Q5158 — Denosumab-bnht 60 Mg/ml Subcutaneous Syringe
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). DENOSUMAB-BNHT 60 MG/ML SUBCUTANEOUS SYRINGE (CPT Q5158) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Q5158?code_type=CPT
MLA (9th ed.)
“DENOSUMAB-BNHT 60 MG/ML SUBCUTANEOUS SYRINGE (CPT Q5158) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Q5158?code_type=CPT. Accessed .
Chicago (notes-bibliography)
“DENOSUMAB-BNHT 60 MG/ML SUBCUTANEOUS SYRINGE (CPT Q5158) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Q5158?code_type=CPT.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $71–$5,940 (25th–75th percentile) across 450 hospitals · 1,230 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS Q5158 — 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
$71
$3,169 typical
$5,940
The middle 50% of negotiated facility rates for this procedure, measured across 450 hospitals.
What you’ll likely be billed
| Hospital facility Actual median across hospitals The hospital’s negotiated facility rate — from our MRF data. | $3,169 |
| Likely subtotal | $3,169 |
Facility charge (no separate professional fee)
$3,169
- 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 |
|---|---|---|---|---|---|---|---|
| COX MONETT HOSPITAL OutpatientFacility | None | — | — | $1.00 | $0.31 | 2026-04-24 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | United Healthcare | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Priority Health | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Meridian | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Molina | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | Blue Cross Complete | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE MANISTEE HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | McLaren Health Plan | Managed Medicaid | $15.02 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $15.58 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $15.58 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $15.58 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $15.58 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $15.58 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE OTSEGO MEMORIAL HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $15.58 | — | — | 2026-04-17 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Aetna Medicare | Medicare | $15.68 | — | — | 2026-03-29 | MRF ↗ |
| RESNICK NEUROPSYCHIATRIC HOSPITAL AT UCLA Outpatient | Blue Shield | Medicare Advantage | $15.68 | — | — | 2026-03-29 | MRF ↗ |
| Saint Mary's Health Care BothFacility | HAP MEDICAID | HAP CARESOURCE MEDICAID | $15.70 | $15,389.50 | $10,003.17 | 2026-03-31 | MRF ↗ |
| Saint Mary's Health Care BothFacility | BLUE CROSS COMPLETE - MI | BLUE CROSS COMPLETE MEDICAID | $15.70 | $15,389.50 | $10,003.17 | 2026-03-31 | MRF ↗ |
| TRINITY HEALTH OAKLAND HOSPITAL BothFacility | BLUE CROSS COMPLETE - MI | BLUE CROSS COMPLETE MEDICAID | $15.70 | $8,366.40 | $5,438.16 | 2026-03-31 | MRF ↗ |
| TRINITY HEALTH OAKLAND HOSPITAL BothFacility | HAP MEDICAID | HAP CARESOURCE MEDICAID | $15.70 | $8,366.40 | $5,438.16 | 2026-03-31 | MRF ↗ |
| TRINITY HEALTH OAKLAND HOSPITAL BothFacility | MCLAREN HEALTH MEDICAID | MCLAREN MEDICAID | $15.70 | $8,366.40 | $5,438.16 | 2026-03-31 | MRF ↗ |
| Saint Mary's Health Care BothFacility | MCLAREN HEALTH MEDICAID | MCLAREN MEDICAID | $15.70 | $15,389.50 | $10,003.17 | 2026-03-31 | MRF ↗ |
| Saint Mary's Health Care BothFacility | MOLINA MEDICAID | MOLINA MEDICAID | $16.01 | $15,389.50 | $10,003.17 | 2026-03-31 | MRF ↗ |
| TRINITY HEALTH OAKLAND HOSPITAL BothFacility | MOLINA MEDICAID | MOLINA MEDICAID | $16.01 | $8,366.40 | $5,438.16 | 2026-03-31 | MRF ↗ |
| Saint Mary's Health Care BothFacility | ACCESS HEALTH | ACCESS HEALTH | $20.11 | $15,389.50 | $10,003.17 | 2026-03-31 | MRF ↗ |
| KALKASKA MEMORIAL HEALTH CENTER OutpatientFacility | Meridian | Managed Medicaid | $20.25 | — | — | 2026-04-17 | MRF ↗ |
| CHARLEVOIX AREA HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $20.25 | — | — | 2026-04-17 | MRF ↗ |
| CHARLEVOIX AREA HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $20.25 | — | — | 2026-04-17 | MRF ↗ |
| CHARLEVOIX AREA HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $20.25 | — | — | 2026-04-17 | MRF ↗ |
| KALKASKA MEMORIAL HEALTH CENTER OutpatientFacility | McLaren Health Plan | Managed Medicaid | $20.25 | — | — | 2026-04-17 | MRF ↗ |
| KALKASKA MEMORIAL HEALTH CENTER OutpatientFacility | Molina | Managed Medicaid | $20.25 | — | — | 2026-04-17 | MRF ↗ |
| KALKASKA MEMORIAL HEALTH CENTER OutpatientFacility | Priority Health | Managed Medicaid | $20.25 | — | — | 2026-04-17 | MRF ↗ |
| KALKASKA MEMORIAL HEALTH CENTER OutpatientFacility | Blue Cross Complete | Managed Medicaid | $20.25 | — | — | 2026-04-17 | MRF ↗ |
| CHARLEVOIX AREA HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $20.25 | — | — | 2026-04-17 | MRF ↗ |
| KALKASKA MEMORIAL HEALTH CENTER OutpatientFacility | United Healthcare | Managed Medicaid | $20.25 | — | — | 2026-04-17 | MRF ↗ |
| CHARLEVOIX AREA HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $20.25 | — | — | 2026-04-17 | MRF ↗ |
| RHODE ISLAND HOSPITAL OutpatientFacility | Bcbs | Blue Chip Direct Advance Other Commercial Plan | $20.53 | — | — | 2026-04-01 | MRF ↗ |
| RHODE ISLAND HOSPITAL OutpatientFacility | Bcbs | Blue Chip Direct Advance Other Commercial Plan | $20.53 | — | — | 2026-04-01 | MRF ↗ |
| PAUL OLIVER MEMORIAL HOSPITAL OutpatientFacility | Blue Cross Complete | Managed Medicaid | $21.01 | — | — | 2026-04-17 | MRF ↗ |
| PAUL OLIVER MEMORIAL HOSPITAL OutpatientFacility | United Healthcare | Managed Medicaid | $21.01 | — | — | 2026-04-17 | MRF ↗ |
| PAUL OLIVER MEMORIAL HOSPITAL OutpatientFacility | Priority Health | Managed Medicaid | $21.01 | — | — | 2026-04-17 | MRF ↗ |
| PAUL OLIVER MEMORIAL HOSPITAL OutpatientFacility | Meridian | Managed Medicaid | $21.01 | — | — | 2026-04-17 | MRF ↗ |
| PAUL OLIVER MEMORIAL HOSPITAL OutpatientFacility | McLaren Health Plan | Managed Medicaid | $21.01 | — | — | 2026-04-17 | MRF ↗ |
| PAUL OLIVER MEMORIAL HOSPITAL OutpatientFacility | Molina | Managed Medicaid | $21.01 | — | — | 2026-04-17 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UPMC HEALTH PLAN 5138 | UPMC HEALTH PLAN 513801 | $21.54 | — | — | 2026-01-01 | MRF ↗ |
| PALI MOMI MEDICAL CENTER Outpatient | UnitedHealthcare | Quest | $21.54 | — | — | 2026-02-12 | MRF ↗ |
| JONES MEMORIAL HOSPITAL Outpatient | UPMC HEALTH PLAN 5138 | UPMC HEALTH PLAN 513801 | $21.54 | — | — | 2026-01-01 | MRF ↗ |
| WILCOX MEMORIAL HOSPITAL Outpatient | UnitedHealthcare | Quest | $21.54 | — | — | 2026-02-12 | MRF ↗ |
| STRAUB CLINIC AND HOSPITAL Outpatient | UnitedHealthcare | Quest | $21.54 | — | — | 2026-02-12 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | HEALTH SHARE KAISER [543] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | HEALTH SHARE KAISER [543] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | ALLCARE HEALTH PLAN [538] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | ALLCARE HEALTH PLAN [538] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | HEALTH SHARE [537] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | HEALTH SHARE PROVIDENCE [548] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | HEALTH SHARE PROVIDENCE [548] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | ADVANCED HEALTH [534] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | HEALTH SHARE KAISER [543] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | UMPQUA HEALTH [533] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | COLUMBIA PACIFIC COORDINATED CARE LLC [539] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | WILLAMETTE VALLEY COMMUNITY HEALTH [536] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | JACKSON CARE CONNECT [542] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | HEALTH SHARE [537] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | HEALTH SHARE CARE OREGON [526] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | WILLAMETTE VALLEY COMMUNITY HEALTH [536] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | JACKSON CARE CONNECT [542] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | HEALTH SHARE CARE OREGON [526] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | HEALTH SHARE TUALITY [549] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | ADVANCED HEALTH [534] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | INTERCOMMUNITY HEALTH [530] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | HEALTH SHARE CARE OREGON [526] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | HEALTH SHARE TUALITY [549] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | TRILLIUM MEDICAID [535] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | PRIMARY HEALTH OF JOSPEHINE COUNTY LLC [547] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | YAMHILL COUNTY COORDINATED CARE ORG [550] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | TRILLIUM MEDICAID [535] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | YAMHILL COUNTY COORDINATED CARE ORG [550] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | CASCADE HEALTH ALLIANCE [532] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | PRIMARY HEALTH OF JOSPEHINE COUNTY LLC [547] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | HEALTH SHARE TUALITY [549] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | HEALTH SHARE OHSU OHP [552] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | JACKSON CARE CONNECT [542] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | PRIMARY HEALTH OF JOSPEHINE COUNTY LLC [547] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | INTERCOMMUNITY HEALTH [530] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | CASCADE HEALTH ALLIANCE [532] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | HEALTH SHARE PROVIDENCE [548] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | YAMHILL COUNTY COORDINATED CARE ORG [550] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | UMPQUA HEALTH [533] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | COLUMBIA PACIFIC COORDINATED CARE LLC [539] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | ADVANCED HEALTH [534] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | HEALTH SHARE [537] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | COLUMBIA PACIFIC COORDINATED CARE LLC [539] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | CASCADE HEALTH ALLIANCE [532] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | UMPQUA HEALTH [533] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | HEALTH SHARE OHSU OHP [552] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | INTERCOMMUNITY HEALTH [530] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | HEALTH SHARE OHSU OHP [552] | Health Share CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | TRILLIUM MEDICAID [535] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | WILLAMETTE VALLEY COMMUNITY HEALTH [536] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | ALLCARE HEALTH PLAN [538] | Oregon Medicaid CCO | $22.40 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD OutpatientFacility | Health Net of California | Managed Medi-Cal | $22.98 | — | — | 2026-03-18 | MRF ↗ |
| Hackensack University Medical Center OutpatientFacility | OPTUM HEALTH | MANAGED MEDICAID | $22.98 | — | — | 2025-12-31 | MRF ↗ |
| LOS ANGELES COMMUNITY HOSPITAL OutpatientFacility | Health Net of California | Managed Medi-Cal | $22.98 | — | — | 2026-03-18 | MRF ↗ |
| Southern California Hospital At Culver City OutpatientFacility | Health Net of California | Managed Medi-Cal | $22.98 | — | — | 2026-03-18 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | MODA MEDICAID [528] | Eastern Oregon CCO | $22.98 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| ST CHARLES MEDICAL CENTER - BEND Outpatient | MODA MEDICAID [528] | Eastern Oregon CCO | $22.98 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| St Charles Redmond Outpatient | MODA MEDICAID [528] | Eastern Oregon CCO | $22.98 | $413.77 | $5,175.62 | 2026-04-01 | MRF ↗ |
| NICHOLAS H NOYES MEMORIAL HOSPITAL Outpatient | MEDICARE BLUE CHOICE 1306 | MEDICARE BLUE CHOICE 130601 | $23.55 | — | — | 2026-01-01 | MRF ↗ |
| CAROLINA PINES REGIONAL MEDICAL CENTER OutpatientFacility | BCBS | Blue Preferred | $23.93 | — | — | 2025-01-01 | MRF ↗ |
| WHITFIELD REGIONAL HOSPITAL OutpatientFacility | WellCare | All Products | $24.41 | — | — | 2026-04-01 | MRF ↗ |
| KUAKINI MEDICAL CENTER OutpatientFacility | WELLCARE | QUEST INT | $24.41 | — | — | 2026-01-25 | MRF ↗ |
| MEMORIAL HOSPITAL AND HEALTH CARE CENTER OutpatientFacility | TriCare | Government | $24.41 | — | — | 2026-02-13 | MRF ↗ |
| ST JAMES HOSPITAL Outpatient | MEDICARE BLUE CHOICE 1306 | MEDICARE BLUE CHOICE 130601 | $24.99 | — | — | 2026-01-01 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL Both | MEDICAID TN-TENNCARE WELLPOINT [3233] | PHTN HB WELLPOINT MEDICAID - BLOUNT | $24.99 | $7,007.50 | $2,172.32 | 2026-03-01 | MRF ↗ |
| MUNSON HEALTHCARE CADILLAC HOSPITAL OutpatientFacility | McLaren Health Plan | Commercial | $25.85 | — | — | 2026-04-17 | MRF ↗ |
| ENGLEWOOD HOSPITAL AND MEDICAL CENTER OutpatientFacility | HIP Health Plan | Managed Medicaid | $25.85 | — | — | 2026-02-02 | MRF ↗ |
| MUNSON MEDICAL CENTER OutpatientFacility | McLaren Health Plan | Commercial | $25.85 | — | — | 2026-04-17 | MRF ↗ |
| MUNSON HEALTHCARE GRAYLING HOSPITAL OutpatientFacility | McLaren Health Plan | Commercial | $25.85 | — | — | 2026-04-17 | MRF ↗ |
| SIERRA VIEW MEDICAL CENTER OutpatientFacility | HEALTHNET | MEDI-CAL | $25.85 | — | — | 2026-04-01 | MRF ↗ |
| ENGLEWOOD HOSPITAL AND MEDICAL CENTER OutpatientFacility | Heathnet Federal Services | Tricare | $26.42 | — | — | 2026-02-02 | MRF ↗ |
| JENNIE STUART MEDICAL CENTER OutpatientFacility | Humana Military (Tricare) | Government | $26.42 | — | — | 2026-02-12 | MRF ↗ |
| ROGER WILLIAMS MEDICAL CENTER OutpatientFacility | Neighborhood Health Plan of Rhode Island | Commercial HMO | $26.65 | — | — | 2026-01-01 | MRF ↗ |
| ROGER WILLIAMS MEDICAL CENTER OutpatientFacility | Neighborhood Health Plan of Rhode Island | Commercial HMO | $26.65 | — | — | 2026-01-01 | MRF ↗ |
| CAROLINA PINES REGIONAL MEDICAL CENTER OutpatientFacility | BCBS | Blue Choice | $27.05 | — | — | 2025-01-01 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Health | Medicare Advantage | $27.28 | — | — | 2026-03-31 | MRF ↗ |
| SHANDS JACKSONVILLE OutpatientFacility | Aetna Health | Medicare Advantage | $27.28 | — | — | 2026-03-31 | MRF ↗ |
| ENGLEWOOD HOSPITAL AND MEDICAL CENTER OutpatientFacility | HIP Health Plan | Managed Medicare | $27.28 | — | — | 2026-02-02 | MRF ↗ |
| JEWISH HOME & REHAB CENTER OutpatientFacility | HealthNet | Medicare Advantage | $27.28 | — | — | 2026-04-30 | MRF ↗ |
| SANFORD WORTHINGTON MEDICAL CENTER OutpatientFacility | Sanford Health Plan Align | Medicare Replacement | $27.29 | — | — | 2026-03-04 | MRF ↗ |
| SANFORD MEDICAL CENTER FARGO OutpatientFacility | Sanford Health Plan Align | Medicare Replacement | $27.29 | — | — | 2026-03-04 | MRF ↗ |
| Nationwide Children’s Hospital Toledo, Llc OutpatientFacility | Tricare CHAMPUS | All Products | $27.29 | — | — | 2026-04-01 | MRF ↗ |
| SANFORD MEDICAL CENTER BISMARCK OutpatientFacility | Sanford Health Plan Align | Medicare Replacement | $27.29 | — | — | 2026-03-04 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Tricare CHAMPUS | All Products | $27.29 | — | — | 2026-04-01 | MRF ↗ |
| Nationwide Children's Hospital OutpatientFacility | Tricare CHAMPUS | All Products | $27.29 | — | — | 2026-04-01 | MRF ↗ |
| MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL OutpatientFacility | Heritage Provider Network (HPN) | Medicare Advantage | $27.29 | — | — | 2026-03-26 | MRF ↗ |
| MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL OutpatientFacility | Heritage Provider Network (HPN) | Exchange | $27.29 | — | — | 2026-03-26 | MRF ↗ |
| HEARTLAND REGIONAL MEDICAL CENTER OutpatientFacility | Prime Health Services | Medicare Advantage | $27.29 | — | — | 2026-02-03 | MRF ↗ |
| SANFORD BEMIDJI MEDICAL CENTER OutpatientFacility | Sanford Health Plan Align | Medicare Replacement | $27.29 | — | — | 2026-03-04 | MRF ↗ |
| SANFORD USD MEDICAL CENTER OutpatientFacility | Sanford Health Plan Align | Medicare Replacement | $27.29 | — | — | 2026-03-04 | MRF ↗ |
| MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL OutpatientFacility | Heritage Provider Network (HPN) | Commercial | $27.29 | — | — | 2026-03-26 | MRF ↗ |
| ORLANDO HEALTH SOUTH LAKE HOSPITAL OutpatientFacility | Compassionate Care | Hospice | $27.29 | — | — | 2026-04-01 | MRF ↗ |
| SANFORD MEDICAL CENTER ABERDEEN OutpatientFacility | Sanford Health Plan Align | Medicare Replacement | $27.29 | — | — | 2026-03-04 | MRF ↗ |
| NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC OutpatientFacility | Tricare CHAMPUS | All Products | $27.29 | — | — | 2026-04-01 | MRF ↗ |
| NORTHERN LIGHT BLUE HILL MEMORIAL HOSPITAL OutpatientFacility | Anthem | Enhanced Pathways | $27.79 | — | — | 2026-03-30 | MRF ↗ |
| NORTHERN LIGHT MAINE COAST HOSPITAL OutpatientFacility | Anthem | Enhanced Pathways | $27.79 | — | — | 2026-03-30 | MRF ↗ |
| NORTHERN LIGHT C A DEAN HOSPITAL OutpatientFacility | Anthem | Enhanced Pathways | $27.79 | — | — | 2026-03-30 | MRF ↗ |
| NORTHERN LIGHT A R GOULD HOSPITAL OutpatientFacility | Anthem | Enhanced Pathways | $27.79 | — | — | 2026-03-30 | MRF ↗ |
| NORTHERN LIGHT SEBASTICOOK VALLEY HOSPITAL OutpatientFacility | Anthem | Enhanced Pathways | $27.79 | — | — | 2026-03-30 | MRF ↗ |
| NORTHERN LIGHT A R GOULD HOSPITAL OutpatientFacility | Anthem | Enhanced Pathways | $27.79 | — | — | 2026-03-30 | MRF ↗ |
| NORTHERN LIGHT EASTERN MAINE MEDICAL CENTER OutpatientFacility | Anthem | Enhanced Pathways | $27.79 | — | — | 2026-02-03 | MRF ↗ |
| NORTHERN LIGHT MERCY HOSPITAL OutpatientFacility | Anthem | Enhanced Pathways | $27.79 | — | — | 2026-04-15 | MRF ↗ |
| UNIVERSITY OF COLORADO HOSPITAL AUTHORITY OutpatientFacility | United Healthcare | Medicare Advantage | $27.86 | — | — | 2025-11-01 | MRF ↗ |
| FLOYD CHEROKEE MEDICAL CENTER OutpatientFacility | Blue Cross Blue Shield of Alabama | Medicare Advantage | $27.86 | — | — | 2025-11-19 | MRF ↗ |
| MONTEFIORE ST LUKE'S CORNWALL Outpatient | Fidelis | Medicaid Managed Care, FHP, CHP, HARP | $28.07 | — | $35.09 | 2026-04-01 | MRF ↗ |
| MONTEFIORE ST LUKE'S CORNWALL Outpatient | Fidelis | Medicare | $28.07 | — | $35.09 | 2026-04-01 | MRF ↗ |
| Saint Mary's Health Care BothFacility | BLUE CROSS - MI MEDICARE ADVANTAGE | BCBS MEDICARE ADVANTAGE | $28.15 | $15,389.50 | $10,003.17 | 2026-03-31 | MRF ↗ |
| Saint Mary's Health Care BothFacility | PRIORITY HEALTH MEDICARE ADVANTAGE | PRIORITY HEALTH MEDICARE ADVANTAGE | $28.15 | $15,389.50 | $10,003.17 | 2026-03-31 | MRF ↗ |
| Saint Mary's Health Care BothFacility | BLUE CARE NETWORK ADVANTAGE | BCN MEDICARE ADVANTAGE | $28.15 | $15,389.50 | $10,003.17 | 2026-03-31 | MRF ↗ |
| Saint Mary's Health Care BothFacility | HAP MEDICARE ADVANTAGE | HAP MEDICARE ADVANTAGE | $28.15 | $15,389.50 | $10,003.17 | 2026-03-31 | MRF ↗ |
| Saint Mary's Health Care BothFacility | MOLINA MEDICARE ADVANTAGE | MOLINA MEDICARE ADVANTAGE | $28.15 | $15,389.50 | $10,003.17 | 2026-03-31 | MRF ↗ |
| Saint Mary's Health Care BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $28.15 | $15,389.50 | $10,003.17 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $28.15 | $15,389.50 | $15,389.50 | 2026-03-31 | MRF ↗ |
| TRINITY HEALTH OAKLAND HOSPITAL BothFacility | BLUE CROSS - MI MEDICARE ADVANTAGE | BCBS MEDICARE ADVANTAGE | $28.15 | $8,366.40 | $5,438.16 | 2026-03-31 | MRF ↗ |
| TRINITY HEALTH OAKLAND HOSPITAL BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $28.15 | $8,366.40 | $5,438.16 | 2026-03-31 | MRF ↗ |
| TRINITY HEALTH OAKLAND HOSPITAL BothFacility | HAP MEDICARE ADVANTAGE | HAP MEDICARE ADVANTAGE | $28.15 | $8,366.40 | $5,438.16 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER BothFacility | MEDICARE MEDICAL ASSOCIATES HEALTH PLANS | MEDICAL ASSOCIATES MEDICARE ADVANTAGE | $28.15 | $15,389.50 | $15,389.50 | 2026-03-31 | MRF ↗ |
| TRINITY HEALTH OAKLAND HOSPITAL BothFacility | MOLINA MEDICARE ADVANTAGE | MOLINA MEDICARE ADVANTAGE | $28.15 | $8,366.40 | $5,438.16 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER BothFacility | MEDIGOLD MEDICARE ADVANTAGE | MERCYONE HEALTH PLAN MEDICARE ADVANTAGE | $28.15 | $15,389.50 | $15,389.50 | 2026-03-31 | MRF ↗ |
| TRINITY HEALTH OAKLAND HOSPITAL BothFacility | BLUE CARE NETWORK ADVANTAGE | BCN MEDICARE ADVANTAGE | $28.15 | $8,366.40 | $5,438.16 | 2026-03-31 | MRF ↗ |
| TRINITY HEALTH OAKLAND HOSPITAL BothFacility | PRIORITY HEALTH MEDICARE ADVANTAGE | PRIORITY HEALTH MEDICARE ADVANTAGE | $28.15 | $8,366.40 | $5,438.16 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER BothFacility | MEDICARE MEDICAL ASSOCIATES HEALTH PLANS | MEDICAL ASSOCIATES MEDICARE ADVANTAGE | $28.15 | $15,389.50 | $15,389.50 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $28.15 | $15,389.50 | $15,389.50 | 2026-03-31 | MRF ↗ |
| MERCYONE NEWTON MEDICAL CENTER BothFacility | MEDIGOLD MEDICARE ADVANTAGE | MERCYONE HEALTH PLAN MEDICARE ADVANTAGE | $28.15 | $15,389.50 | $15,389.50 | 2026-03-31 | MRF ↗ |
| MERCY MEDICAL CTR BothFacility | TUFTS MEDICARE ADVANTAGE | TUFTS MEDICARE ADVANTAGE | $28.15 | $5,019.85 | $5,019.85 | 2026-03-31 | MRF ↗ |
| SIGNATURE HEALTHCARE BROCKTON HOSPITAL OutpatientFacility | Fallon | Medicare Plus | $28.15 | — | — | 2026-01-28 | MRF ↗ |
| MERCY MEDICAL CTR BothFacility | CONNECTICARE VIP MEDICARE ADVANTAGE | CONNECTICARE MEDICARE ADVANTAGE | $28.15 | $9,233.70 | $9,233.70 | 2026-03-31 | MRF ↗ |
| MERCY MEDICAL CTR BothFacility | BCBS MEDICARE ADVANTAGE GENERIC | BCBS MEDICARE ADVANTAGE | $28.15 | $5,019.85 | $5,019.85 | 2026-03-31 | MRF ↗ |
| MERCYONE WATERLOO MEDICAL CENTER BothFacility | MEDICARE MEDICAL ASSOCIATES HEALTH PLANS | MEDICAL ASSOCIATES MEDICARE ADVANTAGE | $28.15 | $8,366.40 | $8,366.40 | 2026-03-31 | MRF ↗ |
| MERCYONE NORTH IOWA MEDICAL CENTER BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $28.15 | $15,389.50 | $15,389.50 | 2026-03-31 | MRF ↗ |
| MERCYONE CLINTON MEDICAL CENTER BothFacility | MEDICARE MEDICAL ASSOCIATES HEALTH PLANS | MEDICAL ASSOCIATES MEDICARE ADVANTAGE | $28.15 | $8,366.40 | $8,366.40 | 2026-03-31 | MRF ↗ |
| MERCY MEDICAL CTR BothFacility | MEDIGOLD MEDICARE ADVANTAGE | MOUNT CARMEL HEALTH PLAN | $28.15 | $9,233.70 | $9,233.70 | 2026-03-31 | MRF ↗ |
| MERCY MEDICAL CTR BothFacility | AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $28.15 | $9,233.70 | $9,233.70 | 2026-03-31 | MRF ↗ |
| MERCYONE WATERLOO MEDICAL CENTER BothFacility | MEDIGOLD MEDICARE ADVANTAGE | MERCYONE HEALTH PLAN MEDICARE ADVANTAGE | $28.15 | $8,366.40 | $8,366.40 | 2026-03-31 | 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.