Q4197 — Puraply Xt 1 Sq Cm
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Puraply xt 1 sq cm (HCPCS Q4197) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Q4197?code_type=HCPCS
MLA (9th ed.)
“Puraply xt 1 sq cm (HCPCS Q4197) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Q4197?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Puraply xt 1 sq cm (HCPCS Q4197) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Q4197?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $126–$630 (25th–75th percentile) across 1,178 hospitals · 1,944 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS Q4197 — 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
$126
$213 typical
$630
The middle 50% of negotiated facility rates for this procedure, measured across 1,178 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $213 |
| Likely subtotal | $213 |
Facility charge (no separate professional fee)
$213
- 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 |
|---|---|---|---|---|---|---|---|
| ROUND ROCK MEDICAL CENTER Outpatient | Superior Health Plan | CHIP | $0.05 | $1.00 | $1.00 | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | Superior Health Plan | STAR | $0.05 | $1.00 | $1.00 | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | Superior Health Plan | STARPLUS | $0.05 | $1.00 | $1.00 | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | Superior Health Plan | CHPFC | $0.05 | $1.00 | $1.00 | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | Amerigroup | CHIP | $0.14 | $1.00 | $1.00 | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | Amerigroup | MCD | $0.14 | $1.00 | $1.00 | 2026-03-01 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $0.30 | $169.00 | — | 2025-12-31 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | UNITED HEALTHCARE | UNITED COMMERCIAL | $0.45 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | UNITED HEALTHCARE | UNITED COMMERCIAL | $0.45 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | First Health | PPO | $0.63 | $1.00 | $1.00 | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | First Health | PPO | $0.69 | $1.00 | $1.00 | 2026-03-01 | MRF ↗ |
| ROUND ROCK MEDICAL CENTER Outpatient | First Health | PPO | $0.72 | $1.00 | $1.00 | 2026-03-01 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | VIVA | VIVA COMMERCIAL | $0.80 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | AETNA | AETNA COMMERCIAL | $0.80 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | VIVA | VIVA COMMERCIAL | $0.80 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | AETNA | AETNA COMMERCIAL | $0.80 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | WELLCARE | WELLCARE MEDICARE | $1.00 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ESSENTIA HEALTH OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | CIGNA | CIGNA COMMERCIAL | $1.00 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | AMBETTER | AMBETTER COMMERCIAL | $1.00 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER OutpatientFacility | BLUE PLUS PMAP PCC PRIME | Medicaid | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | DEVOTED | DEVOTED MEDICARE | $1.00 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | WELLCARE | WELLCARE MEDICARE | $1.00 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ESSENTIA HEALTH DULUTH OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | AMBETTER | AMBETTER COMMERCIAL | $1.00 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | CIGNA | CIGNA COMMERCIAL | $1.00 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | BLUE CROSS TN | BLUE ADVANTAGE | $1.00 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | UNITED HEALTHCARE | UNITED MEDICARE | $1.00 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ESSENTIA HEALTH OutpatientFacility | BCBS PLUS PMAP PCC PRIME | Medicaid | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | UNITED HEALTHCARE | UNITED MEDICARE | $1.00 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | DEVOTED | DEVOTED MEDICARE | $1.00 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| ATHENS LIMESTONE HOSPITAL Both | BLUE CROSS TN | BLUE ADVANTAGE | $1.00 | $1.00 | $1.00 | 2026-03-25 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | UnitedHealth Group of WI | Medicare Advantage | $1.56 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $1.56 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $1.56 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $1.60 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $1.64 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| FLAMBEAU HOSPITAL OutpatientFacility | Point Comfort Underwriters | Organizational | $1.69 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $2.02 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $2.02 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Preferred Blue | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Aetna Healthcare | Medicare Advantage/QHP/Exchange | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Managed Medicaid | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | Medicare Advantage/VACCN | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage/Dual | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Blue Essentials | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | WellCare | Medicare Advantage | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Celtic | Exchange | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | All Payor | $2.03 | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Molina | Managed Medicaid | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Select Health | Managed Medicaid | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Humana | Medicare Advantage/Dual | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Blue Cross Blue Shield | State Health Plan | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Select Health | Medicare Advantage/Dual | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Devoted Health | Medicare Advantage | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Liberty Advantage | Medicare Advantage | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Blue Choice HMO | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Absolute Total Care | Managed Medicaid | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Blue Options | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | MME | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Molina | Exchange | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Molina | Medicare Advantage/Dual | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | OccuNet | Provider Alliance | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Point Comfort Underwriters | Organizational | $2.07 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $2.07 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Security Health Plan (SHP) | Medicare Advantage | $2.07 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Veteran's Administration (VA CCN) | VA Network | $2.07 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Anthem BCBS of WI | Medicare Advantage | $2.11 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL InpatientFacility | Cigna | Commercial | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL InpatientFacility | PHCS/Multiplan | Commercial | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Aetna Healthcare | Commercial HMO/PPO | $2.13 | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL InpatientFacility | United Healthcare | All Payor | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL InpatientFacility | United Healthcare | Options PPO | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - LADYSMITH OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $2.15 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Group Health Cooperative of Eau Claire | Medicare Advantage | $2.19 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| MARSHFIELD MEDICAL CENTER - NEILLSVILLE OutpatientFacility | Point Comfort Underwriters | Organizational | $2.28 | $421.60 | $400.52 | 2026-02-20 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | Options PPO | $2.32 | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Cigna | Commercial | $2.43 | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | PHCS/Multiplan | Commercial | $2.70 | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $7.59 | $4,216.00 | — | 2025-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $7.59 | $4,216.00 | — | 2024-12-31 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $7.59 | $4,216.00 | — | 2024-12-31 | MRF ↗ |
| SAVANNAH HEALTH SERVICES LLC DBA MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER Outpatient | Peach State | MGMCD | $13.21 | — | — | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Peach State | MGMCD | $13.21 | — | — | 2024-10-01 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | HORIZON | MANAGED MEDICAID | $16.90 | $169.00 | — | 2025-12-31 | MRF ↗ |
| GUNDERSEN ST JOSEPHS HOSPITAL AND CLINICS OutpatientFacility | Security Health Plan | All Products | $20.86 | $106.25 | $61.73 | 2025-06-27 | MRF ↗ |
| ARTESIA GENERAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $23.50 | $94.00 | $56.40 | 2026-02-20 | MRF ↗ |
| ARTESIA GENERAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $23.50 | $94.00 | $56.40 | 2026-02-20 | MRF ↗ |
| JONES REGIONAL MEDICAL CENTER OutpatientFacility | Health Partners Open Network | Commercial | $23.60 | $65.00 | $52.00 | 2026-01-28 | MRF ↗ |
| ARTESIA GENERAL HOSPITAL OutpatientFacility | Humana | ChoiceCare | $24.44 | $94.00 | $56.40 | 2026-02-20 | MRF ↗ |
| ARTESIA GENERAL HOSPITAL OutpatientFacility | Humana | ChoiceCare | $24.44 | $94.00 | $56.40 | 2026-02-20 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan – Hmo | $24.70 | — | — | 2026-03-01 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan | $24.70 | — | — | 2026-03-01 | MRF ↗ |
| HELEN NEWBERRY JOY HOSPITAL Outpatient | MI WC - ALL PLANS | MI WC - ALL PLANS | $25.57 | $71.04 | $44.76 | 2026-01-27 | MRF ↗ |
| ARTESIA GENERAL HOSPITAL InpatientFacility | Zelis | Worker's Compensation | $25.66 | $94.00 | $56.40 | 2026-02-20 | MRF ↗ |
| ARTESIA GENERAL HOSPITAL InpatientFacility | Zelis | Worker's Compensation | $25.66 | $94.00 | $56.40 | 2026-02-20 | MRF ↗ |
| JONES REGIONAL MEDICAL CENTER OutpatientFacility | Wellmark Blue Cross and Blue Shield | Medicare Advantage | $25.86 | $65.00 | $52.00 | 2026-01-28 | MRF ↗ |
| JONES REGIONAL MEDICAL CENTER OutpatientFacility | Aetna | Medicare Advantage | $26.00 | $65.00 | $52.00 | 2026-01-28 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $26.20 | $169.00 | — | 2025-12-31 | MRF ↗ |
| JONES REGIONAL MEDICAL CENTER OutpatientFacility | Iowa Health | Medicare Advantage | $26.62 | $65.00 | $52.00 | 2026-01-28 | MRF ↗ |
| JONES REGIONAL MEDICAL CENTER OutpatientFacility | Amerivantage | Medicare Advantage | $26.62 | $65.00 | $52.00 | 2026-01-28 | MRF ↗ |
| JONES REGIONAL MEDICAL CENTER OutpatientFacility | United Healthcare | Medicare Advantage | $26.65 | $65.00 | $52.00 | 2026-01-28 | MRF ↗ |
| JONES REGIONAL MEDICAL CENTER OutpatientFacility | Humana | Medicare Advantage | $26.65 | $65.00 | $52.00 | 2026-01-28 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Celtic Insurance Company | Medicare Advantage | $28.21 | $70.54 | $35.27 | 2026-03-17 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | UHC | VA CCN | $28.21 | $70.54 | $35.27 | 2026-03-17 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Humana | ChoiceCare | $28.21 | $70.54 | $35.27 | 2026-03-17 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Wellcare | by Allwell Medicare Advantage | $28.21 | $70.54 | $35.27 | 2026-03-17 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Sunflower State | Medicare Advantage | $28.21 | $70.54 | $35.27 | 2026-03-17 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | ANTHEM | HPN | $28.33 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | ANTHEM | HPN | $28.33 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| JONES REGIONAL MEDICAL CENTER OutpatientFacility | Iowa Total Care | Managed Medicaid | $28.60 | $65.00 | $52.00 | 2026-01-28 | MRF ↗ |
| JONES REGIONAL MEDICAL CENTER OutpatientFacility | Amerigroup | Managed Medicaid | $28.60 | $65.00 | $52.00 | 2026-01-28 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Triwest | All Plans | $29.70 | $70.54 | $35.27 | 2026-03-17 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $30.42 | $169.00 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $30.42 | $169.00 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $30.42 | $169.00 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $30.42 | $169.00 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $30.42 | $169.00 | — | 2025-12-31 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $30.42 | $169.00 | — | 2025-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $30.59 | $169.00 | — | 2025-12-31 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Celtic Insurance Company | HMO | $31.03 | $70.54 | $35.27 | 2026-03-17 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Celtic Insurance Company | PPO | $31.03 | $70.54 | $35.27 | 2026-03-17 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Sunflower State | CommercialExchange | $31.03 | $70.54 | $35.27 | 2026-03-17 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Ambetter | HMO | $31.03 | $70.54 | $35.27 | 2026-03-17 | MRF ↗ |
| KINGMAN HEALTHCARE CENTER OutpatientFacility | Ambetter | PPO | $31.03 | $70.54 | $35.27 | 2026-03-17 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | ANTHEM | PPO/HMO | $31.47 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | ANTHEM | PPO/HMO | $31.47 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | PACE | Senior Care Partners | $32.30 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | PACE | Senior Care Partners | $32.30 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| JONES REGIONAL MEDICAL CENTER InpatientFacility | Health Partners Open Network | Commercial | $32.50 | $65.00 | $52.00 | 2026-01-28 | 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 ↗ |
| JONES REGIONAL MEDICAL CENTER InpatientFacility | Wellmark Blue Cross and Blue Shield | HMO | $33.15 | $65.00 | $52.00 | 2026-01-28 | MRF ↗ |
| JONES REGIONAL MEDICAL CENTER InpatientFacility | Wellmark Blue Cross and Blue Shield | PPO | $33.15 | $65.00 | $52.00 | 2026-01-28 | MRF ↗ |
| JONES REGIONAL MEDICAL CENTER InpatientFacility | Wellmark UPH Self-Funded | Commercial | $33.15 | $65.00 | $52.00 | 2026-01-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $33.26 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $33.26 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $33.26 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $33.26 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| EUCLID HOSPITAL OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $33.26 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $33.26 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| UNION HOSPITAL OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $33.26 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $33.26 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | MMO | ALL PRODUCTS | $33.72 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | MMO | ALL PRODUCTS | $33.72 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | MMO | ALL PRODUCTS | $33.87 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| EUCLID HOSPITAL OutpatientFacility | MMO | ALL PRODUCTS | $33.87 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | MMO | ALL PRODUCTS | $33.87 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | MMO | ALL PRODUCTS | $33.87 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | BCBS | MAPPO | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Railroad Medicare | Medicare | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Health Alliance Plan | Medicare Advantage | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | PHP | Medicare Advantage | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | UHC | Exchange | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | UHC | Dual Complete DSNP | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | UHC | Exchange | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | PHP | Medicare Advantage | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | PACE | SWMI | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | BCBS | MAPPO | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Health Alliance Plan | Medicare Advantage | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | BCN | Medicare Advantage | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | VA | VA | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | VA | VA | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | UHC | Medicare Advantage | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | UHC | Medicare Advantage | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | UHC | Dual Complete DSNP | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | PACE | SWMI | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Railroad Medicare | Medicare | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | BCN | Medicare Advantage | $34.00 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Priority Health | Medicare | $34.34 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Priority Health | Medicare | $34.34 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $34.48 | $169.00 | — | 2025-12-31 | 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 ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $35.32 | $169.00 | — | 2025-12-31 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Aetna | Medicare | $35.36 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Aetna | Medicare | $35.36 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $35.49 | $169.00 | — | 2025-12-31 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Meridian | Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage | $35.70 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Meridian | Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage | $35.70 | $136.00 | $108.80 | 2026-02-01 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $35.83 | $169.00 | — | 2025-12-31 | MRF ↗ |
| ARTESIA GENERAL HOSPITAL InpatientFacility | First Health | Workers Compensation | $36.29 | $94.00 | $56.40 | 2026-02-20 | MRF ↗ |
| ARTESIA GENERAL HOSPITAL InpatientFacility | First Health | Workers Compensation | $36.29 | $94.00 | $56.40 | 2026-02-20 | MRF ↗ |
| AMBERWELL ATCHISON ASSOCIATION Outpatient | BCBS BLUE CHOICE | BCBS BLUE CHOICE | $36.46 | $3,785.00 | $3,785.00 | 2026-03-13 | MRF ↗ |
| HIAWATHA COMMUNITY HOSPITAL Outpatient | BCBS BLUE CHOICE | BCBS BLUE CHOICE | $36.46 | $3,785.00 | $3,785.00 | 2026-02-19 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $36.84 | $169.00 | — | 2025-12-31 | MRF ↗ |
| LEE'S SUMMIT MEDICAL CENTER Outpatient | HealthyBlue | MGMCD | $37.06 | $185.30 | $185.30 | 2026-03-01 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | OPTUM HEALTH | MANAGED MEDICAID | $37.18 | $169.00 | — | 2025-12-31 | MRF ↗ |
| MERCY HOSPITAL - CASSVILLE OutpatientFacility | KANCARE CONTRACTED [320213] | HB CASV AETNA BETTER HEALTH (KANCARE) | $37.50 | $150.00 | $97.50 | 2026-03-15 | MRF ↗ |
| MERCY HOSPITAL - CASSVILLE OutpatientFacility | KANCARE [20213] | HB CASV AETNA BETTER HEALTH (KANCARE) | $37.50 | $150.00 | $97.50 | 2026-03-15 | MRF ↗ |
| ARTESIA GENERAL HOSPITAL InpatientFacility | Zelis | Auto | $37.60 | $94.00 | $56.40 | 2026-02-20 | MRF ↗ |
| ARTESIA GENERAL HOSPITAL InpatientFacility | Zelis | Auto | $37.60 | $94.00 | $56.40 | 2026-02-20 | MRF ↗ |
| CLARKE COUNTY HOSPITAL OutpatientFacility | Iowa Total Care | Managed Medicaid | $38.35 | $65.00 | $65.00 | 2025-05-01 | MRF ↗ |
| CLARKE COUNTY HOSPITAL OutpatientFacility | Molina Healthcare | Managed Medicaid | $38.35 | $65.00 | $65.00 | 2025-05-01 | MRF ↗ |
| CLARKE COUNTY HOSPITAL OutpatientFacility | Wellpoint | Managed Medicaid | $38.35 | $65.00 | $65.00 | 2025-05-01 | MRF ↗ |
| AMBERWELL ATCHISON ASSOCIATION Outpatient | BCBS CAP - ALL OTHER PLANS | BCBS CAP - ALL OTHER PLANS | $38.38 | $3,785.00 | $3,785.00 | 2026-03-13 | 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.