Q4235 — Amniorepair Or Altiply Sq Cm
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Amniorepair or altiply sq cm (HCPCS Q4235) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Q4235?code_type=HCPCS
MLA (9th ed.)
“Amniorepair or altiply sq cm (HCPCS Q4235) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Q4235?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Amniorepair or altiply sq cm (HCPCS Q4235) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Q4235?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $131–$398 (25th–75th percentile) across 948 hospitals · 870 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS Q4235 — 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 the whole episode might cost
Your hospital facility price plus the separately-billed professional fees a complete episode adds. The facility figure is an actual negotiated rate from our data; the surgeon and anesthesia figures are estimates from the Medicare fee schedule scaled to commercial rates — not facility-specific quotes.
What hospitals actually negotiate
Measured
$131
$181 typical
$398
The middle 50% of negotiated facility rates for this procedure, measured across 948 hospitals. Surgeon & anesthesia fees are modeled estimates added on top.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $181 |
| Surgeon (professional fee) Estimate national typical Medicare PFS $127 × 1.22 commercial. | $155 |
| Likely subtotal | $337 |
Surgical episode (typical)
~$337
Your recovery plan — adjust to what your surgeon told you
After surgery, recovery care is billed separately. We pre-fill the typical plan; change it to your situation.
Recovery cost modeled
~$3,785
With your recovery plan (typical)
~$4,122
How each figure is sourced
- Hospital facility (actual)
- source: Hospital MRF (45 CFR 180)
- Surgeon (professional fee) (estimate)
- rvu_version: RVU26A (updated 2025-12-29) · gpci: National (unadjusted, GPCI = 1.000) · cf_rule: CMS-1832-F ($33.40) · multiplier_source: HCCI 2017 national
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 |
|---|---|---|---|---|---|---|---|
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | Community Coffee Group | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Aetna | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Humana | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Louisiana Healthcare Connection | Medicaid | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Cigna of LA | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Aetna | Better Health | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | HMO | — | — | — | 2026-03-17 | MRF ↗ |
| TEXAS HEALTH HUGULEY HOSPITAL FORT WORTH SOUTH Inpatient | None | — | — | $873.99 | $437.00 | 2024-12-15 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | USA Managed Care Organization | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | VA CCN | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | Exchange Compass | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Peoples Health | Medicare Enrollees | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Amerihealth Caritas | Medicaid | — | — | — | 2026-03-17 | MRF ↗ |
| TEXAS HEALTH HOSPITAL MANSFIELD Inpatient | None | — | — | $873.99 | $437.00 | 2024-12-15 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Gilsbar 360 | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Three Rivers Provider Network | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Womans Hospital Employees | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | First Health | Aetna Medical Rental Network | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | United Healthcare | Community Plan | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | Medical Cost Containment Professionals | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OUR LADY OF THE LAKE SURGICAL HOSPITAL OutpatientFacility | HS Technology | All Plans | — | — | — | 2026-03-17 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.29 | $161.20 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $0.35 | $193.09 | — | 2025-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.35 | $193.09 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $0.52 | $286.76 | — | 2025-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.52 | $286.76 | — | 2024-12-31 | MRF ↗ |
| ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER OutpatientFacility | BLUE PLUS PMAP PCC PRIME | Medicaid | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| ESSENTIA HEALTH DULUTH OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| ESSENTIA HEALTH OutpatientFacility | MN BCBS Commercial | BCBS MN | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| ESSENTIA HEALTH OutpatientFacility | BCBS PLUS PMAP PCC PRIME | Medicaid | $1.00 | — | — | 2026-01-01 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $1.56 | $868.00 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $1.56 | $868.00 | — | 2025-12-31 | MRF ↗ |
| SAVANNAH HEALTH SERVICES LLC DBA MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER Outpatient | Peach State | MGMCD | $20.94 | — | — | 2024-10-01 | MRF ↗ |
| MEMORIAL HEALTH MEADOWS HOSPITAL Outpatient | Peach State | MGMCD | $20.94 | — | — | 2024-10-01 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $23.37 | $161.20 | — | 2024-12-31 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $24.99 | $161.20 | — | 2025-12-31 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $24.99 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicaid | $25.95 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | United | Managed Medicaid | $27.71 | $161.20 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $28.00 | $193.09 | — | 2024-12-31 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCBlueChoice | $28.70 | — | — | 2024-12-08 | MRF ↗ |
| HELEN NEWBERRY JOY HOSPITAL Outpatient | MI WC - ALL PLANS | MI WC - ALL PLANS | $28.97 | $80.48 | $50.70 | 2026-01-27 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $29.02 | $161.20 | — | 2025-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $29.02 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $29.02 | $161.20 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $29.02 | $161.20 | — | 2025-12-31 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $29.02 | $161.20 | — | 2025-12-31 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $29.02 | $161.20 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $29.02 | $161.20 | — | 2024-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $29.02 | $161.20 | — | 2025-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $29.02 | $161.20 | — | 2024-12-31 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $29.02 | $161.20 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $29.18 | $161.20 | — | 2025-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $29.18 | $161.20 | — | 2024-12-31 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $29.93 | $193.09 | — | 2025-12-31 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $29.93 | $193.09 | — | 2024-12-31 | MRF ↗ |
| COASTAL CAROLINA HOSPITAL Outpatient | BCBS-SC | BCBSSCPreferredBlue | $30.90 | — | — | 2024-12-08 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicaid | $31.09 | $193.09 | — | 2024-12-31 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan – Hmo | $32.35 | — | — | 2026-03-01 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan | $32.35 | — | — | 2026-03-01 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $32.88 | $161.20 | — | 2024-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $32.88 | $161.20 | — | 2024-12-31 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $32.88 | $161.20 | — | 2025-12-31 | 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 ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | United | Managed Medicaid | $33.19 | $193.09 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $33.21 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $33.21 | $161.20 | — | 2024-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $33.69 | $161.20 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $33.85 | $161.20 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $34.17 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $34.17 | $161.20 | — | 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 | CLOVER | MEDICARE ADVANTAGE | $34.76 | $193.09 | — | 2025-12-31 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $34.76 | $193.09 | — | 2024-12-31 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $34.76 | $193.09 | — | 2025-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $34.76 | $193.09 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $34.76 | $193.09 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $34.76 | $193.09 | — | 2024-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $34.76 | $193.09 | — | 2025-12-31 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $34.76 | $193.09 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | CLOVER | MEDICARE ADVANTAGE | $34.76 | $193.09 | — | 2025-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $34.76 | $193.09 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $34.95 | $193.09 | — | 2025-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $34.95 | $193.09 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Amerigroup | Medicare Advantage | $35.14 | $161.20 | — | 2024-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $35.14 | $161.20 | — | 2025-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | OPTUM HEALTH | MANAGED MEDICAID | $35.46 | $161.20 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $37.40 | $161.20 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Horizon Braven | Managed Medicare | $37.40 | $161.20 | — | 2024-12-31 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $39.39 | $193.09 | — | 2025-12-31 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $39.39 | $193.09 | — | 2024-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $39.39 | $193.09 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $39.78 | $193.09 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $39.78 | $193.09 | — | 2024-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $40.36 | $193.09 | — | 2025-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $40.55 | $193.09 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $40.94 | $193.09 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $40.94 | $193.09 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $41.58 | $286.76 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Amerigroup | Medicare Advantage | $42.09 | $193.09 | — | 2024-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $42.09 | $193.09 | — | 2025-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Amerigroup | Medicare Advantage | $42.23 | $161.20 | — | 2024-12-31 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | OPTUM HEALTH | MANAGED MEDICAID | $42.48 | $193.09 | — | 2025-12-31 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $44.45 | $286.76 | — | 2025-12-31 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicare | $44.45 | $286.76 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | HORIZON BCBS BRAVEN | MEDICARE ADVANTAGE | $44.80 | $193.09 | — | 2025-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Horizon Braven | Managed Medicare | $44.80 | $193.09 | — | 2024-12-31 | MRF ↗ |
| INTEGRIS GROVE HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $45.00 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $45.00 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS MIAMI HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $45.00 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH ENID HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $45.00 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH EDMOND HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $45.00 | — | — | 2026-04-01 | MRF ↗ |
| ALLIANCEHEALTH WOODWARD OutpatientFacility | Healthchoice | All Commercial Plans | $45.00 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS CANADIAN VALLEY HOSPITAL OutpatientFacility | Healthchoice | All Commercial Plans | $45.00 | — | — | 2026-04-01 | MRF ↗ |
| LAKESIDE WOMEN'S HOSPITAL, A MEMBER OF INTEGRIS HE OutpatientFacility | Healthchoice | All Commercial Plans | $45.00 | — | — | 2026-04-01 | MRF ↗ |
| INTEGRIS HEALTH PONCA CITY OutpatientFacility | Healthchoice | All Commercial Plans | $45.00 | — | — | 2026-04-01 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Aetna | Managed Medicaid | $46.17 | $286.76 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | AMERIHEALTH | LOCAL HMO | $46.89 | $161.20 | — | 2025-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Amerihealth | Local HMO | $46.89 | $161.20 | — | 2024-12-31 | MRF ↗ |
| RIVERVIEW MEDICAL CENTER OutpatientFacility | AMERIHEALTH | LOCAL HMO | $46.89 | $161.20 | — | 2025-12-31 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | Amerihealth | Local HMO | $46.89 | $161.20 | — | 2024-12-31 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | Amerihealth | Local PPO | $46.89 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AMERIHEALTH | LOCAL HMO | $46.89 | $161.20 | — | 2025-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Amerihealth | Local PPO | $46.89 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Amerihealth | Local HMO | $46.89 | $161.20 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | Amerihealth | Local PPO | $46.89 | $161.20 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | Amerihealth | Local HMO | $46.89 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Amerihealth | Local PPO | $46.89 | $161.20 | — | 2024-12-31 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | AMERIHEALTH | LOCAL HMO | $46.89 | $161.20 | — | 2025-12-31 | MRF ↗ |
| SOUTHERN OCEAN MEDICAL CENTER OutpatientFacility | AMERIHEALTH | LOCAL HMO | $46.89 | $161.20 | — | 2025-12-31 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2025-03-27 | MRF ↗ |
| REID HEALTH OutpatientFacility | Anthem Blue Cross Blue Shield | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| REID HEALTH OutpatientFacility | Anthem Blue Cross Blue Shield | Pathways for Aging/Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| REID HEALTH OutpatientFacility | MDWise | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| REID HEALTH OutpatientFacility | MHS | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Humana | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| REID HEALTH OutpatientFacility | Caresource of Indiana | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | CareSource Indiana Healthy Indiana Plan (HIP) | 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 CLARK HOSPITAL OutpatientFacility | Anthem Blue Cross Blue Shield | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | MHS Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | CareSource Indiana Healthy Indiana Plan (HIP) | Managed Medicaid | $47.71 | — | — | 2025-03-27 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Healthwise (HHW) | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | Managed Health Services (MHS) | Managed Medicaid | $47.71 | — | — | 2025-03-27 | MRF ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | Anthem | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | MDWise | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| REID HEALTH OutpatientFacility | Humana of Indiana | Pathways for Aging/Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $47.72 | $161.20 | — | 2025-12-31 | 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 ↗ |
| TERRE HAUTE REGIONAL HOSPITAL Outpatient | Hospice of Bloomington Hospital | MCR | $48.68 | — | — | 2024-10-01 | MRF ↗ |
| TERRE HAUTE REGIONAL HOSPITAL Outpatient | Hospice of Bloomington Hospital | MCR | $48.68 | — | — | 2024-10-01 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | United Healthcare 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 | Anthem IN | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Caresource HIP | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | MHS Behavioral | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Caresource 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 ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | MDWise HIP | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Anthem 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 ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | United | Managed Medicaid | $49.29 | $286.76 | — | 2024-12-31 | 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 ↗ |
| EAST COOPER 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 ↗ |
| HILTON HEAD REGIONAL 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 | HoosierHealthwise | $50.14 | — | — | 2024-10-01 | MRF ↗ |
| TERRE HAUTE REGIONAL HOSPITAL Outpatient | MDwise Hoosier Alliance | HoosierCareConnect | $50.14 | — | — | 2024-10-01 | MRF ↗ |
| HENRY COUNTY MEMORIAL HOSPITAL Outpatient | ANTHEM MEDICAID | ANTHEM MEDICAID | $50.55 | $24,875.00 | $17,412.50 | 2026-04-21 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Molina Healthcare of Indiana | Managed Medicaid | $50.57 | — | — | 2025-04-24 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Amerigroup | Medicare Advantage | $50.59 | $193.09 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Cigna | HMO | $50.78 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Cigna | HMO | $50.78 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Cigna | PPO | $50.78 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Cigna | PPO | $50.78 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Amerihealth | Regional PPO | $51.29 | $161.20 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | Amerihealth | Regional PPO | $51.29 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Amerihealth | Regional HMO | $51.29 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Amerihealth | Regional HMO | $51.29 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Amerihealth | Local HMO | $51.29 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Amerihealth | Local PPO | $51.29 | $161.20 | — | 2024-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Amerihealth | Regional HMO | $51.29 | $161.20 | — | 2024-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | Amerihealth | Regional HMO | $51.29 | $161.20 | — | 2024-12-31 | MRF ↗ |
| OCEAN MEDICAL CENTER OutpatientFacility | Amerihealth | Regional PPO | $51.29 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | Amerihealth | Regional PPO | $51.29 | $161.20 | — | 2024-12-31 | MRF ↗ |
| JERSEY SHORE UNIVERSITY MEDICAL CENTER OutpatientFacility | AMERIHEALTH | REGIONAL HMO | $51.29 | $161.20 | — | 2025-12-31 | MRF ↗ |
| BAYSHORE MEDICAL CENTER OutpatientFacility | AMERIHEALTH | REGIONAL HMO | $51.29 | $161.20 | — | 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.