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 $199–$2,887 (25th–75th percentile) across 907 hospitals · 719 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/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.
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 |
|---|---|---|---|---|---|---|---|
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Anthem BCBS | All Products | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children's Hospital OutpatientFacility | Anthem BCBS | All Products | $0.03 | — | — | 2026-04-01 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Aetna | Medicaid Replacement | $0.13 | $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 ↗ |
| IBERIA MEDICAL CENTER Outpatient | Healthy Blue Community Care of LA MCD | Default | $0.13 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Gilsbar Inc | Default | $0.13 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | PPO Plus LLC | Default | $0.13 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | First Health | Default | $0.13 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Verity National Group | Default | $0.13 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Multiplan Inc. for American Family | Default | $0.13 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Humana Healthy Horizons MCD Rep | Medicaid Replacement | $0.13 | $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 | PHCS GEHA Govt Employee Health Assc | Default | $0.13 | $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 | UHC Community Plan LA MCD Rep | Default | $0.13 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Louisiana Healthcare Connections MCD Rep | Default | $0.13 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Peoples Health Network DOS lt 01012024 | Default | $0.13 | $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 | Humana | Medicare Advantage | — | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| 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 | WebTPA | Default | $0.13 | $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 Advantage of LA | Default | — | $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 ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusCentralHMO | $0.29 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusHMO | $0.29 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusHMO | $0.29 | — | — | 2025-04-16 | MRF ↗ |
| HEYWOOD HOSPITAL - Outpatient | Fallon | MedicarePlusCentralHMO | $0.29 | — | — | 2025-04-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Meritain | Default | $0.63 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Aetna | Default | $0.63 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Great West Healthcare | Default | $0.69 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | APWU Health Plan | Default | $0.69 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | CIGNA Healthspring MCR Adv | Default | $0.69 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Cigna | Default | $0.69 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Cigna PPO | Default | $0.69 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Aetna | Medicare Advantage | $0.98 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Medicare B LA JH | Default | $0.98 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| ESSENTIA HEALTH DULUTH OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | UHC Definity Services | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| ESSENTIA HEALTH OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | GEHA Multiplan Network | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | United Healthcare | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER OutpatientFacility | BLUE PLUS PMAP PCC PRIME | Medicaid | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Golden Rule Insurance Company | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | UMR United Medical Resources | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Blue Cross Blue Shield of LA | Default | $1.00 | $1.00 | $0.60 | 2025-07-16 | MRF ↗ |
| ESSENTIA HEALTH OutpatientFacility | BCBS PLUS PMAP PCC PRIME | Medicaid | $1.00 | — | — | 2026-01-01 | 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 ↗ |
| ST MARY'S MEDICAL CENTER Outpatient | UHC | UHC KS Medicaid | $44.02 | — | — | 2025-12-09 | MRF ↗ |
| ST JOSEPH MEDICAL CENTER Outpatient | UHC | UHC KS Medicaid | $44.02 | — | — | 2025-12-09 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Healthwise (HHW) | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | United Healthcare of Indiana | Managed Medicaid | $47.71 | — | — | 2025-03-27 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2025-03-27 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | CareSource Indiana Healthy Indiana Plan (HIP) | Managed Medicaid | $47.71 | — | — | 2025-03-27 | MRF ↗ |
| REID HEALTH OutpatientFacility | Anthem Blue Cross Blue Shield | Pathways for Aging/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 | MHS | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| REID HEALTH OutpatientFacility | MDWise | 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 | Anthem Blue Cross Blue Shield | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Humana | 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 ↗ |
| REID HEALTH OutpatientFacility | Anthem Blue Cross Blue Shield | Managed Medicaid | $47.71 | — | — | 2025-07-21 | 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 ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | Anthem | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| REID HEALTH OutpatientFacility | Caresource of Indiana | Managed Medicaid | $47.71 | — | — | 2025-07-21 | 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 ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | United Healthcare 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 ↗ |
| TERRE HAUTE REGIONAL HOSPITAL Outpatient | Hospice of Bloomington Hospital | MCR | $48.68 | — | — | 2024-10-01 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Anthem IN | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Anthem IN Pathways for Aging | 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 | MHS Behavioral | 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 | 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 ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| EAST COOPER MEDICAL CENTER Outpatient | BCBS-SC | BCBSSCState | $50.00 | — | — | 2024-12-08 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | MDwise Hoosier Healthwise (HHW) | Managed Medicaid | $50.10 | — | — | 2025-03-27 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Mdwise Hoosier Healthwise (HHW) | Managed Medicaid | $50.10 | — | — | 2025-04-24 | 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 ↗ |
| 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 ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID CENPATICO BHS [211] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID ANTHEM MAGELLAN HLT [212] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID MANAGED HEALTH [210] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID [200] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID ADVANTAGED HEALTH [201] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID MDWISE [220] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID MDWISE ST MARG BHS [224] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID MDWISE CARE SELECT [221] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID HIP [230] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | CARETAKER HIP [232] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | CARESOURCE HOOSIER HEALTHWISE [233] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID MANAGED HEALTH [210] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID PATHWAYS [270] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID MDWISE ST MARG BHS [224] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID MDWISE STC BHS [222] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID ADVANTAGED HEALTH [201] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | CARESOURCE HOOSIER HEALTHWISE [233] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID ANTHEM MAGELLAN HLT [212] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | FRANCISCAN ACO [236] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID HIP [230] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | CARETAKER HIP [232] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID PRESUMPTIVE [250] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID PATHWAYS [270] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID [200] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID MDWISE STC BHS [222] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID MDWISE HOOSIER BHS [223] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID MD WISE HIP STC BHS [231] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID MDWISE [220] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID HIP [230] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | CARESOURCE HOOSIER HEALTHWISE [233] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID MDWISE CARE SELECT [221] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID PATHWAYS [270] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | FRANCISCAN ACO [236] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID MDWISE ST MARG BHS [224] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | CARETAKER HIP [232] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | CARETAKER HIP [232] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID PRESUMPTIVE [250] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MDWISE [220] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID PATHWAYS [270] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID MDWISE [220] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MDWISE ST MARG BHS [224] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID MDWISE CARE SELECT [221] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID CENPATICO BHS [211] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID ANTHEM MAGELLAN HLT [212] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID MDWISE STC BHS [222] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID MD WISE HIP STC BHS [231] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID MANAGED HEALTH [210] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID ADVANTAGED HEALTH [201] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID CENPATICO BHS [211] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MANAGED HEALTH [210] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID PRESUMPTIVE [250] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID MDWISE HOOSIER BHS [223] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | CARESOURCE HOOSIER HEALTHWISE [233] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | FRANCISCAN ACO [236] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID [200] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID HIP [230] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MDWISE CARE SELECT [221] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MDWISE STC BHS [222] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MD WISE HIP STC BHS [231] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| Powers Health Rehabilitation Center Both | MEDICAID MDWISE HOOSIER BHS [223] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID ADVANTAGED HEALTH [201] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | FRANCISCAN ACO [236] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID [200] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID PRESUMPTIVE [250] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| COMMUNITY HOSPITAL Both | MEDICAID CENPATICO BHS [211] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID MDWISE HOOSIER BHS [223] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST MARY MEDICAL CENTER INC Both | MEDICAID MD WISE HIP STC BHS [231] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 2026-04-01 | MRF ↗ |
| ST CATHERINE HOSPITAL INC Both | MEDICAID ANTHEM MAGELLAN HLT [212] | Indiana Medicaid | $50.55 | $625.00 | $375.00 | 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 ↗ |
| IBERIA MEDICAL CENTER Outpatient | Multiplan Inc. for American Family | Default | $63.06 | $495.00 | $297.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Peoples Health Network DOS lt 01012024 | Default | $63.06 | $495.00 | $297.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | First Health | Default | $63.06 | $495.00 | $297.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Aetna | Medicaid Replacement | $63.06 | $495.00 | $297.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | PPO Plus LLC | Default | $63.06 | $495.00 | $297.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Humana Healthy Horizons MCD Rep | Medicaid Replacement | $63.06 | $495.00 | $297.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Healthy Blue Community Care of LA MCD | Default | $63.06 | $495.00 | $297.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | UHC Community Plan LA MCD Rep | Default | $63.06 | $495.00 | $297.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Louisiana Healthcare Connections MCD Rep | Default | $63.06 | $495.00 | $297.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Gilsbar Inc | Default | $63.06 | $495.00 | $297.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | WebTPA | Default | $63.06 | $495.00 | $297.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | Verity National Group | Default | $63.06 | $495.00 | $297.00 | 2025-07-16 | MRF ↗ |
| IBERIA MEDICAL CENTER Outpatient | PHCS GEHA Govt Employee Health Assc | Default | $63.06 | $495.00 | $297.00 | 2025-07-16 | MRF ↗ |
| METROHEALTH SYSTEM OutpatientFacility | Medical Mutual | Cle-Care Hmo | $64.09 | — | — | 2026-04-01 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $64.85 | — | — | 2026-04-17 | 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.