Q4309 — Via Matrix, Per Sq Cm
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). Via matrix, per sq cm (HCPCS Q4309) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Q4309?code_type=HCPCS
MLA (9th ed.)
“Via matrix, per sq cm (HCPCS Q4309) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Q4309?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“Via matrix, per sq cm (HCPCS Q4309) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Q4309?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $235–$3,466 (25th–75th percentile) across 868 hospitals · 679 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS Q4309 — 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
$235
$1,473 typical
$3,466
The middle 50% of negotiated facility rates for this procedure, measured across 868 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $1,473 |
| Likely subtotal | $1,473 |
Facility charge (no separate professional fee)
$1,473
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 $235–$3,466.
- 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 |
|---|---|---|---|---|---|---|---|
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | Managed Health Services (MHS) | Managed Medicaid | $47.71 | — | — | 2026-06-03 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Caresource | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hip Bh | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| REID HEALTH OutpatientFacility | MDWise | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | Anthem | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Healthwise (HHW) | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hip | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hhw | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Humana | Pathways For Aging | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-08-01 | MRF ↗ |
| REID HEALTH OutpatientFacility | MHS | 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 ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Caresource | In Medicaid Hip | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| UofL Health - Peace Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | MHS Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hcc Bh | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-14 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mdwise | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| REID HEALTH OutpatientFacility | Humana of Indiana | Pathways for Aging/Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mhs | In Medicaid Hhw | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | Managed Health Services (MHS) Hoosier Care Connect | Managed Medicaid | $47.71 | — | — | 2026-06-03 | MRF ↗ |
| UofL Health - Medical Center East Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-08-01 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Anthem | Pathways For Aging | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Anthem | In Medicaid Hhw | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| UOFL HEALTH - SHELBYVILLE HOSPITAL Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Anthem | In Medicaid Hip | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hhw | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Caresource | In Medicaid Hhw | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-05-22 | MRF ↗ |
| UofL Health - South Hospital Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | CareSource Indiana Healthy Indiana Plan (HIP) | Managed Medicaid | $47.71 | — | — | 2026-06-03 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | In Medicaid Hcc | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Humana | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| UofL Health - Medical Center Northeast Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mdwise | In Medicaid Hhw | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | United Healthcare of Indiana | Managed Medicaid | $47.71 | — | — | 2026-06-03 | MRF ↗ |
| REID HEALTH OutpatientFacility | Anthem Blue Cross Blue Shield | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mhs | In Medicaid Hcc | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | MDWise | Managed Medicaid | $47.71 | — | — | 2026-02-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Caresource | In Medicaid Hip | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Mhs | In Medicaid Hcc | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hip | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Humana | Pathways For Aging | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | Exchange | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Caresource | In Medicaid Hip | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hcc | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Uhc | Pathways For Aging | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mdwise | In Medicaid Hip | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hip | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| REID HEALTH OutpatientFacility | Anthem Blue Cross Blue Shield | Pathways for Aging/Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| UofL Health - Medical Center Southwest Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Uhc | Pathways For Aging | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Anthem Blue Cross Blue Shield | Managed Medicaid | $47.71 | — | — | 2025-04-24 | MRF ↗ |
| ELKHART GENERAL HOSPITAL Outpatient | Anthem | Pathways For Aging | $47.71 | — | — | 2026-05-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Humana | Pathways For Aging | $47.71 | — | — | 2026-09-16 | MRF ↗ |
| REID HEALTH OutpatientFacility | Caresource of Indiana | Managed Medicaid | $47.71 | — | — | 2025-07-21 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Anthem | In Medicaid Hcc | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| UofL Health - Frazier Rehabilitation Hospital - Brownsboro Outpatient | Anthem | In Medicaid | $47.71 | — | — | 2026-07-15 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mhs | In Medicaid Hip | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Mdwise | In Medicaid Hhw | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Uhc | Pathways For Aging | $47.71 | — | — | 2026-09-21 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | CareSource Indiana Hoosier Healthwise (HHW) | Managed Medicaid | $48.19 | — | — | 2026-06-03 | MRF ↗ |
| REID HEALTH OutpatientFacility | United Healthcare | Pathways for Aging/Managed Medicaid | $48.66 | — | — | 2025-07-21 | MRF ↗ |
| REID HEALTH OutpatientFacility | United Healthcare | Managed Medicaid | $48.66 | — | — | 2025-07-21 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Anthem HIP | 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 ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Uhc Pathways | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Mdwise Bhmi | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Caresource Hhw | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Caresource HIP | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Caresource IN | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | Anthem IN | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Anthem Indiana | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Anthem | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Molina | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hhw | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hhw | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Caresource Hip | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Humana | Pathways For Aging | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Uhc | Pathways For Aging | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Uhc | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mdwise | In Medicaid Hip | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hip | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | MHS Behavioral | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | In Medicaid Hcc | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| MEMORIAL HOSPITAL OF SOUTH BEND Outpatient | Uhc | In Medicaid Hcc | $48.68 | — | — | 2026-09-21 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Mhs | In Medicaid Hip | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | United Healthcare IN | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Bcbs | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Anthem | Pathways For Aging | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Meridian | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Outpatient | Anthem | In Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Caresource | In Medicaid Hip | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN HOSPITAL Outpatient | Aetna | Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| UNIVERSITY OF LOUISVILLE HOSPITAL Outpatient | Anthem | In Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| COMMUNITY HOSPITAL OF BREMEN INC Outpatient | Caresource | In Medicaid Hhw | $48.68 | — | — | 2026-07-15 | MRF ↗ |
| THE WOMEN'S HOSPITAL OutpatientFacility | MDWise HIP | Managed Medicaid | $48.68 | — | — | 2026-02-13 | MRF ↗ |
| UOFL HEALTH - SHELBYVILLE HOSPITAL Outpatient | Anthem | In Medicaid | $48.68 | — | — | 2026-07-17 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | CareSource Indiana Hoosier Healthwise (HHW) | Managed Medicaid | $49.14 | — | — | 2025-04-24 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $49.14 | — | — | 2025-04-24 | MRF ↗ |
| UNIVERSITY OF LOUISVILLE HOSPITAL Outpatient | Anthem | In Medicaid | $49.24 | — | — | 2026-05-22 | MRF ↗ |
| UNIVERSITY OF LOUISVILLE HOSPITAL Outpatient | Anthem | In Medicaid | $49.24 | — | — | 2026-05-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Surest | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | Geha | Geha | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Healthscope | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Medica | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Surest | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | Geha | Geha | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Surest | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | Geha | Geha | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Medica | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-07-15 | MRF ↗ |
| LUTHERAN MEDICAL CENTER Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Medica | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Healthscope | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Medica | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Surest | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-07-15 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Golden Rule Ins | — | — | — | 2026-07-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-07-15 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Medica | — | — | — | 2026-07-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | All Savers Alternative Funding | — | — | — | 2026-07-14 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-07-15 | MRF ↗ |
| GOOD SAMARITAN MEDICAL CENTER LLC Outpatient | Geha | Geha | — | — | — | 2026-07-15 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Surest | — | — | — | 2026-07-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Selectcolorado | — | — | — | 2026-07-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-07-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | Geha | Geha Mcr Supplemental | — | — | — | 2026-07-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | United Healthcare | — | — | — | 2026-07-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-07-14 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | Geha | Geha | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Healthscope | — | — | — | 2026-07-15 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Uhc Charter/Navigate | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Uhc Other/Supplemental | — | — | — | 2026-07-15 | MRF ↗ |
| SAINT JOSEPH HOSPITAL Outpatient | United Healthcare | Umr-United Med Resources | — | — | — | 2026-07-14 | MRF ↗ |
| INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL Outpatient | United Healthcare | Healthscope | — | — | — | 2026-07-15 | MRF ↗ |
| INTERMOUNTAIN HEALTH PLATTE VALLEY HOSPITAL Outpatient | United Healthcare | Uhc Exchange Plan | — | — | — | 2026-07-15 | MRF ↗ |
| NORTON SCOTT HOSPITAL OutpatientFacility | MDwise Hoosier Healthwise (HHW) | Managed Medicaid | $50.10 | — | — | 2026-06-03 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Mdwise Hoosier Healthwise (HHW) | Managed Medicaid | $50.10 | — | — | 2025-04-24 | MRF ↗ |
| NORTON CLARK HOSPITAL OutpatientFacility | Molina Healthcare of Indiana | Managed Medicaid | $50.57 | — | — | 2025-04-24 | MRF ↗ |
| METROHEALTH SYSTEM OutpatientFacility | Medical Mutual | Cle-Care Hmo | $64.09 | — | — | 2026-04-01 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Priority Health | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Molina | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | United Healthcare | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Meridian | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | McLaren Health Plan | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $64.85 | — | — | 2026-04-17 | MRF ↗ |
Showing the first 200 rate rows. The CSV export above returns up to 1,000 rows — filter by state to narrow a code with more than that.