S0164 — Injection, Pantoprazole Sodium, 40 Mg
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). INJECTION, PANTOPRAZOLE SODIUM, 40 MG (HCPCS S0164) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/S0164?code_type=HCPCS
MLA (9th ed.)
“INJECTION, PANTOPRAZOLE SODIUM, 40 MG (HCPCS S0164) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/S0164?code_type=HCPCS. Accessed .
Chicago (notes-bibliography)
“INJECTION, PANTOPRAZOLE SODIUM, 40 MG (HCPCS S0164) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/S0164?code_type=HCPCS.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $10–$35 (25th–75th percentile) across 483 hospitals · 524 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CPT/HCPCS S0164 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
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 |
|---|---|---|---|---|---|---|---|
| CEDARS-SINAI MEDICAL CENTER Inpatient | HealthNet of California, Inc. | HMO | — | $290.00 | $188.50 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | California PhysiciansÆ Service, dba Blue Shield of California | Medi-Cal | — | $190.00 | $123.50 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | HMO, Non-City of LA, Vivity | — | $190.00 | $123.50 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | HMO | — | $190.00 | $123.50 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | HMO, City of LA, Vivity | — | $190.00 | $123.50 | 2025-11-26 | MRF ↗ |
| CEDAR-SINAI MARINA DEL REY HOSPITAL Outpatient | Health Net of California, Inc. | HMO | — | $223.00 | $144.95 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | Medicare Advantage | — | $190.00 | $123.50 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Alignment Health Plan | Medicare Advantage | — | $20,482.80 | $13,313.82 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Health Net of California, Inc. | HMO | — | $190.00 | $123.50 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Humana Health Plan, Inc. | Medicare Advantage | — | $190.00 | $123.50 | 2025-11-26 | MRF ↗ |
| CEDAR-SINAI MARINA DEL REY HOSPITAL Outpatient | CareMore Health Plan | Medicare Advantage | — | $1,115.26 | $724.92 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Kaiser Foundation Hospitals on behalf of its Southern California Region | Medicare Advantage | — | $190.00 | $123.50 | 2025-11-26 | MRF ↗ |
| HUNTINGTON HOSPITAL Outpatient | Blue Cross of California d/b/a Anthem Blue Cross | PPO | — | $4,077.10 | $2,650.12 | 2025-11-26 | MRF ↗ |
| CEDAR-SINAI MARINA DEL REY HOSPITAL Outpatient | KAISER FOUNDATION HOSPITALS and CENTINELA FREEMAN HEALTHSYSTEM dba DANIEL FREEMAN MARINA HOSPITAL | Medicare Advantage | — | $223.00 | $144.95 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Central Health Plan of California | Medicare Advantage | — | $20,482.80 | $13,313.82 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | SCAN Health Plan | Medicare Advantage | — | $20,482.80 | $13,313.82 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | UHC of California, dba UnitedHealthcare of California and fka PacificCare of California | Medicare Advantage | — | $20,482.80 | $13,313.82 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | AIDS Healthcare Foundation and AHF Healthcare Centers | PHC California/Medi-Cal HMO | — | $20,482.80 | $13,313.82 | 2025-11-26 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | AIDS Healthcare Foundation and AHF Healthcare Centers | PHP/Medicare Advantage Special Needs HMO | — | $20,482.80 | $13,313.82 | 2025-11-26 | MRF ↗ |
| MONMOUTH MEDICAL CENTER OutpatientFacility | Horizon | Managed Medicaid | $1.35 | — | — | 2024-12-31 | MRF ↗ |
| UPMC NORTHWEST OutpatientFacility | Aetna | Medicare | $1.46 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Aetna | Medicare | $1.46 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | Aetna | Medicare | $1.46 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Aetna | Medicare | $1.46 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | Aetna | Medicare | $1.46 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | Aetna | Neighborhood Network | $1.47 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | Aetna | Neighborhood Network | $1.47 | $5.82 | — | 2026-03-06 | MRF ↗ |
| RANGE REGIONAL HEALTH SERVICES OutpatientFacility | Blue Cross of Minnesota | PMAP | $1.49 | $50.00 | $21.25 | 2026-01-29 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | UPMC Work Partners | Workers Comp | $1.50 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | UPMC Work Partners | Workers Comp | $1.50 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | Aetna | Neighborhood Network | $1.52 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | Aetna | Neighborhood Network | $1.52 | $5.82 | — | 2026-03-06 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $1.54 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $1.54 | — | — | 2026-03-18 | MRF ↗ |
| JEFFERSON STRATFORD HOSPITAL OutpatientFacility | Horizon NJ Health NJ | Medicaid | $1.54 | — | — | 2026-03-18 | MRF ↗ |
| CAREWELL HEALTH MEDICAL CENTER OutpatientFacility | Horizon New Jersey Health | Managed Medicaid | $1.57 | — | — | 2025-06-17 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | Aetna | Home Depot Employer Group | $1.59 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | Aetna | Home Depot Employer Group | $1.59 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | UPMC Work Partners | Workers Comp | $1.60 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | UPMC Work Partners | Workers Comp | $1.60 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Aetna | Neighborhood Network | $1.62 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Aetna | Neighborhood Network | $1.62 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | Cigna | New Business ASO | $1.63 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | Aetna | NBR ASO/FI | $1.63 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | Aetna | NBR ASO/FI | $1.63 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | Cigna | New Business ASO | $1.63 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | Aetna | Home Depot Employer Group | $1.65 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | Aetna | Home Depot Employer Group | $1.65 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | Aetna | NBR ASO/FI | $1.69 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | Cigna | New Business ASO | $1.69 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | Cigna | New Business ASO | $1.69 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | Aetna | NBR ASO/FI | $1.69 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Aetna | Home Depot Employer Group | $1.77 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Aetna | Home Depot Employer Group | $1.77 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Aetna | Neighborhood Network | $1.78 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Aetna | Neighborhood Network | $1.78 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Aetna | NBR ASO/FI | $1.80 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Aetna | NBR ASO/FI | $1.80 | $5.82 | — | 2026-03-06 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | CC EHP | ALL PRODUCTS | $1.84 | — | — | 2025-06-28 | MRF ↗ |
| LUTHERAN HOSPITAL OutpatientFacility | CC EHP | ALL PRODUCTS | $1.84 | — | — | 2025-06-28 | MRF ↗ |
| EUCLID HOSPITAL OutpatientFacility | CC EHP | ALL PRODUCTS | $1.84 | — | — | 2025-06-28 | MRF ↗ |
| SOUTH POINTE HOSPITAL OutpatientFacility | CC EHP | ALL PRODUCTS | $1.84 | — | — | 2025-06-28 | MRF ↗ |
| MERCY MEDICAL CENTER OutpatientFacility | CC EHP | ALL PRODUCTS | $1.84 | — | — | 2025-06-28 | MRF ↗ |
| HILLCREST HOSPITAL OutpatientFacility | CC EHP | ALL PRODUCTS | $1.84 | — | — | 2025-06-28 | MRF ↗ |
| CLEVELAND CLINIC OutpatientFacility | CC EHP | ALL PRODUCTS | $1.84 | — | — | 2025-06-28 | MRF ↗ |
| MARYMOUNT HOSPITAL OutpatientFacility | CC EHP | ALL PRODUCTS | $1.84 | — | — | 2025-06-28 | MRF ↗ |
| NORTH COUNTRY HOSPITAL AND HEALTH CENTER OutpatientFacility | UHC | Medicare Advantage | $1.90 | $7.93 | $6.34 | 2026-01-01 | MRF ↗ |
| NORTH COUNTRY HOSPITAL AND HEALTH CENTER OutpatientFacility | MVP | Medicare Advantage | $1.90 | $7.93 | $6.34 | 2026-01-01 | MRF ↗ |
| NORTH COUNTRY HOSPITAL AND HEALTH CENTER OutpatientFacility | BCBS | Blue Advantage | $1.90 | $7.93 | $6.34 | 2026-01-01 | MRF ↗ |
| NORTH COUNTRY HOSPITAL AND HEALTH CENTER OutpatientFacility | MVP | Medicare Advantage | $1.92 | $8.00 | $6.40 | 2026-01-01 | MRF ↗ |
| NORTH COUNTRY HOSPITAL AND HEALTH CENTER OutpatientFacility | BCBS | Blue Advantage | $1.92 | $8.00 | $6.40 | 2026-01-01 | MRF ↗ |
| NORTH COUNTRY HOSPITAL AND HEALTH CENTER OutpatientFacility | UHC | Medicare Advantage | $1.92 | $8.00 | $6.40 | 2026-01-01 | MRF ↗ |
| UPMC MERCY InpatientFacility | Aetna | Home Depot Employer Group | $1.94 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Aetna | Home Depot Employer Group | $1.94 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Cigna | New Business ASO | $1.98 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Aetna | NBR ASO/FI | $1.98 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Aetna | NBR ASO/FI | $1.98 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Cigna | New Business ASO | $1.98 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | UPMC Work Partners | Workers Comp | $2.02 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | UPMC Work Partners | Workers Comp | $2.02 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Bravo | Medicare | $2.04 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Bravo | Medicare | $2.04 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC NORTHWEST OutpatientFacility | UPMC Work Partners | Workers Comp | $2.10 | $5.82 | — | 2026-03-06 | MRF ↗ |
| ENGLEWOOD HOSPITAL AND MEDICAL CENTER OutpatientFacility | Horizon New Jersey Health_674 | All Commercial Products | $2.15 | — | — | 2026-02-02 | MRF ↗ |
| UPMC MERCY InpatientFacility | UPMC Work Partners | Workers Comp | $2.15 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | UPMC Work Partners | Workers Comp | $2.15 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | Aetna | EBR FI | $2.21 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Aetna | EBR FI | $2.21 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Aetna | EBR FI | $2.21 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | Aetna | EBR FI | $2.21 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC NORTHWEST InpatientFacility | UPMC Work Partners | Workers Comp | $2.23 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Aetna | EBR ASO | $2.33 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC NORTHWEST InpatientFacility | Cigna | Commercial | $2.33 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | Cigna | Commercial | $2.33 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | Aetna | EBR ASO | $2.33 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | Aetna | EBR ASO | $2.33 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET InpatientFacility | Cigna | Commercial | $2.33 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Cigna | Commercial | $2.33 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Cigna | Commercial | $2.33 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC NORTHWEST InpatientFacility | Aetna | EBR ASO | $2.33 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Aetna | EBR ASO | $2.33 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Cigna | New Business ASO | $2.39 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Cigna | New Business ASO | $2.39 | $5.82 | — | 2026-03-06 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | CareMore Health Plan | Medicare Advantage | — | $20,482.80 | $13,313.82 | 2025-11-26 | MRF ↗ |
| UPMC MERCY InpatientFacility | Coventry/First Health | Commercial | $2.56 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Coventry/First Health | Commercial | $2.56 | $5.82 | — | 2026-03-06 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | Horizon | Managed Medicaid | $2.66 | — | — | 2024-12-31 | MRF ↗ |
| PALISADES MEDICAL CENTER OutpatientFacility | HORIZON | MANAGED MEDICAID | $2.66 | — | — | 2025-12-31 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | CareMore Health Plan | Medicare Advantage | — | $290.00 | $188.50 | 2025-11-26 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Horizon | Managed Medicaid | $2.70 | — | — | 2024-12-31 | MRF ↗ |
| JFK UNIVERSITY MEDICAL CENTER OutpatientFacility | Horizon | Managed Medicaid | $2.70 | — | — | 2024-12-31 | MRF ↗ |
| GRAND ITASCA CLINIC AND HOSPITAL OutpatientFacility | Blue Cross of Minnesota | PMAP | $2.78 | $50.00 | $21.25 | 2026-01-28 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Highmark Wholecare (prev Gateway) | Medicare | $2.91 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | InterGroup | PPO | $2.91 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | Highmark Wholecare (prev Gateway) | Medicare | $2.91 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | Highmark Wholecare (prev Gateway) | Medicare | $2.91 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | Highmark Wholecare (prev Gateway) | Medicare | $2.91 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | InterGroup | PPO | $2.91 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC NORTHWEST OutpatientFacility | Highmark Wholecare (prev Gateway) | Medicare | $2.91 | $5.82 | — | 2026-03-06 | MRF ↗ |
| NEBRASKA ORTHOPAEDIC HOSPITAL OutpatientFacility | UNITED HEALTHCARE | MEDICAID | $2.96 | $10.20 | — | 2025-12-27 | MRF ↗ |
| NEBRASKA ORTHOPAEDIC HOSPITAL OutpatientFacility | UNITED HEALTHCARE | MEDICAID | $2.96 | $10.20 | — | 2025-12-27 | MRF ↗ |
| MCLAREN CARO REGION Both | McLaren Commercial Ins | McLaren Commercial Ins | $3.00 | $6.00 | $3.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CARO REGION Both | McLaren Commercial Ins | McLaren Commercial Ins | $3.00 | $6.00 | $3.00 | 2025-02-03 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | UCare | Medicare Advantage/MSHO | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | Hennepin Health | PMAP | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | Itasca Medical Care | Medicare Advantage/MSHO | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | United Healthcare | Medicare Advantage | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | Primewest | MSHO | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | Health Partners | Medicare Advantage | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | Sanford Health Plan | Medicare Advantage | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | Medica | Medicare Advantage Non-SNP | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | WellCare | Medicare Advantage | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | Primewest | Managed Medicaid | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | Security Health Plan | Medicare Advantage | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | Itasca Medical Care | Managed Medicaid | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | Blue Cross of Minnesota | Medicare Advantage | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | Blue Cross of Minnesota | PMAP | $3.07 | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | Optum | Behavioral Commercial/Medicare/Medicaid | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | South Country Health Alliance | PMAP | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC OutpatientFacility | South Country Health Alliance | Medicare Advantage | — | $50.00 | $20.65 | 2025-02-10 | MRF ↗ |
| M HEALTH FAIRVIEW UNIVERSITY OF MN MEDICAL CENTER OutpatientFacility | Blue Cross of Minnesota | PMAP | $3.10 | $50.00 | $20.05 | 2026-02-06 | MRF ↗ |
| M HEALTH FAIRVIEW ST JOHN'S HOSPITAL OutpatientFacility | Blue Cross of Minnesota | PMAP | $3.10 | $50.00 | $20.05 | 2026-02-05 | MRF ↗ |
| M HEALTH FAIRVIEW SOUTHDALE HOSPITAL OutpatientFacility | Blue Cross of Minnesota | PMAP | $3.10 | $50.00 | $20.05 | 2026-02-06 | MRF ↗ |
| M HEALTH FAIRVIEW WOODWINDS HOSPITAL OutpatientFacility | Blue Cross of Minnesota | PMAP | $3.10 | $50.00 | $20.05 | 2026-02-05 | MRF ↗ |
| FAIRVIEW LAKES HEALTH SERVICES OutpatientFacility | Blue Cross of Minnesota | PMAP | $3.10 | $50.00 | $20.05 | 2026-02-05 | MRF ↗ |
| FAIRVIEW NORTHLAND REGIONAL HOSPITAL OutpatientFacility | Itasca Medical Care | Medicare Advantage/MSHO | — | $50.00 | $20.05 | 2026-01-29 | MRF ↗ |
| M HEALTH FAIRVIEW RIDGES HOSPITAL OutpatientFacility | Blue Cross of Minnesota | PMAP | $3.10 | $50.00 | $21.25 | 2026-02-06 | MRF ↗ |
| FAIRVIEW NORTHLAND REGIONAL HOSPITAL OutpatientFacility | Blue Cross of Minnesota | PMAP | $3.10 | $50.00 | $20.05 | 2026-01-29 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | PA Health & Wellness | PA Medicaid HMO | $3.20 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC NORTHWEST OutpatientFacility | PA Health & Wellness | PA Medicaid HMO | $3.20 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $3.20 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY OutpatientFacility | PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $3.20 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC ST MARGARET OutpatientFacility | PA Health & Wellness | PA Medicaid HMO | $3.20 | $5.82 | — | 2026-03-06 | MRF ↗ |
| PERMIAN REGIONAL MEDICAL CENTER ANDREWS COUNTY HO OutpatientFacility | Blue Cross Blue Shield | Commercial | $3.23 | — | — | 2025-12-03 | MRF ↗ |
| UPMC NORTHWEST InpatientFacility | Aetna | EBR FI | $3.38 | $5.82 | — | 2026-03-06 | MRF ↗ |
| RARITAN BAY MEDICAL CENTER OutpatientFacility | HORIZON | MANAGED MEDICAID | $3.38 | — | — | 2025-12-31 | MRF ↗ |
| Shepherd Center Outpatient | Bcbs | Ppo | $3.42 | — | — | 2026-05-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Cigna Behavioral Health | Commercial | $3.49 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC NORTHWEST OutpatientFacility | Aetna | EBR FI | $3.49 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC NORTHWEST OutpatientFacility | Aetna | Neighborhood Network | $3.49 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC MERCY InpatientFacility | Cigna Behavioral Health | Commercial | $3.49 | $5.82 | — | 2026-03-06 | MRF ↗ |
| PERMIAN REGIONAL MEDICAL CENTER ANDREWS COUNTY HO OutpatientFacility | Blue Cross Blue Shield | HMO | $3.56 | — | — | 2025-12-03 | MRF ↗ |
| CEDARS-SINAI MEDICAL CENTER Outpatient | Kaiser Foundation Hospitals | Medicare Advantage | — | $20,482.80 | $13,313.82 | 2025-11-26 | MRF ↗ |
| UPMC NORTHWEST OutpatientFacility | Aetna | Home Depot Employer Group | $3.59 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC NORTHWEST InpatientFacility | Aetna | Neighborhood Network | $3.61 | $5.82 | — | 2026-03-06 | MRF ↗ |
| ASCENSION GENESYS HOSPITAL Outpatient | HAP PHP | 419_HAP PHP 20200101 | $3.62 | $15.86 | $6.66 | 2026-01-01 | MRF ↗ |
| ASCENSION PROVIDENCE HOSPITAL, SOUTHFIELD AND NOVI Outpatient | HAP PHP | 419_HAP PHP 20200101 | $3.62 | $15.86 | $6.66 | 2026-01-01 | MRF ↗ |
| PETERSON REGIONAL MEDICAL CENTER OutpatientFacility | Blue Cross Blue Shield | Blue Essential | $3.67 | — | — | 2025-10-14 | MRF ↗ |
| MEDICAL CENTER HOSPITAL OutpatientFacility | BlueCross BlueShield | Medicare Advantage | $3.67 | $26.05 | $7.30 | 2025-02-14 | MRF ↗ |
| PETERSON REGIONAL MEDICAL CENTER OutpatientFacility | Blue Cross Blue Shield | Indemnity/Traditional | $3.67 | — | — | 2025-10-14 | MRF ↗ |
| MEDICAL CENTER HOSPITAL OutpatientFacility | BlueCross BlueShield | Indemnity/PPO/POS | $3.67 | $26.05 | $7.30 | 2025-02-14 | MRF ↗ |
| PETERSON REGIONAL MEDICAL CENTER OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $3.67 | — | — | 2025-10-14 | MRF ↗ |
| UPMC NORTHWEST OutpatientFacility | Aetna | NBR ASO/FI | $3.67 | $5.82 | — | 2026-03-06 | MRF ↗ |
| PETERSON REGIONAL MEDICAL CENTER OutpatientFacility | Blue Cross Blue Shield | POS/PPO | $3.67 | — | — | 2025-10-14 | MRF ↗ |
| MEDICAL CENTER HOSPITAL OutpatientFacility | BlueCross BlueShield | HMO | $3.67 | $26.05 | $7.30 | 2025-02-14 | MRF ↗ |
| UPMC NORTHWEST OutpatientFacility | Cigna | New Business ASO | $3.67 | $5.82 | — | 2026-03-06 | MRF ↗ |
| MEDICAL CENTER HOSPITAL OutpatientFacility | Health Select | PPO | $3.67 | $26.05 | $7.30 | 2025-02-14 | MRF ↗ |
| MEDICAL CENTER HOSPITAL OutpatientFacility | BlueCross BlueShield | HMO | $3.67 | $26.05 | $7.30 | 2025-02-14 | MRF ↗ |
| MEDICAL CENTER HOSPITAL OutpatientFacility | BlueCross BlueShield | Indemnity/PPO/POS | $3.67 | $26.05 | $7.30 | 2025-02-14 | MRF ↗ |
| MEDICAL CENTER HOSPITAL OutpatientFacility | Health Select | PPO | $3.67 | $26.05 | $7.30 | 2025-02-14 | MRF ↗ |
| MEDICAL CENTER HOSPITAL OutpatientFacility | BlueCross BlueShield | Medicare Advantage | $3.67 | $26.05 | $7.30 | 2025-02-14 | MRF ↗ |
| MEMORIAL CARE MILLER CHILDREN'S & WOMEN'S HOSP LB OutpatientFacility | Aetna | Whole Health Hmo | $3.70 | — | — | 2026-04-01 | MRF ↗ |
| UPMC NORTHWEST InpatientFacility | Aetna | Home Depot Employer Group | $3.71 | $5.82 | — | 2026-03-06 | MRF ↗ |
| PERMIAN REGIONAL MEDICAL CENTER ANDREWS COUNTY HO OutpatientFacility | Blue Cross Blue Shield | PPO | $3.74 | — | — | 2025-12-03 | MRF ↗ |
| UPMC NORTHWEST InpatientFacility | Aetna | NBR ASO/FI | $3.78 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC NORTHWEST InpatientFacility | Cigna | New Business ASO | $3.78 | $5.82 | — | 2026-03-06 | MRF ↗ |
| UPMC NORTHWEST InpatientFacility | InterGroup | PPO | $3.78 | $5.82 | — | 2026-03-06 | MRF ↗ |
| Five Rivers Medical Center OutpatientFacility | Arkansas Total Care | Managed Care | $3.79 | — | — | 2025-06-11 | MRF ↗ |
| LAWRENCE MEMORIAL HOSPITAL OutpatientFacility | Arkansas Total Care | Managed Medicaid | $3.79 | — | — | 2024-11-12 | MRF ↗ |
| Five Rivers Medical Center OutpatientFacility | Arkansas Total Care | Managed Care | $3.79 | — | — | 2025-06-11 | MRF ↗ |
| FORT MEMORIAL HOSPITAL OutpatientFacility | Humana | All Products | $3.98 | — | — | 2025-07-22 | MRF ↗ |
| LAWRENCE MEMORIAL HOSPITAL OutpatientFacility | Empower Healthcare Solutions | Managed Medicaid | $3.98 | — | — | 2024-11-12 | MRF ↗ |
| STONESPRINGS HOSPITAL CENTER Outpatient | Cigna | IFP | $3.99 | — | — | 2024-10-01 | MRF ↗ |
| RESTON HOSPITAL CENTER Outpatient | Cigna | IFP | $3.99 | — | — | 2024-10-01 | MRF ↗ |
| MCLAREN CARO REGION Both | MI Amish Medical Board | MI Amish Medical Board | $4.00 | $6.00 | $3.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CARO REGION Both | Medicare - Fidelis | Medicare - Fidelis | $4.00 | $6.00 | $3.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CARO REGION Both | Medicare - Humana | Medicare - Humana | $4.00 | $6.00 | $3.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CARO REGION Both | Medicare - Molina | Medicare - Molina | $4.00 | $6.00 | $3.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CARO REGION Both | Medicare - Priority Health | Medicare - Priority Health | $4.00 | $6.00 | $3.00 | 2025-02-03 | MRF ↗ |
| MCLAREN CARO REGION Both | Medicare - United | Medicare - United | $4.00 | $6.00 | $3.00 | 2025-02-03 | 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.