MEDICAID | MOLINA MEDICAID | $38.20 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | WELLPOINT MEDICAID | WELLPOINT MEDICAID | $38.35 | $231.82 | $231.82 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | WELLPOINT MEDICAID | WELLPOINT MEDICAID | $38.35 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | COUNTYCARE IL COOK CO [1607] | KH ILLINOIS MEDICAID | — | $563.17 | $394.22 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | MERIDIAN HEALTH PLAN HMO [1604] | KH ILLINOIS MEDICAID | — | $563.17 | $394.22 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | FAMILY HEALTH NETWORK HMO [1610] | KH ILLINOIS MEDICAID | — | $563.17 | $394.22 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | CENPATICO BEHAVIORAL HEALTH [1603] | KH ILLINOIS MEDICAID | — | $563.17 | $394.22 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | HEALTH ALLIANCE MEDICAID [1310] | KH ILLINOIS MEDICAID | — | $563.17 | $394.22 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | CIGNA HEALTHSPRING SPECIALCARE OF IL [1608] | KH ILLINOIS MEDICAID | — | $563.17 | $394.22 | 2026-04-01 | MRF ↗ |
| NORTHWESTERN MEDICINE KISHWAUKEE HOSPITAL Outpatient | BLUE CROSS MEDICAID [1612] | KH ILLINOIS MEDICAID | — | $563.17 | $394.22 | 2026-04-01 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL OutpatientFacility | Superior Health Plan | Medicaid | $39.09 | $244.30 | $146.58 | 2026-02-20 | MRF ↗ |
| Baylor All Saints Medical Center Of Fort Worth OutpatientFacility | Superior Health Plan | Medicaid | $39.09 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - CENTENNIAL OutpatientFacility | WellPoint (fka Amerigroup) | CHIP/Medicaid | $39.09 | $244.30 | $146.58 | 2026-02-20 | MRF ↗ |
| Baylor All Saints Medical Center Of Fort Worth OutpatientFacility | WellPoint (fka Amerigroup) | CHIP/Medicaid | $39.09 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| Baylor All Saints Medical Center Of Fort Worth OutpatientFacility | Cook Children's Health Plan | Medicaid | $39.09 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | Sedgwick | Preferred Network | $39.45 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | CareWorks fka Rockport | Worker's Compensation | $39.45 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | Injury Management Organization | Med Select Network | $39.45 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE HOSPITAL BRENHAM OutpatientFacility | Baylor Scott & White Health Plan | BSW Premier - Individual | $39.87 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| Baylor All Saints Medical Center Of Fort Worth OutpatientFacility | Aetna | Medicaid | $39.87 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| Lake City Medical Center Suwannee Campus Outpatient | Aetna | MCR | $39.95 | $579.00 | $579.00 | 2026-03-01 | MRF ↗ |
| GLENDALE MEM HOSPITAL & HLTH CENTER Outpatient | SCAN | Medicare|All Plans | $40.00 | $8,025.00 | $2,616.15 | 2026-02-28 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| GLENDALE MEM HOSPITAL & HLTH CENTER Outpatient | SCAN | Medicare|All Plans | $40.00 | $8,025.00 | $2,616.15 | 2026-02-28 | MRF ↗ |
| SARTORI MEMORIAL HOSPITAL, INC BothFacility | IOWA TOTAL CARE | IOWA TOTAL CARE MEDICAID | $40.20 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| Salem Medical Center OutpatientFacility | Braven Health | Medicare Advantage | $40.20 | $442.19 | $442.19 | 2026-03-24 | MRF ↗ |
| MERCY MEDICAL CTR BothFacility | HEALTH NEW ENGLAND MEDICARE ADVANTAGE | HEALTH NEW ENGLAND MEDICARE ADVANTAGE | $40.45 | $147.64 | $95.97 | 2026-03-31 | MRF ↗ |
| MERCY MEDICAL CTR BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $40.45 | $147.64 | $95.97 | 2026-03-31 | MRF ↗ |
| SARTORI MEMORIAL HOSPITAL, INC BothFacility | MOLINA MEDICAID | MOLINA MEDICAID | $40.59 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | IOWA TOTAL CARE | IOWA TOTAL CARE MEDICAID | $40.60 | $248.77 | $248.77 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | IOWA TOTAL CARE | IOWA TOTAL CARE MEDICAID | $40.60 | $248.77 | $161.70 | 2026-03-31 | MRF ↗ |
| SARTORI MEMORIAL HOSPITAL, INC BothFacility | WELLPOINT MEDICAID | WELLPOINT MEDICAID | $40.75 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | MOLINA MEDICAID | MOLINA MEDICAID | $41.00 | $248.77 | $248.77 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | MOLINA MEDICAID | MOLINA MEDICAID | $41.00 | $248.77 | $161.70 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | WELLPOINT MEDICAID | WELLPOINT MEDICAID | $41.16 | $248.77 | $248.77 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | WELLPOINT MEDICAID | WELLPOINT MEDICAID | $41.16 | $248.77 | $161.70 | 2026-03-31 | MRF ↗ |
| Salem Medical Center OutpatientFacility | United Healthcare Medicare | Medicare Advantage | $42.05 | $442.19 | $442.19 | 2026-03-24 | MRF ↗ |
| BAYLOR SCOTT & WHITE HEART & VASCULAR HOSPITAL - DALLAS OutpatientFacility | Superior Health Plan | Medicaid | $42.35 | $529.38 | $317.63 | 2026-02-21 | MRF ↗ |
| The Burdett Care Center BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $43.00 | $171.98 | $111.79 | 2026-03-31 | MRF ↗ |
| SARTORI MEMORIAL HOSPITAL, INC BothFacility | IOWA TOTAL CARE | IOWA TOTAL CARE MEDICAID | $43.14 | $248.77 | $161.70 | 2026-03-31 | MRF ↗ |
| SARTORI MEMORIAL HOSPITAL, INC BothFacility | MOLINA MEDICAID | MOLINA MEDICAID | $43.56 | $248.77 | $161.70 | 2026-03-31 | MRF ↗ |
| SARTORI MEMORIAL HOSPITAL, INC BothFacility | WELLPOINT MEDICAID | WELLPOINT MEDICAID | $43.73 | $248.77 | $161.70 | 2026-03-31 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BUDA OutpatientFacility | Superior Health Plan | Medicaid | $43.97 | $244.30 | $146.58 | 2026-02-20 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER PFLUGERVILLE OutpatientFacility | Superior Health Plan | Medicaid | $43.97 | $244.30 | $146.58 | 2026-02-18 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - MARBLE FALLS OutpatientFacility | Superior Health Plan | Medicaid | $43.97 | $244.30 | $146.58 | 2026-02-20 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER BothFacility | IOWA TOTAL CARE | IOWA TOTAL CARE MEDICAID | $44.93 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE CLINTON MEDICAL CENTER BothFacility | IOWA TOTAL CARE | IOWA TOTAL CARE MEDICAID | $44.93 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE CLINTON MEDICAL CENTER BothFacility | MOLINA MEDICAID | MOLINA MEDICAID | $45.37 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER BothFacility | MOLINA MEDICAID | MOLINA MEDICAID | $45.37 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER BothFacility | WELLPOINT MEDICAID | WELLPOINT MEDICAID | $45.54 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE CLINTON MEDICAL CENTER BothFacility | WELLPOINT MEDICAID | WELLPOINT MEDICAID | $45.54 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| TRINITY HEALTH OAKLAND HOSPITAL BothFacility | BLUE CROSS - MI | BCBS MI LOCAL HMO | $46.02 | $200.18 | $130.12 | 2026-03-31 | MRF ↗ |
| The Burdett Care Center BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $46.14 | $184.55 | $119.96 | 2026-03-31 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | KANCARE CONTRACTED [320213] | HB JOPL AETNA BETTER HEALTH (KANCARE) | $46.25 | $185.00 | $120.25 | 2026-06-09 | MRF ↗ |
| MERCY HOSPITAL JOPLIN OutpatientFacility | KANCARE [20213] | HB JOPL AETNA BETTER HEALTH (KANCARE) | $46.25 | $185.00 | $120.25 | 2026-06-09 | MRF ↗ |
| MERCYONE WATERLOO MEDICAL CENTER BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $46.36 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $46.36 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE DUBUQUE MEDICAL CENTER BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $46.36 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $46.36 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $46.36 | $231.82 | $231.82 | 2026-03-31 | MRF ↗ |
| MERCYONE NORTH IOWA MEDICAL CENTER BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $46.36 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| SARTORI MEMORIAL HOSPITAL, INC BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $46.36 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $46.36 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE CLINTON MEDICAL CENTER BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $46.36 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER AT IRVING OutpatientFacility | WellPoint (fka Amerigroup) | CHIP/Medicaid | $46.41 | $421.93 | $253.16 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT AND WHITE MEDICAL CENTER LAKE POINTE OutpatientFacility | WellPoint (fka Amerigroup) | CHIP/Medicaid | $46.41 | $421.93 | $253.16 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT AND WHITE MEDICAL CENTER LAKE POINTE OutpatientFacility | Superior Health Plan | Medicaid | $46.41 | $421.93 | $253.16 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER AT IRVING OutpatientFacility | Superior Health Plan | Medicaid | $46.41 | $421.93 | $253.16 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE THE HEART HOSPITAL PLANO OutpatientFacility | Superior Health Plan | Medicaid | $46.41 | $421.93 | $253.16 | 2026-02-20 | MRF ↗ |
| BAYLOR UNIVERSITY MEDICAL CENTER OutpatientFacility | Superior Health Plan | Medicaid | $46.42 | $244.30 | $146.58 | 2026-02-18 | MRF ↗ |
| BAYLOR UNIVERSITY MEDICAL CENTER OutpatientFacility | WellPoint (fka Amerigroup) | CHIP/Medicaid | $46.42 | $244.30 | $146.58 | 2026-02-18 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER GRAPEVINE OutpatientFacility | Superior Health Plan | Medicaid | $46.42 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER- WAXAHACHIE OutpatientFacility | Superior Health Plan | Medicaid | $46.42 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | CHIP | $46.45 | $929.00 | $929.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | STARPLUS | $46.45 | $929.00 | $929.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | STAR | $46.45 | $929.00 | $929.00 | 2026-03-01 | MRF ↗ |
| NORTH AUSTIN MEDICAL CENTER Outpatient | Superior Health Plan | CHPFC | $46.45 | $929.00 | $929.00 | 2026-03-01 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | HEALTH CHOICES | MEDICAL ASSOCIATES | $46.60 | $231.82 | $231.82 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | MEDICAL ASSOCIATES | MEDICAL ASSOCIATES | $46.60 | $231.82 | $231.82 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | MEDICAL ASSOCIATES | MEDICAL ASSOCIATES | $46.60 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MERCYONE DES MOINES MEDICAL CENTER BothFacility | HEALTH CHOICES | MEDICAL ASSOCIATES | $46.60 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $46.90 | — | — | 2026-05-24 | MRF ↗ |
| MC DONOUGH DISTRICT HOSPITAL Outpatient | Health Alliance | Commercial | $46.90 | — | — | 2026-05-14 | MRF ↗ |
| MERCYONE WATERLOO MEDICAL CENTER BothFacility | IOWA TOTAL CARE | IOWA TOTAL CARE MEDICAID | $47.29 | $231.82 | $150.68 | 2026-03-31 | MRF ↗ |
| BAYLOR SCOTT & WHITE MEDICAL CENTER GRAPEVINE OutpatientFacility | Aetna | Medicaid | $47.35 | $244.30 | $146.58 | 2026-02-21 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | United Healthcare of Indiana | Managed Medicaid | $47.71 | — | — | 2026-06-03 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | MEDICAID ILLINOIS [1091] | IN MCD-CIR-INDIANAPOLIS | $47.71 | $1,643.00 | $432.11 | 2025-07-01 | MRF ↗ |
| UofL Health - Medical Center East Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-08-01 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Anthem Blue Cross Blue Shield | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | CareSource Indiana Healthy Indiana Plan (HIP) | Managed Medicaid | $47.71 | — | — | 2026-06-03 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hip | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Humana | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | Managed Health Services (MHS) | Managed Medicaid | $47.71 | — | — | 2026-06-03 | MRF ↗ |
| REID HEALTH OutpatientFacility | MHS | Managed Medicaid | $47.71 | $7,801.82 | $5,071.18 | 2025-07-21 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | MDWISE [1175] | IN MCD-CIR-INDIANAPOLIS | $47.71 | $1,643.00 | $432.11 | 2025-07-01 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | ALT TRADITIONAL MEDICAID SECONDARY [109200] | IN MCD-CIR-INDIANAPOLIS | $47.71 | $1,643.00 | $432.11 | 2025-07-01 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2026-06-03 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hcc | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Caresource | In Medicaid Hip | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | MEDICAID INDIANA [2051] | HB XR INDIANA MEDICAID | $47.71 | $3,101.35 | $1,860.81 | 2025-12-19 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | HUMANA MEDICAID IN [3103] | HB XR INDIANA MEDICAID | $47.71 | $13,008.35 | $7,805.01 | 2025-12-19 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-22 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-14 | MRF ↗ |
| REID HEALTH OutpatientFacility | Humana of Indiana | Pathways for Aging/Managed Medicaid | $47.71 | $7,801.82 | $5,071.18 | 2025-07-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Humana | Pathways For Aging | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Healthwise (HHW) | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | CARESOURCE [2031] | HB XR INDIANA MEDICAID | $47.71 | $13,008.35 | $7,805.01 | 2025-12-19 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hip Bh | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | ANTHEM MEDICAID INDIANA [2212] | HB XR INDIANA MEDICAID | $47.71 | $8,978.32 | $5,386.99 | 2025-12-19 | MRF ↗ |
| CHRIST HOSPITAL Outpatient | MDWISE INDIANA MEDICAID [2214] | HB XR INDIANA MEDICAID | $47.71 | $8,978.32 | $5,386.99 | 2025-12-19 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Uhc | Pathways For Aging | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hhw | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hcc | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mdwise | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| UOFL HEALTH - SHELBYVILLE HOSPITAL Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mdwise | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| REID HEALTH OutpatientFacility | Anthem Blue Cross Blue Shield | Managed Medicaid | $47.71 | $7,801.82 | $5,071.18 | 2025-07-21 | MRF ↗ |
| UofL Health - Peace Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hcc Bh | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Uhc | Pathways For Aging | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| UofL Health - Medical Center Southwest Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| UofL Health - South Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Humana | Pathways For Aging | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| UofL Health - Frazier Rehabilitation Hospital - Brownsboro Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| UofL Health - Medical Center Northeast Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| REID HEALTH OutpatientFacility | Anthem Blue Cross Blue Shield | Pathways for Aging/Managed Medicaid | $47.71 | $7,801.82 | $5,071.18 | 2025-07-21 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-08-01 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | Pathways For Aging | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Caresource | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | MDWise | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hcc | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | MHS Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | Anthem | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Caresource | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | CareSource Indiana Healthy Indiana Plan (HIP) | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| FRANCISCAN HEALTH ORTHOPEDIC HOSPITAL CARMEL Outpatient | MEDICAID [1092] | IN MCD-CIR-INDIANAPOLIS | $47.71 | $1,643.00 | $432.11 | 2025-07-01 | MRF ↗ |
| REID HEALTH OutpatientFacility | Caresource of Indiana | Managed Medicaid | $47.71 | $7,801.82 | $5,071.18 | 2025-07-21 | MRF ↗ |
| REID HEALTH OutpatientFacility | MDWise | Managed Medicaid | $47.71 | $7,801.82 | $5,071.18 | 2025-07-21 | 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.