Q4199 — Cygnus Matrix, Per Sq Cm
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Cygnus matrix, per sq cm (HCPCS Q4199) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Q4199?code_type=HCPCS
MLA (9th ed.)
“Cygnus matrix, per sq cm (HCPCS Q4199) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Q4199?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Cygnus matrix, per sq cm (HCPCS Q4199) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Q4199?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $176–$923 (25th–75th percentile) across 1,215 hospitals · 1,531 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS Q4199 — 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
$345 typical
$923
The middle 50% of negotiated facility rates for this procedure, measured across 1,215 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $345 |
| Likely subtotal | $345 |
Facility charge (no separate professional fee)
$345
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–$923.
- 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 |
|---|---|---|---|---|---|---|---|
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | — | — | — | $844.72 | $422.36 | 2024-12-15 | MRF ↗ |
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | — | — | — | $844.72 | $422.36 | 2024-12-15 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Healthcare Highways | PPO | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | United Healthcare | All Payer | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Imperial Health Plan | MM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | United Healthcare | VA CCN MM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | United Healthcare | Star KM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Naphcare Inc. | RRMB | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | United Healthcare | Star Kids KM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Superior | Star KM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Molina | Healthspring Star Plus KM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Superior | Star Kids KM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Coventry | First Health | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Cigna | PPO | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Aetna | MM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Superior | Chip KM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Molina | Chip KM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Texas Childrens Health Plan | Star Plus KM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Christus Health | HIX | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Molina | Star Plus KM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Amerigroup | Star KM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Triwest | VA MM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Healthsmart | Preferred | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Aetna | All Plans | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Amerigroup | MM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Coventry | First Health PPO | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Christus Health | Med Adv MM | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | United Healthcare | HIX | — | — | — | 2026-01-12 | MRF ↗ |
| CHRISTUS MOTHER FRANCES HOSPITAL SULPHUR SPRINGS OutpatientFacility | Phcs | PPO | — | — | — | 2026-01-12 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL AND REHAB CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FREMONT Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MODESTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| San Leandro Hospital Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - VACAVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FRESNO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-17 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ROSEVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| SANTA ROSA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSP SO SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ANTIOCH Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - REDWOOD CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SANTA CLARA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WALNUT CREEK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MANTECA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SAN JOSE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-17 | MRF ↗ |
| SAN FRANCISCO VA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicaid] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL AND REHAB CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SOUTH SAN FRANCISCO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| San Leandro Hospital Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - WALNUT CREEK Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SANTA CLARA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - VACAVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-17 | MRF ↗ |
| SANTA ROSA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-18 | MRF ↗ |
| SAN FRANCISCO VA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - REDWOOD CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ROSEVILLE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FREMONT Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FRESNO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MODESTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ANTIOCH Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MANTECA Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-18 | MRF ↗ |
| MT SAN RAFAEL HOSPITAL Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-17 | MRF ↗ |
| KAISER FOUNDATION HOSP SO SACRAMENTO Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SAN JOSE Both | [Kaiser Foundation Health Plan, Inc.] | [Medicare] | — | $80.00 | $44.80 | 2026-07-17 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | CareSource | CareSource | $32.02 | $258.00 | $193.50 | 2026-02-15 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $32.20 | $154.06 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $32.20 | $154.06 | — | 2025-12-31 | MRF ↗ |
| METHODIST MANSFIELD MEDICAL CENTER Both | MOLINA MEDICAID MANAGED CARE [5005] | MHS HB MEDICAID 110% STAR PLUS MMMC | $32.30 | $121.88 | $60.94 | 2026-03-21 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $32.35 | $154.06 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $32.35 | $154.06 | — | 2025-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $32.55 | $180.84 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $32.55 | $180.84 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $32.55 | $180.84 | — | 2025-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $32.55 | $180.84 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $32.55 | $180.84 | — | 2025-12-31 | MRF ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $32.55 | $180.84 | — | 2025-12-31 | MRF ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $32.55 | $180.84 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $32.55 | $180.84 | — | 2025-12-31 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $32.55 | $180.84 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $32.55 | $180.84 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $32.55 | $180.84 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $32.55 | $180.84 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $32.55 | $180.84 | — | 2025-12-31 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Centene | Peach State Medicaid | $32.59 | $258.00 | $193.50 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Institutional GA Medicaid | Institutional GA Medicaid | $32.59 | $258.00 | $193.50 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Institutional Gwinnett County Govt | Institutional Gwinnett County Govt | $32.59 | $258.00 | $193.50 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Amerigroup | Amerigroup Medicaid | $32.59 | $258.00 | $193.50 | 2026-02-14 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $32.66 | $154.06 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $32.66 | $154.06 | — | 2025-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $32.73 | $180.84 | — | 2025-12-31 | MRF ↗ |
| MIDLAND MEMORIAL HOSPITAL OutpatientFacility | Bcbs Advantage | Exchange | $33.04 | — | — | 2026-04-01 | MRF ↗ |
| MIDLAND MEMORIAL HOSPITAL OutpatientFacility | Bcbs Advantage | Exchange | $33.04 | — | — | 2026-04-01 | 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 ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Institutional 115 Percent_Georgia Medicaid | Institutional 115 Percent_Georgia Medicaid | $33.16 | $258.00 | $193.50 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | CareSource | CareSource | $33.57 | $258.00 | $193.50 | 2026-02-14 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $33.59 | $154.06 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $33.59 | $154.06 | — | 2025-12-31 | MRF ↗ |
| Baylor Scott & White Medical Center - Lakeway OutpatientFacility | Blue Cross Blue Shield | Blue Premier/High Performance Network/My BlueHealth | $33.76 | $627.40 | $376.44 | 2026-06-13 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | OPTUM HEALTH | MANAGED MEDICAID | $33.89 | $154.06 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | OPTUM HEALTH | MANAGED MEDICAID | $33.89 | $154.06 | — | 2025-12-31 | MRF ↗ |
| METHODIST SOUTHLAKE MEDICAL CENTER Both | UNITED HEALTHCARE MEDICAID MANAGED CARE [5015] | MHS HB UNITED MEDICAID STAR PLUS MSMC | $34.08 | $121.88 | $60.94 | 2026-03-23 | MRF ↗ |
| METHODIST SOUTHLAKE MEDICAL CENTER Both | UNITED HEALTHCARE MEDICAID MANAGED CARE [5015] | MHS HB UNITED MEDICAID STAR PLUS MSMC | $34.08 | $121.88 | $60.94 | 2026-03-23 | MRF ↗ |
| Baylor Scott & White Medical Center - Lakeway OutpatientFacility | Blue Cross Blue Shield | Blue Advantage | $34.17 | $627.40 | $376.44 | 2026-06-13 | MRF ↗ |
| HCA FLORIDA SARASOTA DOCTORS HOSPITAL Outpatient | United | OptionsPPO | $34.52 | $197.25 | $197.25 | 2024-10-01 | 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 ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $35.74 | $154.06 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $35.74 | $154.06 | — | 2025-12-31 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Institutional 115 Percent_Georgia Medicaid | Institutional 115 Percent_Georgia Medicaid | $35.75 | $258.00 | $193.50 | 2026-02-15 | MRF ↗ |
| METHODIST HOSPITAL STONE OAK Outpatient | Superior Health | CHPFC | $35.82 | $597.00 | $597.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL STONE OAK Outpatient | Superior Health | STARKids | $35.82 | $597.00 | $597.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL STONE OAK Outpatient | Superior Health | CHIP | $35.82 | $597.00 | $597.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL STONE OAK Outpatient | Superior Health | STAR | $35.82 | $597.00 | $597.00 | 2025-01-01 | MRF ↗ |
| METHODIST HOSPITAL STONE OAK Outpatient | Superior Health | STARPLUS | $35.82 | $597.00 | $597.00 | 2025-01-01 | MRF ↗ |
| MIDLAND MEMORIAL HOSPITAL OutpatientFacility | Bcbs Hmo | Hmo | $36.11 | — | — | 2026-04-01 | MRF ↗ |
| MIDLAND MEMORIAL HOSPITAL OutpatientFacility | Bcbs Hmo | Hmo | $36.11 | — | — | 2026-04-01 | MRF ↗ |
| HCA FLORIDA PASADENA HOSPITAL A PART OF HCA FLORID Outpatient | Simply Healthcare | MGMCR | $36.12 | $234.55 | $234.55 | 2026-03-01 | MRF ↗ |
| METHODIST MANSFIELD MEDICAL CENTER Both | WELLPOINT MEDICAID MANAGED CARE [5001] | MHS HB WELLPOINT MEDICAID STAR MMMC | $36.21 | $112.50 | $56.25 | 2026-03-21 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Amerigroup | Amerigroup Medicare Advantage | $36.70 | $258.00 | $193.50 | 2026-02-15 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $36.89 | $180.84 | — | 2025-12-31 | MRF ↗ |
| NORTHSIDE HOSPITAL FORSYTH Outpatient | Cigna | CIGNA HealthSprings Medicare Advantage | $37.05 | $258.00 | $193.50 | 2026-02-15 | MRF ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $37.25 | $180.84 | — | 2025-12-31 | MRF ↗ |
| HACKENSACK UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $37.25 | $180.84 | — | 2025-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $37.25 | $180.84 | — | 2025-12-31 | MRF ↗ |
| NORTHSIDE HOSPITAL DULUTH Outpatient | Institutional 115 Percent_Georgia Medicaid | Institutional 115 Percent_Georgia Medicaid | $37.48 | $258.00 | $193.50 | 2026-02-14 | MRF ↗ |
| HCA FLORIDA OAK HILL HOSPITAL Outpatient | Simply Healthcare | MGMCR | $37.53 | $234.55 | $234.55 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA SOUTH TAMPA HOSPITAL Outpatient | Simply Healthcare | MGMCR | $37.53 | $234.55 | $234.55 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA SARASOTA DOCTORS HOSPITAL Outpatient | Simply Healthcare | MGMCR | $37.53 | $234.55 | $234.55 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA PASADENA HOSPITAL A PART OF HCA FLORID Outpatient | Simply Healthcare | MGMCR | $37.53 | $234.55 | $234.55 | 2024-10-01 | MRF ↗ |
| HCA FLORIDA NORTHSIDE HOSPITAL Outpatient | Simply Healthcare | MGMCR | $37.53 | $234.55 | $234.55 | 2024-10-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Mdwise | Medicaid | $37.56 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Caresource | Commercial | $37.56 | — | — | 2026-07-17 | MRF ↗ |
| ASCENSION ST VINCENT EVANSVILLE Outpatient | ANTHEM MEDICAID | 7373_ANTHEM MEDICAID REPLACEMENT OUTPATIENT 20230101 | $37.56 | $4,373.00 | $2,623.80 | 2026-01-01 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Anthem | Medicaid | $37.56 | — | — | 2026-07-17 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $37.80 | $180.84 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $37.80 | $180.84 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $37.98 | $180.84 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $37.98 | $180.84 | — | 2025-12-31 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Amerigroup | Amerigroup Medicare Advantage | $38.28 | $258.00 | $193.50 | 2026-02-14 | MRF ↗ |
| SAVANNAH HEALTH SERVICES LLC DBA MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER Outpatient | Peach State | MGMCD | $38.32 | — | — | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Peach State | MGMCD | $38.32 | — | — | 2024-10-01 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $38.34 | $180.84 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $38.34 | $180.84 | — | 2025-12-31 | MRF ↗ |
| HCA FLORIDA PASADENA HOSPITAL A PART OF HCA FLORID Outpatient | United | OptionsPPO | $38.47 | $234.55 | $234.55 | 2026-03-01 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | UHC COMMUNITY PLAN MEDICAID | UHC COMMUNITY PLAN MEDICAID | $38.61 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | HOME STATE HEALTH PLAN MCAID-ALL PLANS | HOME STATE HEALTH PLAN MCAID-ALL PLANS | $38.61 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | UHC COMMUNITY PLAN MEDICAID | UHC COMMUNITY PLAN MEDICAID | $38.61 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | UHC MEDICAID | UHC MEDICAID | $38.61 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | HOME STATE HEALTH PLAN MCAID-ALL PLANS | HOME STATE HEALTH PLAN MCAID-ALL PLANS | $38.61 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | UHC MEDICAID | UHC MEDICAID | $38.61 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | NEBRASKA TOTAL CARE MCAID-ALL PLANS | NEBRASKA TOTAL CARE MCAID-ALL PLANS | $38.61 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | NEBRASKA TOTAL CARE MCAID-ALL PLANS | NEBRASKA TOTAL CARE MCAID-ALL PLANS | $38.61 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| NORTHSIDE HOSPITAL CHEROKEE Outpatient | Cigna | CIGNA HealthSprings Medicare Advantage | $38.65 | $258.00 | $193.50 | 2026-02-14 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Amerigroup | Amerigroup Medicare Advantage | $38.81 | $258.00 | $193.50 | 2026-02-15 | MRF ↗ |
| MIDLAND MEMORIAL HOSPITAL OutpatientFacility | Bcbs Ppo | Ppo | $38.87 | — | — | 2026-04-01 | MRF ↗ |
| MIDLAND MEMORIAL HOSPITAL OutpatientFacility | Bcbs Federal | Traditional | $38.87 | — | — | 2026-04-01 | MRF ↗ |
| MIDLAND MEMORIAL HOSPITAL OutpatientFacility | Bcbs Ppo | Ppo | $38.87 | — | — | 2026-04-01 | MRF ↗ |
| MIDLAND MEMORIAL HOSPITAL OutpatientFacility | Bcbs Federal | Traditional | $38.87 | — | — | 2026-04-01 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | IOWA TOTAL CARE MCAID-ALL PLANS | IOWA TOTAL CARE MCAID-ALL PLANS | $39.00 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | IOWA TOTAL CARE MCAID-ALL PLANS | IOWA TOTAL CARE MCAID-ALL PLANS | $39.00 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | WELLPOINT | MANAGED MEDICAID | $39.10 | $200.00 | — | 2025-08-30 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | WELLPOINT | MANAGED MEDICAID | $39.10 | $200.00 | — | 2025-08-30 | MRF ↗ |
| Baylor Scott & White Medical Center - Lakeway OutpatientFacility | Blue Cross Blue Shield | Blue Essentials (HMO) | $39.18 | $627.40 | $376.44 | 2026-06-13 | MRF ↗ |
| NORTHSIDE HOSPITAL GWINNETT Outpatient | Cigna | CIGNA HealthSprings Medicare Advantage | $39.19 | $258.00 | $193.50 | 2026-02-15 | MRF ↗ |
| METHODIST MANSFIELD MEDICAL CENTER Both | WELLPOINT MEDICAID MANAGED CARE [5001] | MHS HB WELLPOINT MEDICAID STAR MMMC | $39.23 | $121.88 | $60.94 | 2026-03-21 | MRF ↗ |
| CHRISTUS SANTA ROSA HOSPITAL-SAN MARCOS OutpatientFacility | Blue Cross Blue Shield Of Texas | HMO | $39.28 | — | — | 2026-01-13 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | AMERIGROUP MCAID-ALL PLANS | AMERIGROUP MCAID-ALL PLANS | $39.38 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | AMERIGROUP MCAID-ALL PLANS | AMERIGROUP MCAID-ALL PLANS | $39.38 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | TRIWEST WELLMARK - ALL PLANS | TRIWEST WELLMARK - ALL PLANS | $39.38 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | TRIWEST WELLMARK - ALL PLANS | TRIWEST WELLMARK - ALL PLANS | $39.38 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $39.42 | $180.84 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $39.42 | $180.84 | — | 2025-12-31 | MRF ↗ |
| METHODIST DALLAS MEDICAL CENTER Both | SUPERIOR MEDICAID MANAGED CARE [5007] | MHS HB MEDICAID 110% STAR PLUS MDMC | $39.76 | $112.50 | $56.25 | 2026-03-20 | MRF ↗ |
| METHODIST DALLAS MEDICAL CENTER Both | MOLINA MEDICAID MANAGED CARE [5005] | MHS HB MEDICAID 110% STAR PLUS MDMC | $39.76 | $112.50 | $56.25 | 2026-03-20 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | AETNA MCR ADV | AETNA MCR ADV | $39.78 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | TRICARE-ALL PLANS | TRICARE-ALL PLANS | $39.78 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | UHC HEALTHY WELL KIDS (HAWK-I) | UHC HEALTHY WELL KIDS (HAWK-I) | $39.78 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | TRICARE-ALL PLANS | TRICARE-ALL PLANS | $39.78 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | AETNA MCR ADV | AETNA MCR ADV | $39.78 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| SHENANDOAH MEDICAL CENTER Outpatient | UHC HEALTHY WELL KIDS (HAWK-I) | UHC HEALTHY WELL KIDS (HAWK-I) | $39.78 | $117.00 | $76.05 | 2026-04-03 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | OPTUM HEALTH | MANAGED MEDICAID | $39.78 | $180.84 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | OPTUM HEALTH | MANAGED MEDICAID | $39.78 | $180.84 | — | 2025-12-31 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL MANTECA Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $80.00 | $44.80 | 2026-07-18 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL-SANTA CLARA Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FREMONT Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| SAN FRANCISCO VA MEDICAL CENTER Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - ANTIOCH Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - OAKLAND/RICHMOND Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - REDWOOD CITY Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $80.00 | $44.80 | 2026-07-15 | MRF ↗ |
| KAISER FOUNDATION HOSPITAL - FRESNO Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $80.00 | $44.80 | 2026-07-17 | MRF ↗ |
| San Leandro Hospital Both | [Kaiser Foundation Health Plan, Inc.] | [Commercial] | — | $80.00 | $44.80 | 2026-07-17 | 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.