Q5135 — Tocilizumab-aazg 200 Mg/10 Ml (20 Mg/ml) Intravenous Solution
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). TOCILIZUMAB-AAZG 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION (HCPCS Q5135) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Q5135?code_type=HCPCS
MLA (9th ed.)
“TOCILIZUMAB-AAZG 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION (HCPCS Q5135) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Q5135?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“TOCILIZUMAB-AAZG 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION (HCPCS Q5135) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Q5135?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $8–$2,423 (25th–75th percentile) across 1,607 hospitals · 3,777 payers.
“Negotiated” is the hospital’s negotiated facility rate for this HCPCS Q5135 — 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
$8
$994 typical
$2,423
The middle 50% of negotiated facility rates for this procedure, measured across 1,607 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $994 |
| Likely subtotal | $994 |
Facility charge (no separate professional fee)
$994
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 $8–$2,423.
- 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 |
|---|---|---|---|---|---|---|---|
| STURDY MEMORIAL HOSPITAL Outpatient | Blue Cross Ri | Commercial | — | — | — | 2026-07-15 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Serenity Pace | Medicare Managed Care | $0.09 | $18.62 | $18.62 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Wellpoint | All Commercial | $0.12 | $18.62 | $18.62 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Serenity Pace | Medicare Managed Care | $0.12 | $24.87 | $24.87 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Multiplan | All Commercial Plans | $0.13 | $18.62 | $18.62 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | PPO Commercial | $0.14 | $18.62 | $18.62 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | Indemnity Commercial | $0.14 | $18.62 | $18.62 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | HMO Commercial | $0.14 | $18.62 | $18.62 | 2026-06-05 | MRF ↗ |
| MONTGOMERY CANCER CENTER Outpatient | United Healthcare | Medicare Advantage | $0.14 | $8.81 | $5.29 | 2025-12-30 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Wellpoint | All Commercial | $0.16 | $24.87 | $24.87 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Connecticare | All Commercial Plans | $0.16 | $18.62 | $18.62 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Connecticare | CBI Other Commercial Plan | $0.16 | $18.62 | $18.62 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | First Health | PPO | $0.16 | $18.62 | $18.62 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Aetna | All Commercial Plans | $0.16 | $18.62 | $18.62 | 2026-06-05 | MRF ↗ |
| MCLEOD HEALTH CHERAW Both | Cigna | Commercial | $0.17 | $11,586.00 | $8,226.06 | 2026-07-15 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Multiplan | All Commercial Plans | $0.17 | $24.87 | $24.87 | 2026-06-05 | MRF ↗ |
| MCLEOD HEALTH CLARENDON Both | Cigna | Commercial | $0.17 | $11,586.00 | $8,226.06 | 2026-07-15 | MRF ↗ |
| MCLEOD MEDICAL CENTER - DILLON Both | Cigna | Commercial | $0.17 | $11,586.00 | $8,226.06 | 2026-07-15 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Coventry | Health Care Workers Comp | $0.18 | $18.62 | $18.62 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | PPO Commercial | $0.19 | $24.87 | $24.87 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | HMO Commercial | $0.19 | $24.87 | $24.87 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | BCBS | Indemnity Commercial | $0.19 | $24.87 | $24.87 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Connecticare | All Commercial Plans | $0.21 | $24.87 | $24.87 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Aetna | All Commercial Plans | $0.21 | $24.87 | $24.87 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | First Health | PPO | $0.21 | $24.87 | $24.87 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Connecticare | CBI Other Commercial Plan | $0.21 | $24.87 | $24.87 | 2026-06-05 | MRF ↗ |
| BAYSTATE WING HOSPITAL Both | Coventry | Health Care Workers Comp | $0.24 | $24.87 | $24.87 | 2026-06-05 | MRF ↗ |
| BERKSHIRE MEDICAL CENTER Outpatient | Commcare Alliance | Mcrmanaged Cca One Care | $0.41 | $1,854.03 | $1,761.33 | 2026-07-15 | MRF ↗ |
| James Cancer Hospital & Solove Research Institute Outpatient | Cigna | Cigna - Transplant | $0.62 | $25.03 | — | 2026-07-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CLEAR LAKE Outpatient | Superior Health Plan | STARKids | $0.66 | $10.98 | $10.98 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CLEAR LAKE Outpatient | Superior Health Plan | CHPFC | $0.66 | $10.98 | $10.98 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CLEAR LAKE Outpatient | Superior Health Plan | STARPLUS | $0.66 | $10.98 | $10.98 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CLEAR LAKE Outpatient | Superior Health Plan | STAR | $0.66 | $10.98 | $10.98 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CLEAR LAKE Outpatient | Superior Health Plan | CHIP | $0.66 | $10.98 | $10.98 | 2026-03-01 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | Wellcare | Managed Medicaid | $0.68 | $16.00 | $16.00 | 2026-04-30 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | Wellcare | Managed Medicaid | $0.68 | $16.00 | $16.00 | 2026-04-30 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | Amerigroup | Managed Medicaid | $0.70 | $16.00 | $16.00 | 2026-04-30 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | Amerigroup | Managed Medicaid | $0.70 | $16.00 | $16.00 | 2026-04-30 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | United Healthcare | Managed Medicaid | $0.72 | $18.00 | $18.00 | 2026-06-24 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | Fidelis Managed Medicaid | Managed Medicaid | $0.77 | $18.00 | $18.00 | 2026-06-24 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | Wellpoint | Managed Medicaid | $0.78 | $18.00 | $18.00 | 2026-06-24 | MRF ↗ |
| MACNEAL HOSPITAL OutpatientFacility | BCBS IL | PPO | $0.81 | — | — | 2026-03-31 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | United Healthcare | Managed Medicaid | $0.84 | $16.00 | $16.00 | 2026-04-30 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | United Healthcare | Managed Medicaid | $0.84 | $16.00 | $16.00 | 2026-04-30 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | Aetna Better Health | Managed Medicaid | $0.87 | $16.00 | $16.00 | 2026-04-30 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | Aetna Better Health | Managed Medicaid | $0.87 | $16.00 | $16.00 | 2026-04-30 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | Aetna Better Health | Managed Medicaid | $0.97 | $18.00 | $18.00 | 2026-06-24 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | United Behavioral Health | Optum Medicaid | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Corvel | Workers Compensation | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS EXCHANGE | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Self-Pay | Generic | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | United Behavioral Health | Optum Medicare | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Medicare / Medicare Advantage | Generic | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Humana | Medicare Advantage | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Direct Contracted Employers | Generic | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Phcs | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRADITIONAL | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Medicaid | Medicaid | $1.00 | $7,833.60 | $3,916.80 | 2026-07-01 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Other Contracted Managed Care | Generic | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Freeman Pho | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Blu Current Credit Union | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Anthem | Blue Traditional | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Texas Co Memorial Hospital | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | United Healthcare | All Payer | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Anthem | Blue Preferred | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| HURON VALLEY-SINAI HOSPITAL OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS BLUE CARE NETWORK | $1.00 | — | — | 2026-05-20 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | First Health | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Cox Healthplans | Employee Plan | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| Harper University Hospital OutpatientFacility | BLUE CROSS/BLUE SHIELD | BCBS TRUST PPO | $1.00 | — | — | 2026-09-02 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Cigna | Commercial Test | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Architectural Systems Inc | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | City Of Lebanon | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Show Me Benefit Consortium | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Missouri Affiliated School Consortium (Masc) | Missouri Affiliated School Consortium (Masc) | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Loren Cook | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Springfieldgreene Co Library | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Anthem | Blue Access | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Flora Farms | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Anthem | Pathway/Pathway X | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Ozark County | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Coastal Energy Corporation | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Advanced Concrete Technology | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Heart Of America Beverage Company | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Multiplan | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Custom Powder Systems | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Mirma Health | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Aetna | Premier Network | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Parkcrest Dental Group | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | United Healthcare | Core Payer | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Xerox | Workers Compensation | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Missouri Eye Institute | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Centene Home State Health | Medicaid | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Ozark Anesthesia Assoc. Inc | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Amprod | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Bjc Health Solutions | Commercial | $1.00 | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Medicare Advantage | Non Contracted Payors | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | The Durham Company | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Town And Country Super Market | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | United Healthcare | Va Ccn | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Cox Healthplans | Epo | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Justice Furniture And Bedding Co | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MEDICAL CENTERS Outpatient | Bjc Health Solutions | Commercial | $1.00 | $1.00 | $0.25 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Ozarks Cocacola | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | United Healthcare | Medicaid | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Workers Compensation | Workers Compensation | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Cox Healthplans | Medicare Advantage | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Cox Healthplans | Aca Marketplace | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Phelps Health | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Centene Wellcare | Medicare Advantage | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Mihlfeld & Associates | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Compalliance | Workers Compensation | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Cox Healthplans | Bjc Consortium | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Src Holdings Corporation | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Cox Healthplans | Ppo | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Merril Iron And Steel | Commercial | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | United Healthcare | Medicare | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Healthy Blue Mo | Medicaid Managed Care | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| COX MONETT HOSPITAL Outpatient | Non Contracted | Managed Care | — | $1.00 | $0.31 | 2026-07-15 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | Wellcare | Managed Medicaid | $1.02 | $24.00 | $24.00 | 2026-04-30 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | Wellcare | Managed Medicaid | $1.02 | $24.00 | $24.00 | 2026-04-30 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | WELLCARE | MCARE HMO | $1.03 | $2,351.00 | $352.65 | 2025-12-23 | MRF ↗ |
| JAY HOSPITAL OutpatientFacility | WELLCARE | MCARE HMO DUAL PLAN | $1.03 | $2,351.00 | $352.65 | 2025-12-23 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | Amerigroup | Managed Medicaid | $1.04 | $24.00 | $24.00 | 2026-04-30 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | United Healthcare | Managed Medicaid | $1.04 | $26.00 | $26.00 | 2026-06-24 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | Amerigroup | Managed Medicaid | $1.04 | $24.00 | $24.00 | 2026-04-30 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | Geisinger Family Plan | Geisinger Family Plan - Managed Medicaid | $1.07 | $7,833.60 | $3,916.80 | 2026-07-01 | MRF ↗ |
| GEISINGER-LEWISTOWN HOSPITAL Outpatient | AmeriHealth | AmeriHealth Cartias - Managed Medicaid | $1.10 | $7,833.60 | $3,916.80 | 2026-07-01 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | Fidelis Managed Medicaid | Managed Medicaid | $1.11 | $26.00 | $26.00 | 2026-06-24 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | Wellpoint | Managed Medicaid | $1.12 | $26.00 | $26.00 | 2026-06-24 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | United Healthcare | Managed Medicaid | $1.26 | $24.00 | $24.00 | 2026-04-30 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | United Healthcare | Managed Medicaid | $1.26 | $24.00 | $24.00 | 2026-04-30 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | Aetna Better Health | Managed Medicaid | $1.31 | $24.00 | $24.00 | 2026-04-30 | MRF ↗ |
| CAPITAL HEALTH REGIONAL MEDICAL CENTER OutpatientFacility | Aetna Better Health | Managed Medicaid | $1.31 | $24.00 | $24.00 | 2026-04-30 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan – Hmo | $1.40 | — | — | 2026-03-01 | MRF ↗ |
| CAPITAL HEALTH MEDICAL CENTER - HOPEWELL OutpatientFacility | Aetna Better Health | Managed Medicaid | $1.40 | $26.00 | $26.00 | 2026-06-24 | MRF ↗ |
| ALTRU HOSPITAL OutpatientFacility | Medica | Medicaid Managed Care Plan | $1.40 | — | — | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CLEAR LAKE Outpatient | Community Health Choice MCD | STAR+PLUS | $1.43 | $10.98 | $10.98 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CLEAR LAKE Outpatient | Community Health Choice MCD | CHIPPerinatal | $1.43 | $10.98 | $10.98 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CLEAR LAKE Outpatient | Community Health Choice MCD | STAR | $1.43 | $10.98 | $10.98 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CLEAR LAKE Outpatient | Community Health Choice MCD | CHIP | $1.43 | $10.98 | $10.98 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CLEAR LAKE Outpatient | Amerigroup | MGMCD | $1.54 | $10.98 | $10.98 | 2026-03-01 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CLEAR LAKE Outpatient | Amerigroup | MCDCHIPBH | $1.54 | $10.98 | $10.98 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Superior Health Plan | STARHealth | $1.56 | $22.33 | $22.33 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Superior Health Plan | STARKids | $1.56 | $22.33 | $22.33 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Superior Health Plan | STARPLUS | $1.56 | $22.33 | $22.33 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Superior Health Plan | CHIP | $1.56 | $22.33 | $22.33 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY FORT WORTH Outpatient | Superior Health Plan | MCDSTAR | $1.56 | $22.33 | $22.33 | 2026-03-01 | MRF ↗ |
| UPMC BEDFORD MEMORIAL OutpatientFacility | Aetna of PA | Medicare | $1.59 | $16.00 | $12.80 | 2026-03-06 | MRF ↗ |
| UPMC MEMORIAL OutpatientFacility | Highmark BCBS of PA | Medicare | $1.61 | $97.00 | $58.20 | 2026-03-06 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Kaiser Northwest | Commercial | — | $3,457.40 | $2,247.31 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Kaiser Wa | All Other Lob | — | $1,080.35 | $702.23 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Kaiser Wa | All Other Lob | — | $3,457.40 | $2,247.31 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Health Net/Centene Health Plan | Commercial | — | $1,080.35 | $702.23 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Pacific Source | Commercial Psn/Voyager | — | $1,080.35 | $702.23 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Molina Healthcare Of Wa | Commercial | $1.68 | $1,080.35 | $702.23 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | First Choice Health | Commercial | — | $1,080.35 | $702.23 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Pacific Source | Coordinated Care (Ind And Nonind) | — | $1,080.35 | $702.23 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Health Net/Centene Health Plan | Commercial | — | $3,457.40 | $2,247.31 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | United Healthcare – Ph Employees | United Healthcare – Ph Employees | — | $3,457.40 | $2,247.31 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Kaiser Northwest | Managed Medicaid | — | $1,080.35 | $702.23 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | United Healthcare – Ph Employees | United Healthcare – Ph Employees | — | $1,080.35 | $702.23 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Pacific Source | Commercial Psn/Voyager | — | $3,457.40 | $2,247.31 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Kaiser Northwest | Managed Medicaid | — | $3,457.40 | $2,247.31 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Pacific Source | Coordinated Care (Ind And Nonind) | — | $3,457.40 | $2,247.31 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Humana Health Plan | Commercial | — | $3,457.40 | $2,247.31 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | First Choice Health | Commercial | — | $3,457.40 | $2,247.31 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | First Choice Health | Administrators | — | $3,457.40 | $2,247.31 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Kaiser Northwest | Commercial | — | $1,080.35 | $702.23 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Moda Health Plan | Connexus/Synergy | — | $3,457.40 | $2,247.31 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Ambetter | Commercial | — | $3,457.40 | $2,247.31 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Humana Health Plan | Commercial | — | $1,080.35 | $702.23 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Providence Health Plan | Commercial | — | $3,457.40 | $2,247.31 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Moda Health Plan | Connexus/Synergy | — | $1,080.35 | $702.23 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Molina Healthcare Of Wa | Commercial | $1.68 | $3,457.40 | $2,247.31 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Ambetter | Commercial | — | $1,080.35 | $702.23 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | First Choice Health | Administrators | — | $1,080.35 | $702.23 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Aetna Health | Commercial | — | $3,457.40 | $2,247.31 | 2026-07-31 | MRF ↗ |
| PEACEHEALTH ST JOHN MEDICAL CENTER Outpatient | Providence Health Plan | Commercial | — | $1,080.35 | $702.23 | 2026-07-31 | MRF ↗ |
| MERCY HOSPITAL LEBANON OutpatientFacility | DEVOTED HEALTH MEDICARE CONTRACTED [320500] | HB LEBN DEVOTED HEALTH MEDICARE ADVANTAGE 104% W/SEQ | $1.71 | $1,312.13 | $852.88 | 2026-06-10 | MRF ↗ |
| MERCY HOSPITAL LEBANON OutpatientFacility | DEVOTED HEALTH MEDICARE CONTRACTED [320500] | HB LEBN DEVOTED HEALTH MEDICARE ADVANTAGE 104% W/SEQ | $1.71 | $1,324.13 | $860.68 | 2026-06-10 | MRF ↗ |
| GRITMAN MEDICAL CENTER OutpatientFacility | Molina of ID | Medicaid Advantage | $1.78 | — | — | 2026-08-19 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CLEAR LAKE Outpatient | Texas Childrens Health Plans | CHIP | $1.82 | $10.98 | $10.98 | 2026-03-01 | MRF ↗ |
| UPMC EAST InpatientFacility | UPMC Work Partners | Workers Comp | $1.91 | $16.00 | $9.60 | 2026-03-06 | MRF ↗ |
| HCA HOUSTON HEALTHCARE CLEAR LAKE Outpatient | United | OptionsPPO | $1.93 | $10.98 | $10.98 | 2026-03-01 | MRF ↗ |
| UPMC SOMERSET OutpatientFacility | Highmark BCBS of PA | Medicare Advantage | $1.95 | $97.00 | $58.20 | 2026-03-06 | MRF ↗ |
| MEDICAL CITY DALLAS HOSPITAL Outpatient | Superior Health Plan | STARKids | $1.96 | $28.01 | $28.01 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY DALLAS HOSPITAL Outpatient | Superior Health Plan | STARPLUS | $1.96 | $28.01 | $28.01 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY DALLAS HOSPITAL Outpatient | Superior Health Plan | MCDSTAR | $1.96 | $28.01 | $28.01 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY DALLAS HOSPITAL Outpatient | Superior Health Plan | CHIP | $1.96 | $28.01 | $28.01 | 2026-03-01 | MRF ↗ |
| MEDICAL CITY DALLAS HOSPITAL Outpatient | Superior Health Plan | STARHealth | $1.96 | $28.01 | $28.01 | 2026-03-01 | MRF ↗ |
| UPMC ALTOONA OutpatientFacility | Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1.97 | $15.00 | $9.00 | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1.97 | $16.00 | $12.80 | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1.97 | $16.00 | $12.80 | 2026-03-06 | MRF ↗ |
| UPMC ALTOONA OutpatientFacility | Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1.97 | $15.00 | $9.00 | 2026-03-06 | MRF ↗ |
| UPMC MCKEESPORT HOSPITAL OutpatientFacility | Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1.99 | $16.00 | $12.80 | 2026-03-06 | MRF ↗ |
| UPMC Shadyside OutpatientFacility | Highmark BCBS of PA | Medicare Advantage | $1.99 | $21.25 | $12.75 | 2026-03-06 | 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.