Q4169 — Artacent Wound, Per Sq Cm
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Artacent wound, per sq cm (HCPCS Q4169) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Q4169?code_type=HCPCS
MLA (9th ed.)
“Artacent wound, per sq cm (HCPCS Q4169) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Q4169?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Artacent wound, per sq cm (HCPCS Q4169) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Q4169?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $176–$2,398 (25th–75th percentile) across 1,020 hospitals · 773 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS Q4169 — 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
$176
$686 typical
$2,398
The middle 50% of negotiated facility rates for this procedure, measured across 1,020 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $686 |
| Likely subtotal | $686 |
Facility charge (no separate professional fee)
$686
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 $176–$2,398.
- 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 |
|---|---|---|---|---|---|---|---|
| IBERIA MEDICAL CENTER Outpatient | Vantage Health/Primewell MCR Adv AR MS only | Default | — | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Tricare East Region DOS lt 01012025 | Default | — | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Blue Cross Blue Shield of LA | Medicare Advantage | — | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Medicare A LA JH | Default | — | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Humana | Medicare Advantage | — | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Blue Advantage of LA | Default | — | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | VAPCCC3 All Regions 1-6 DOS GT 1/30/19 | Federal | — | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Primewell Vantage Health Plan | Default | — | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Wellcare Health Plan Inc MCR Adv | Default | — | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - VACAVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FREMONT Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSP SO SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ANTIOCH Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WALNUT CREEK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MANTECA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ROSEVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SAN JOSE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| SAN FRANCISCO VA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL AND REHAB CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FRESNO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| SANTA ROSA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MODESTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| San Leandro Hospital Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - REDWOOD CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SANTA CLARA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ANTIOCH Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MANTECA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-18 | MRF ↗ |
| San Leandro Hospital Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MODESTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SANTA CLARA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - VACAVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL AND REHAB CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WALNUT CREEK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SAN JOSE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FRESNO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FREMONT Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - REDWOOD CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ROSEVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| SAN FRANCISCO VA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| SANTA ROSA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-18 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSP SO SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WALNUT CREEK Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SAN JOSE Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MODESTO Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ANTIOCH Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL AND REHAB CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MANTECA Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSP SO SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ROSEVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FREMONT Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - REDWOOD CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| SANTA ROSA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-18 | MRF ↗ |
| SAN FRANCISCO VA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - VACAVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SANTA CLARA Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-15 | MRF ↗ |
| San Leandro Hospital Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FRESNO Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $1.00 | $0.56 | 2026-07-17 | 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 | BCBSSCPreferredBlue | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCBlueChoice | $34.60 | — | — | 2024-12-08 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Anthem | Medicaid | $37.56 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Mdwise | Hip | $37.56 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Caresource | Commercial | $37.56 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Mdwise | Medicaid | $37.56 | — | — | 2026-07-17 | MRF ↗ |
| INDEPENDENCE HEALTH SYSTEM BUTLER MEMORIAL HOSPITA Outpatient | Ccbh - Behavioral Health | Behavioral | — | — | — | 2026-07-19 | MRF ↗ |
| ST JOSEPH MEDICAL CENTER Outpatient | UHC | UHC KS Medicaid | $44.02 | — | — | 2025-12-09 | MRF ↗ |
| ST MARY'S MEDICAL CENTER Outpatient | UHC | UHC KS Medicaid | $44.02 | — | — | 2025-12-09 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Caresource | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hcc | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-22 | 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 ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-14 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-08-01 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hcc | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Humana | Pathways For Aging | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mhs | In Medicaid Hhw | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| REID HEALTH OutpatientFacility | Caresource of Indiana | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mdwise | In Medicaid Hhw | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hip Bh | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mdwise | In Medicaid Hip | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mhs | In Medicaid Hip | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| UofL Health - Medical Center Southwest Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Caresource | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mdwise | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Uhc | Pathways For Aging | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mhs | In Medicaid Hcc | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| UofL Health - Medical Center East Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-08-01 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Anthem | In Medicaid Hcc | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Anthem | Pathways For Aging | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Anthem | In Medicaid Hhw | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Caresource | In Medicaid Hip | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hip | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hhw | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Humana | Pathways For Aging | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Humana | Pathways For Aging | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hip | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Uhc | Pathways For Aging | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hhw | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| REID HEALTH OutpatientFacility | Anthem Blue Cross Blue Shield | Pathways for Aging/Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | Pathways For Aging | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| REID HEALTH OutpatientFacility | MDWise | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| REID HEALTH OutpatientFacility | Anthem Blue Cross Blue Shield | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| REID HEALTH OutpatientFacility | MHS | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2026-06-03 | MRF ↗ |
| REID HEALTH OutpatientFacility | Humana of Indiana | Pathways for Aging/Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | United Healthcare of Indiana | Managed Medicaid | $47.71 | — | — | 2026-06-03 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | CareSource Indiana Healthy Indiana Plan (HIP) | Managed Medicaid | $47.71 | — | — | 2026-06-03 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | Managed Health Services (MHS) | Managed Medicaid | $47.71 | — | — | 2026-06-03 | MRF ↗ |
| UOFL HEALTH - SHELBYVILLE HOSPITAL Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Humana | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hcc Bh | $47.71 | — | — | 2026-05-13 | 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 ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | MDWise | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | MHS Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | Anthem | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| UofL Health - South Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | Exchange | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hip | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | CareSource Indiana Healthy Indiana Plan (HIP) | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Anthem | In Medicaid Hip | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| UofL Health - Peace Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Uhc | Pathways For Aging | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mdwise | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Anthem Blue Cross Blue Shield | 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 ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Caresource | In Medicaid Hhw | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | CareSource Indiana Hoosier Healthwise (HHW) | Managed Medicaid | $48.19 | — | — | 2026-06-03 | 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 ↗ |
| 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 ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hhw Bh | $48.68 | — | — | 2026-05-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Anthem IN | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | MDWise HIP | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Caresource HIP | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Anthem HIP | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| TERRE HAUTE REGIONAL HOSPITAL Outpatient | Hospice of Bloomington Hospital | MCR | $48.68 | — | — | 2024-10-01 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Caresource IN | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | MHS Behavioral | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | United Healthcare IN | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Caresource | In Medicaid Hip | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hcc | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | Pathways For Aging | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Humana | Pathways For Aging | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hip | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Caresource | In Medicaid Hhw | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hhw | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hip | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| NORTON-KING'S DAUGHTERS' HEALTH OutpatientFacility | Anthem of Indiana | Managed Medicaid | $48.68 | — | — | 2026-05-05 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Anthem Indiana | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Caresource Hhw | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| UNIVERSITY OF LOUISVILLE HOSPITAL Outpatient | Anthem | In Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Mdwise Bhmi | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Meridian | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Uhc | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Aetna | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Bcbs | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hip | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Uhc | Pathways For Aging | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Caresource Hip | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hhw | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Anthem | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| UOFL HEALTH - SHELBYVILLE HOSPITAL Outpatient | Anthem | In Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Uhc Pathways | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Molina | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Uhc | In Medicaid Hcc | $48.68 | — | — | 2026-09-21 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | CareSource Indiana Hoosier Healthwise (HHW) | Managed Medicaid | $49.14 | — | — | 2025-04-24 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $49.14 | — | — | 2025-04-24 | MRF ↗ |
| UNIVERSITY OF LOUISVILLE HOSPITAL Outpatient | Anthem | In Medicaid | $49.24 | — | — | 2026-05-14 | MRF ↗ |
| UNIVERSITY OF LOUISVILLE HOSPITAL Outpatient | Anthem | In Medicaid | $49.24 | — | — | 2026-05-22 | 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 ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | Geha | Geha | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-07-15 | 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.