Q5116 — Trastuzumab-qyyp 420 Mg Intravenous Solution
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). TRASTUZUMAB-QYYP 420 MG INTRAVENOUS SOLUTION (HCPCS Q5116) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Q5116?code_type=HCPCS
MLA (9th ed.)
“TRASTUZUMAB-QYYP 420 MG INTRAVENOUS SOLUTION (HCPCS Q5116) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Q5116?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“TRASTUZUMAB-QYYP 420 MG INTRAVENOUS SOLUTION (HCPCS Q5116) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Q5116?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $31–$4,150 (25th–75th percentile) across 1,980 hospitals · 4,917 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS Q5116 — 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
$31
$432 typical
$4,150
The middle 50% of negotiated facility rates for this procedure, measured across 1,980 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $432 |
| Likely subtotal | $432 |
Facility charge (no separate professional fee)
$432
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 $31–$4,150.
- 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 |
|---|---|---|---|---|---|---|---|
| SAINT MARY'S HOSPITAL OutpatientFacility | CTCare | Medicare Advantage | — | $9,357.36 | $5,146.55 | 2025-01-01 | MRF ↗ |
| JOHNSON MEMORIAL HOSPITAL OutpatientFacility | CTCare | Medicare Advantage | — | $9,357.36 | $5,146.55 | 2025-01-01 | MRF ↗ |
| JOHNSON MEMORIAL HOSPITAL OutpatientFacility | CTCare | Medicare Advantage | — | $9,357.36 | $5,146.55 | 2025-01-01 | MRF ↗ |
| ST PETER'S HOSPITAL OutpatientFacility | VNA Homecare Options | Medicaid | — | $9,357.36 | $7,953.76 | 2025-01-01 | MRF ↗ |
| NOVANT HEALTH THOMASVILLE MEDICAL CENTER OutpatientFacility | Cigna | Commercial | — | — | — | 2026-03-31 | MRF ↗ |
| MCLEOD HEALTH CLARENDON Both | Cigna | Commercial | $0.17 | $15,567.00 | $11,052.57 | 2026-07-15 | MRF ↗ |
| MCLEOD MEDICAL CENTER - DILLON Both | Cigna | Commercial | $0.17 | $17,568.21 | $12,473.43 | 2026-07-15 | MRF ↗ |
| MCLEOD MEDICAL CENTER - DILLON Both | Cigna | Commercial | $0.17 | $30,466.64 | $21,631.31 | 2026-07-15 | MRF ↗ |
| MCLEOD MEDICAL CENTER - DILLON Both | Cigna | Commercial | $0.17 | $15,567.00 | $11,052.57 | 2026-07-15 | MRF ↗ |
| MCLEOD HEALTH CHERAW Both | Cigna | Commercial | $0.17 | $15,567.00 | $11,052.57 | 2026-07-15 | MRF ↗ |
| MCLEOD HEALTH CLARENDON Both | Cigna | Commercial | $0.17 | $17,568.21 | $12,473.43 | 2026-07-15 | MRF ↗ |
| MCLEOD HEALTH CHERAW Both | Cigna | Commercial | $0.17 | $17,568.21 | $12,473.43 | 2026-07-15 | MRF ↗ |
| MCLEOD HEALTH CLARENDON Both | Cigna | Commercial | $0.17 | $30,466.64 | $21,631.31 | 2026-07-15 | MRF ↗ |
| MCLEOD HEALTH CHERAW Both | Cigna | Commercial | $0.17 | $30,466.64 | $21,631.31 | 2026-07-15 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $0.29 | — | — | 2026-09-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $0.29 | — | — | 2026-09-01 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.37 | $205.36 | $27.24 | 2024-12-31 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | Clover | Managed Medicare | $0.37 | $204.76 | $27.24 | 2024-12-31 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $0.60 | — | — | 2026-09-01 | MRF ↗ |
| SHARP MEMORIAL HOSPITAL Outpatient | Molina | Molina Medi-Cal | $0.61 | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Aetna | Aetna - PPO | $0.61 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Aetna | Aetna - PPO | $0.61 | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Molina | Molina Medi-Cal | $0.61 | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| James Cancer Hospital & Solove Research Institute Outpatient | Cigna | Cigna - Transplant | $0.62 | $363.33 | — | 2026-07-01 | MRF ↗ |
| BERKSHIRE MEDICAL CENTER Outpatient | Commcare Alliance | Mcrmanaged Cca One Care | $0.81 | $365.96 | $347.66 | 2026-07-15 | MRF ↗ |
| Claxton-hepburn Medical Center OutpatientFacility | Coventry | Commercial | $0.86 | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center OutpatientFacility | Humana ChoiceCare | Commercial | $0.86 | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Department of Correctional Services DOCCCS | Managed Medicaid | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Cigna/MVP | Essential Medicaid 3-4 | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Humana ChoiceCare | Medicare Advantage | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Cigna/MVP | Medicare Advantage | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Prime Health Services | Medicare Advantage | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Blue Cross Blue Shield/Excellus | Managed Medicaid | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Nascentia/VNA Homecare Options Inc. | Medicare Advantage/Medicaid Long Term Care | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | HUM Healthcare Systems Inc. (HHS)/Partners Health Plan | Commercial | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Emblem/GHI | Commercial | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Logistic Health Inc. | Commercial | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | United Healthcare | Medicare Advantage | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Humana ChoiceCare | Commercial | $0.95 | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | HUM Healthcare Systems Inc. (HHS)/Partners Health Plan | Medicare Advantage | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Cigna/MVP | Essential Medicaid 1-2/5-6 | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | United Healthcare | Commercial | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Beacon Health Options | Behavioral Health/All Products | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Blue Cross Blue Shield/Excellus | Commercial | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Cigna/MVP | Individual Commercial | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Wellcare | Medicare Advantage | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | HUM Healthcare Systems Inc. (HHS)/Partners Health Plan | Managed Medicaid | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Fidelis | Managed Medicaid | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | United Healthcare | Managed Medicaid | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Blue Cross Blue Shield/Excellus | Medicare Advantage | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Fidelis | Medicare Advantage | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Prime Health Services | Telemedicine Program | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Cigna/MVP | Group Commercial | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | St. Lawrence-Lewis Program/STLLC | School Employee Program | — | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net Individual - EPO | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Bjc Health Solutions | Commercial | $1.00 | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Optum Health | Optum Health - Medicare | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | $488.00 | $366.00 | 2026-05-20 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN OF SC | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Epic Americas | AXA Assistance | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | $488.00 | $366.00 | 2026-05-20 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | $550.00 | $412.50 | 2026-09-02 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | SCAN Health Plan | Medicare Advantage | — | $17,962.56 | $11,675.66 | 2025-11-26 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Aetna | First Health - Direct | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | $550.00 | $412.50 | 2026-09-02 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Kaiser | Kaiser - Rehab | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | $488.00 | $366.00 | 2026-05-20 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net - PPO | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Inpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $17,962.56 | $11,675.66 | 2025-11-26 | MRF ↗ |
| COX MEDICAL CENTERS Outpatient | Bjc Health Solutions | Commercial | $1.00 | $1.00 | $0.25 | 2026-07-15 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Indian Health Council | Indian Health Council | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Aetna | Aetna - HMO/POS | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Optum Health | Optum Health - Commercial | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Molina | Molina Medi-Cal | $1.00 | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | United Healthcare | Core Payer | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Cigna | Cigna - HMO | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | California Health and Wellness | California Health and Wellness | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | San Diego Pace | San Diego Pace | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Cigna | Cigna - PPO | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Molina | Molina Medi-Cal | $1.00 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Medi-Cal | Medi-Cal | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Molina | Molina - Exchange | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Managed Health Network | MHN - Medicare | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BLUECHOICE HEALTHPLAN STATE EMPLOYEE | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | $550.00 | $412.50 | 2026-09-02 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Aetna | Aetna - PPO | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| Harper University Hospital BothFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | $550.00 | $412.50 | 2026-09-02 | MRF ↗ |
| PIEDMONT MEDICAL CENTER OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS PREFERRED BLUE PPO | $1.00 | — | — | 2026-09-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Community Health Group | Community Health Group - Cal Mediconnect | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Health Net | Health Net - HMO/POS/EPO | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Humana | Choice Care Network | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Kaiser | Kaiser - HMO | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Blue Shield | Blue Shield - PPO | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | United Healthcare | All Payer | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | United Healthcare | United Healthcare - HMO | — | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | $488.00 | $366.00 | 2026-05-20 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Serenity Pace | Medicare Managed Care | $1.16 | $231.83 | $231.83 | 2026-06-05 | MRF ↗ |
| CHRISTUS SPOHN HOSPITAL KLEBERG OutpatientFacility | Christus Health | HIX | $1.18 | — | — | 2026-01-13 | MRF ↗ |
| BANNER OCOTILLO MEDICAL CENTER OutpatientFacility | Aetna | Medicare Advantage | $1.23 | $6.17 | $0.88 | 2026-03-02 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | AIDS Healthcare Foundation and AHF Healthcare Centers | PHC California/Medi-Cal HMO | — | $17,962.56 | $11,675.66 | 2025-11-26 | MRF ↗ |
| Claxton-hepburn Medical Center OutpatientFacility | Blue Cross Blue Shield/Excellus | Managed Medicaid | $1.29 | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Community Health Group | Community Health Group - Medi-Cal | $1.35 | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MEMORIAL HOSPITAL Outpatient | Community Health Group | Community Health Group - Medi-Cal | $1.35 | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Inpatient | Medi-Cal | Medi-Cal | $1.35 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Inpatient | Molina | Molina Medi-Cal | $1.35 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | HORIZON | HORIZON NJ HEALTH | $1.45 | $10.00 | — | 2025-08-30 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Aetna | Aetna Whole Health | $1.45 | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | AETNA | BETTER HEALTH | $1.45 | $10.00 | — | 2025-08-30 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Humana | Choice Care Network | $1.45 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | United Healthcare | United Healthcare - PPO | $1.45 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Outpatient | Aetna | Aetna Whole Health | $1.45 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| GROSSMONT HOSPITAL Inpatient | Cigna | Cigna - HMO | $1.45 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | FIDELIS CARE | MANAGED MEDICAID | $1.45 | $10.00 | — | 2025-08-30 | MRF ↗ |
| GROSSMONT HOSPITAL Inpatient | Managed Health Network | MHN - Medicare | $1.45 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Inpatient | Aetna | Aetna - HMO/POS | $1.45 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Inpatient | Health Net | Health Net Individual - EPO | $1.45 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | MANAGED MEDICAID | $1.45 | $10.00 | — | 2025-08-30 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | HORIZON | HORIZON NJ HEALTH | $1.45 | $10.00 | — | 2025-08-30 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | UNITED HEALTHCARE | MANAGED MEDICAID | $1.45 | $10.00 | — | 2025-08-30 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | AETNA | BETTER HEALTH | $1.45 | $10.00 | — | 2025-08-30 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | FIDELIS CARE | MANAGED MEDICAID | $1.45 | $10.00 | — | 2025-08-30 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Allianz Global Assistance | AZGA Services Canada | $1.45 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Wellpoint | All Commercial | $1.51 | $231.83 | $231.83 | 2026-06-05 | MRF ↗ |
| BANNER OCOTILLO MEDICAL CENTER OutpatientFacility | Aetna | Qualified Health Plan | $1.57 | $6.17 | $0.88 | 2026-03-02 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | HORIZON | MEDICARE BLUE | $1.57 | $10.00 | — | 2025-08-30 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | HORIZON | MEDICARE BLUE | $1.57 | $10.00 | — | 2025-08-30 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Multiplan | All Commercial Plans | $1.62 | $231.83 | $231.83 | 2026-06-05 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Blue Shield | Blue Shield - Promise | $1.69 | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MEMORIAL HOSPITAL Outpatient | Blue Shield | Blue Shield - Promise | $1.69 | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | HMO Commercial | $1.77 | $231.83 | $231.83 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | PPO Commercial | $1.79 | $231.83 | $231.83 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | Indemnity Commercial | $1.79 | $231.83 | $231.83 | 2026-06-05 | MRF ↗ |
| BANNER OCOTILLO MEDICAL CENTER OutpatientFacility | Health Choice Arizona, Inc. | Medicare Advantage | $1.85 | $6.17 | $0.88 | 2026-03-02 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | AETNA | WHOLE HEALTH | $1.85 | $10.00 | — | 2025-08-30 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | AETNA | WHOLE HEALTH | $1.85 | $10.00 | — | 2025-08-30 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1.94 | $10.00 | — | 2025-08-30 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Aetna | All Commercial Plans | $1.94 | $231.83 | $231.83 | 2026-06-05 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | AETNA | MEDICARE ADVANTAGE | $1.94 | $10.00 | — | 2025-08-30 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | WELLPOINT | MANAGED MEDICAID | $1.96 | $10.00 | — | 2025-08-30 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | WELLPOINT | MANAGED MEDICAID | $1.96 | $10.00 | — | 2025-08-30 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | First Health | PPO | $1.97 | $231.83 | $231.83 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Connecticare | CBI Other Commercial Plan | $1.99 | $231.83 | $231.83 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Connecticare | All Commercial Plans | $1.99 | $231.83 | $231.83 | 2026-06-05 | MRF ↗ |
| ST BARNABAS HOSPITAL InpatientFacility | Hamaspik Choice Inc | Medicaid | $2.00 | $4.00 | — | 2026-02-27 | MRF ↗ |
| ST BARNABAS HOSPITAL InpatientFacility | Hamaspik Choice Inc | Medicaid | $2.00 | $4.00 | — | 2026-02-27 | MRF ↗ |
| BANNER OCOTILLO MEDICAL CENTER OutpatientFacility | Aetna | Banner Employee Plans | $2.07 | $6.17 | $0.88 | 2026-03-02 | MRF ↗ |
| BANNER OCOTILLO MEDICAL CENTER OutpatientFacility | Hospice of the Valley | Medicare | $2.16 | $6.17 | $0.88 | 2026-03-02 | MRF ↗ |
| FAIRVIEW HOSPITAL OutpatientFacility | AETNA | Asa_Whirlpool_Peia | $2.17 | $16,277.20 | $10,580.18 | 2026-06-15 | MRF ↗ |
| ST BARNABAS HOSPITAL OutpatientFacility | 1199SEIU National Benefit Fund | Commercial | $2.20 | $4.00 | — | 2026-02-27 | MRF ↗ |
| ST BARNABAS HOSPITAL OutpatientFacility | 1199SEIU National Benefit Fund | Commercial | $2.20 | $4.00 | — | 2026-02-27 | MRF ↗ |
| Claxton-hepburn Medical Center InpatientFacility | Multiplan/PHCS | Commercial | $2.24 | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Coventry | Health Care Workers Comp | $2.27 | $231.83 | $231.83 | 2026-06-05 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | OXFORD | ALL PRODUCTS | $2.45 | $10.00 | — | 2025-08-30 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | OXFORD | ALL PRODUCTS | $2.45 | $10.00 | — | 2025-08-30 | MRF ↗ |
| ST BARNABAS HOSPITAL OutpatientFacility | VNS Choice | FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual | $2.60 | $4.00 | — | 2026-02-27 | MRF ↗ |
| ST BARNABAS HOSPITAL OutpatientFacility | VNS Choice | FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual | $2.60 | $4.00 | — | 2026-02-27 | MRF ↗ |
| BANNER OCOTILLO MEDICAL CENTER InpatientFacility | Aetna | Broad Network | $2.61 | $6.17 | $0.88 | 2026-03-02 | MRF ↗ |
| BANNER OCOTILLO MEDICAL CENTER InpatientFacility | Aetna | Designated Group | $2.61 | $6.17 | $0.88 | 2026-03-02 | MRF ↗ |
| BANNER OCOTILLO MEDICAL CENTER InpatientFacility | Aetna | Joint Venture | $2.61 | $6.17 | $0.88 | 2026-03-02 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Health Net | Health Net - HMO/POS/EPO | $2.70 | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | AETNA | POS - EPO - PPO | $2.70 | $10.00 | — | 2025-08-30 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Inpatient | Blue Cross | Blue Cross - HMO | $2.70 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Inpatient | Blue Cross | Blue Cross - MCS | $2.70 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Health Net | Health Net - HMO/POS/EPO | $2.70 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHORE MEDICAL CENTER OutpatientFacility | AETNA | POS - EPO - PPO | $2.70 | $10.00 | — | 2025-08-30 | MRF ↗ |
| ST BARNABAS HOSPITAL OutpatientFacility | Cigna | LocalPlus Benefit Plan | $2.72 | $4.00 | — | 2026-02-27 | MRF ↗ |
| ST BARNABAS HOSPITAL OutpatientFacility | Cigna | LocalPlus Benefit Plan | $2.72 | $4.00 | — | 2026-02-27 | MRF ↗ |
| BANNER OCOTILLO MEDICAL CENTER InpatientFacility | Plotkin Health | Plotkin Health | $2.78 | $6.17 | $0.88 | 2026-03-02 | MRF ↗ |
| Claxton-hepburn Medical Center OutpatientFacility | United Healthcare | Managed Medicaid | $2.80 | $4.30 | $3.44 | 2025-01-28 | MRF ↗ |
| BANNER OCOTILLO MEDICAL CENTER OutpatientFacility | Aetna | Joint Venture | $2.85 | $6.17 | $0.88 | 2026-03-02 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Inpatient | California Health and Wellness | California Health and Wellness | $2.86 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Inpatient | Epic Americas | AXA Assistance | $2.86 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Aetna | Aetna Whole Health | $2.86 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Health Net | Health Net - Medicare | $2.86 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Indian Health Council | Indian Health Council | $2.86 | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Aetna | First Health - Direct | $2.86 | $9.64 | $7.23 | 2025-07-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Indian Health Council | Indian Health Council | $2.86 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| GROSSMONT HOSPITAL Inpatient | County Medical Services | County of San Diego | $2.86 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Aetna | Aetna Whole Health | $2.86 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Inpatient | Aetna | First Health - Direct | $2.86 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| GROSSMONT HOSPITAL Inpatient | United Healthcare | United Healthcare - PPO | $2.86 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP MESA VISTA HOSPITAL Inpatient | Aetna | First Health - Direct | $2.86 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| GROSSMONT HOSPITAL Inpatient | Blue Cross | Blue Cross - Standard | $2.86 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Inpatient | Cigna | Cigna - PPO | $2.86 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| GROSSMONT HOSPITAL Inpatient | Cigna | Cigna - PPO | $2.86 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Cigna | Cigna - HMO | $2.86 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP CORONADO HOSPITAL AND HLTHCR CTR Outpatient | Health Net | Health Net Individual - HMO | $2.89 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| SHARP CHULA VISTA MEDICAL CENTER Outpatient | Health Net | Health Net Cal MediConnect | $2.89 | $9.64 | $7.23 | 2026-04-01 | MRF ↗ |
| TEMPLE HEALTH - CHESTNUT HILL HOSPITAL OutpatientFacility | Blue Cross Blue Shield of Pennsylvania (Independence) | Tiered PPACA | $2.91 | $24,984.20 | — | 2026-04-08 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Priority Health | Commercial | $2.92 | $2,143.71 | $1,822.16 | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Cigna | Commercial | $2.92 | $2,143.71 | $1,822.16 | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Cigna | Commercial | $2.92 | $182.42 | $155.06 | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Priority Health | Commercial | $2.92 | $182.42 | $155.06 | 2026-04-17 | MRF ↗ |
| PAUL OLIVER MEMORIAL HOSPITAL OutpatientFacility | Cigna | Commercial | $2.92 | $182.42 | $155.06 | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | Priority Health | Commercial | $2.92 | $3,577.73 | $3,041.08 | 2026-04-17 | MRF ↗ |
| PAUL OLIVER MEMORIAL HOSPITAL OutpatientFacility | Priority Health | Commercial | $2.92 | $182.42 | $155.06 | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Cigna | Commercial | $2.92 | $3,577.73 | $3,041.08 | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Priority Health | Commercial | $2.92 | $3,577.73 | $3,041.08 | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | Cigna | Commercial | $2.92 | $3,577.73 | $3,041.08 | 2026-04-17 | MRF ↗ |
| CHARLEVOIX AREA HOSPITAL OutpatientFacility | Cigna | Commercial | $2.92 | $3,577.73 | $3,041.08 | 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.