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 $127–$851 (25th–75th percentile) across 1,358 hospitals · 2,007 payers.
“Negotiated” is the hospital’s negotiated facility rate for this 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
$127
$211 typical
$851
The middle 50% of negotiated facility rates for this procedure, measured across 1,358 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $211 |
| Likely subtotal | $211 |
Facility charge (no separate professional fee)
$211
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 $127–$851.
- 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 |
|---|---|---|---|---|---|---|---|
| NEWBERRY COUNTY MEMORIAL HOSPITAL OutpatientFacility | Molina | Medicare Advantage/Dual | — | $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 | United Healthcare | Managed Medicaid | — | $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 | Preferred Blue | — | $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 | Celtic | Exchange | — | $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 | Select Health | 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 | Humana | 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 ↗ |
| 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 | Blue Cross Blue Shield | Blue Essentials | — | $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 | WellCare | Medicare Advantage | — | $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 | 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 | Devoted Health | Medicare Advantage | — | $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 | Absolute Total Care | Managed Medicaid | — | $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 | PHCS/Multiplan | Commercial | — | $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 ↗ |
| NEWBERRY COUNTY MEMORIAL HOSPITAL InpatientFacility | Cigna | Commercial | — | $3.00 | $1.11 | 2025-09-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MANTECA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-18 | MRF ↗ |
| San Leandro Hospital Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FRESNO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| SANTA ROSA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WALNUT CREEK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ROSEVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SAN JOSE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL AND REHAB CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SANTA CLARA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MODESTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSP SO SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FREMONT Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| SAN FRANCISCO VA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - VACAVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ANTIOCH Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - REDWOOD CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSP SO SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ANTIOCH Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ROSEVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - REDWOOD CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - VACAVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WALNUT CREEK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SAN JOSE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FREMONT Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| San Leandro Hospital Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SANTA CLARA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| SANTA ROSA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-18 | MRF ↗ |
| SAN FRANCISCO VA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL AND REHAB CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MODESTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MANTECA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FRESNO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MANTECA Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-18 | MRF ↗ |
| SANTA ROSA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ANTIOCH Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSP SO SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ROSEVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| San Leandro Hospital Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - VACAVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WALNUT CREEK Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FRESNO Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MODESTO Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| SAN FRANCISCO VA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FREMONT Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SANTA CLARA Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - REDWOOD CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL AND REHAB CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SAN JOSE Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $30.00 | $16.80 | 2026-07-17 | MRF ↗ |
| ST FRANCIS REGIONAL MEDICAL CENTER Inpatient | Aetna Direct/Indirect Regional Network | Aetna Direct/Indirect Regional (Bdosv) | $32.01 | $54.00 | $30.24 | 2026-07-15 | MRF ↗ |
| BUFFALO HOSPITAL Inpatient | Aetna Direct/Indirect Regional Network | Aetna Direct/Indirect Regional (Bdosv) | $32.01 | $54.00 | $30.24 | 2026-07-15 | MRF ↗ |
| CAMBRIDGE MEDICAL CENTER Inpatient | Aetna Direct/Indirect Regional Network | Aetna Direct/Indirect Regional (Bdosv) | $32.01 | $54.00 | $30.24 | 2026-07-15 | MRF ↗ |
| ALLINA HEALTH FARIBAULT MEDICAL CENTER Inpatient | Aetna Direct/Indirect Regional Network | Aetna Direct/Indirect Regional (Bdosv) | $32.01 | $54.00 | $30.24 | 2026-07-31 | MRF ↗ |
| OWATONNA HOSPITAL Inpatient | Aetna Direct/Indirect Regional Network | Aetna Direct/Indirect Regional (Bdosv) | $32.01 | $54.00 | $30.24 | 2026-07-31 | MRF ↗ |
| ST FRANCIS REGIONAL MEDICAL CENTER Outpatient | Aetna Direct/Indirect Regional Network | Aetna Direct/Indirect Regional (Bdosv) | $32.10 | $54.00 | $30.24 | 2026-07-15 | MRF ↗ |
| CAMBRIDGE MEDICAL CENTER Outpatient | Aetna Direct/Indirect Regional Network | Aetna Direct/Indirect Regional (Bdosv) | $32.10 | $54.00 | $30.24 | 2026-07-15 | MRF ↗ |
| OWATONNA HOSPITAL Outpatient | Aetna Direct/Indirect Regional Network | Aetna Direct/Indirect Regional (Bdosv) | $32.10 | $54.00 | $30.24 | 2026-07-31 | MRF ↗ |
| ALLINA HEALTH FARIBAULT MEDICAL CENTER Outpatient | Aetna Direct/Indirect Regional Network | Aetna Direct/Indirect Regional (Bdosv) | $32.10 | $54.00 | $30.24 | 2026-07-31 | MRF ↗ |
| BUFFALO HOSPITAL Outpatient | Aetna Direct/Indirect Regional Network | Aetna Direct/Indirect Regional (Bdosv) | $32.10 | $54.00 | $30.24 | 2026-07-15 | 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 ↗ |
| RIVER FALLS AREA HOSPITAL Inpatient | Aetna | Aetna Elevate (N R) | $33.09 | $54.00 | $30.24 | 2026-07-15 | 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 ↗ |
| 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 ↗ |
| JONES REGIONAL MEDICAL CENTER InpatientFacility | Wellmark Blue Cross and Blue Shield | HMO | $33.15 | $65.00 | $52.00 | 2026-01-28 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $33.26 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| MEDINA HOSPITAL OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $33.26 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| RIVER FALLS AREA HOSPITAL Outpatient | Aetna | Aetna Elevate (N R) | $33.42 | $54.00 | $30.24 | 2026-07-15 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | MMO | ALL PRODUCTS | $33.72 | $152.56 | $99.16 | 2026-06-15 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | MMO | ALL PRODUCTS | $33.87 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| MEDINA HOSPITAL OutpatientFacility | MMO | ALL PRODUCTS | $33.87 | $152.56 | $99.16 | 2025-06-28 | MRF ↗ |
| BRONSON LAKEVIEW HOSPITAL OutpatientFacility | Railroad Medicare | Medicare | $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 | 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 | 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 | UHC | 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 | PACE | SWMI | $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 | 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 | PACE | SWMI | $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 | BCN | 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 | 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 | PHP | Medicare Advantage | $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 | 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 ↗ |
| SAINT ANNE'S HOSPITAL Inpatient | Self Pay Non-Traditional | Self Pay Non-Traditional | $34.36 | $429.52 | $429.52 | 2026-07-17 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $34.48 | $169.00 | — | 2025-12-31 | 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 ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $34.81 | $169.00 | — | 2025-12-31 | MRF ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $34.81 | $169.00 | — | 2025-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $34.81 | $169.00 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $35.32 | $169.00 | — | 2025-12-31 | 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 ↗ |
| 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 ↗ |
| RIVER FALLS AREA HOSPITAL Inpatient | Aetna | Aetna Performance (N R) | $35.74 | $54.00 | $30.24 | 2026-07-15 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $35.83 | $169.00 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $35.83 | $169.00 | — | 2025-12-31 | MRF ↗ |
| RIVER FALLS AREA HOSPITAL Outpatient | Aetna | Aetna Performance (N R) | $36.10 | $54.00 | $30.24 | 2026-07-15 | MRF ↗ |
| ABBOTT NORTHWESTERN HOSPITAL Inpatient | Americas Ppo (Araz)(A M U) | Americas Ppo (Araz)(A M U) | $36.14 | $54.00 | $25.92 | 2026-07-15 | MRF ↗ |
| UNITED MEDICAL CENTER Inpatient | Americas Ppo (Araz)(A M U) | Americas Ppo (Araz)(A M U) | $36.14 | $54.00 | $25.92 | 2026-07-15 | 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 ↗ |
| HIAWATHA COMMUNITY HOSPITAL Outpatient | BCBS BLUE CHOICE | BCBS BLUE CHOICE | $36.46 | $3,785.00 | $3,785.00 | 2026-02-19 | MRF ↗ |
| AMBERWELL ATCHISON ASSOCIATION Outpatient | BCBS BLUE CHOICE | BCBS BLUE CHOICE | $36.46 | $3,785.00 | $3,785.00 | 2026-03-13 | MRF ↗ |
| CAMBRIDGE MEDICAL CENTER Outpatient | Healthpartners | Hpi (Bdov) | $36.56 | $54.00 | $30.24 | 2026-07-15 | MRF ↗ |
| ALLINA HEALTH FARIBAULT MEDICAL CENTER Outpatient | Healthpartners | Hpi (Bdov) | $36.56 | $54.00 | $30.24 | 2026-07-31 | MRF ↗ |
| OWATONNA HOSPITAL Outpatient | Healthpartners | Hpi (Bdov) | $36.56 | $54.00 | $30.24 | 2026-07-31 | MRF ↗ |
| BUFFALO HOSPITAL Outpatient | Healthpartners | Hpi (Bdov) | $36.56 | $54.00 | $30.24 | 2026-07-15 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $36.84 | $169.00 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $36.84 | $169.00 | — | 2025-12-31 | MRF ↗ |
| CLINTON REGIONAL HOSPITAL Outpatient | United Healthcare | Commercial | $37.00 | $124.00 | $124.00 | 2026-05-18 | 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 ↗ |
| 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 | 2026-06-10 | MRF ↗ |
| MERCY HOSPITAL - CASSVILLE OutpatientFacility | KANCARE [20213] | HB CASV AETNA BETTER HEALTH (KANCARE) | $37.50 | $150.00 | $97.50 | 2026-06-10 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Caresource | Commercial | $37.56 | — | — | 2026-07-17 | 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 | Mdwise | Medicaid | $37.56 | — | — | 2026-07-17 | 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 ↗ |
| HIAWATHA COMMUNITY HOSPITAL Outpatient | BCBS CAP - ALL OTHER PLANS | BCBS CAP - ALL OTHER PLANS | $38.38 | $3,785.00 | $3,785.00 | 2026-02-19 | 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 ↗ |
| UNITED MEDICAL CENTER Outpatient | Medica Health System | Medica Elect (U M) | $38.72 | $54.00 | $25.92 | 2026-07-15 | MRF ↗ |
| ABBOTT NORTHWESTERN HOSPITAL Outpatient | Medica Health System | Medica Elect (A) | $38.72 | $54.00 | $25.92 | 2026-07-15 | MRF ↗ |
| ST FRANCIS REGIONAL MEDICAL CENTER Outpatient | Medica Health System | Medica Elect (B D O S V) | $38.73 | $54.00 | $30.24 | 2026-07-15 | MRF ↗ |
| CAMBRIDGE MEDICAL CENTER Outpatient | Medica Health System | Medica Elect (B D O S V) | $38.73 | $54.00 | $30.24 | 2026-07-15 | MRF ↗ |
| BUFFALO HOSPITAL Outpatient | Medica Health System | Medica Elect (B D O S V) | $38.73 | $54.00 | $30.24 | 2026-07-15 | MRF ↗ |
| OWATONNA HOSPITAL Outpatient | Medica Health System | Medica Elect (B D O S V) | $38.73 | $54.00 | $30.24 | 2026-07-31 | MRF ↗ |
| ALLINA HEALTH FARIBAULT MEDICAL CENTER Outpatient | Medica Health System | Medica Elect (B D O S V) | $38.73 | $54.00 | $30.24 | 2026-07-31 | MRF ↗ |
| HEDRICK MEDICAL CENTER Both | TRANSPLANTS-CASE RATES [5750] | TRANSPLANT CASE RATE [57508] | $39.04 | $122.00 | $73.20 | 2025-12-31 | MRF ↗ |
| HEDRICK MEDICAL CENTER Both | MEDICARE REPLACEMENT PLAN [1250] | MEDICA PRIME SOLUTION MEDICARE COSTSHARE [12526] | $39.04 | $122.00 | $73.20 | 2025-12-31 | MRF ↗ |
| HEDRICK MEDICAL CENTER Both | TRANSPLANTS-CASE RATES [5750] | TRANSPLANT SINGLE CASE AGREEMENT [57507] | $39.04 | $122.00 | $73.20 | 2025-12-31 | MRF ↗ |
| HEDRICK MEDICAL CENTER Both | MEDICARE REPLACEMENT PLAN [1250] | AETNA MEDICARE ADVANTAGE LEGACY PPO [12524] | $39.04 | $122.00 | $73.20 | 2025-12-31 | MRF ↗ |
| HEDRICK MEDICAL CENTER Both | TRANSPLANTS-CASE RATES [5750] | PRETRANSPLANT [57510] | $39.04 | $122.00 | $73.20 | 2025-12-31 | MRF ↗ |
| HEDRICK MEDICAL CENTER Both | MEDICARE REPLACEMENT PLAN [1250] | HUMANA MEDICARE [12505] | $39.04 | $122.00 | $73.20 | 2025-12-31 | MRF ↗ |
| HEDRICK MEDICAL CENTER Both | MEDICARE REPLACEMENT PLAN [1250] | UHC MEDICARE COMPLETE AARP [12509] | $39.04 | $122.00 | $73.20 | 2025-12-31 | MRF ↗ |
| HEDRICK MEDICAL CENTER Both | MEDICARE REPLACEMENT PLAN [1250] | BC OUT OF AREA MEDICARE ADVANTAGE [12502] | $39.04 | $122.00 | $73.20 | 2025-12-31 | MRF ↗ |
| HEDRICK MEDICAL CENTER Both | MEDICARE REPLACEMENT PLAN [1250] | UHC DUAL COMPLETE SNP KS [12521] | $39.04 | $122.00 | $73.20 | 2025-12-31 | MRF ↗ |
| HEDRICK MEDICAL CENTER Both | TRANSPLANTS-CASE RATES [5750] | HB MEDICARE REPLACEMENT TRANSPLANT [57514] | $39.04 | $122.00 | $73.20 | 2025-12-31 | MRF ↗ |
| HEDRICK MEDICAL CENTER Both | TRANSPLANTS-CASE RATES [5750] | HUMANA GOVT TRANSPLANT [57518] | $39.04 | $122.00 | $73.20 | 2025-12-31 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.