Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HC Immun <= 18 Yrs W Couns 1st
Low
$16
Average
$78
Median
$27
High
$1.3k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
68 hospitals; the 90th percentile is 4.1× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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110 hospital rates
iThe hospitals that file a Wellmark rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | St Josephs Hospital Health Center Syracuse, NY facility · percent of total billed charges · bothfrom % of charges | 1 | $16 | $16 | $6 | 39% | 2–20 | $10 – $22 |
| 2 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 4 | $28 | $27 | $4 | 15% | — | $21 – $33 |
| 3 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 4 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · fee schedule · both | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 5 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $22 | $22 | $12 | 54% | — | $10 – $33 |
| 6 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 4 | $28 | $27 | $4 | 15% | — | $21 – $33 |
| 7 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 4 | $28 | $27 | $4 | 15% | — | $21 – $33 |
| 8 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 9 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 3 | $28 | $27 | $4 | 14% | — | $21 – $33 |
| 10 | Diley Ridge Medical Center Canal Winchester, OH facility · fee schedule · both | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 11 | Floyd Valley Healthcare Le Mars, IA fee schedule · both | 2 | $30 | $30 | $2 | 8% | — | $28 – $33 |
| 12 | Floyd Valley Healthcare Le Mars, IA percent of total billed charges · inpatientfrom % of charges | 2 | $13 | $13 | — | — | — | $13 – $13 |
| 13 | Grinnell Regional Medical Center Grinnell, IA fee schedule · both | 4 | $28 | $27 | $4 | 15% | — | $21 – $33 |
| 14 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · case rate · outpatient | 2 | $96 | $96 | $5 | 5% | — | $92 – $101 |
| 15 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $24 | $24 | $14 | 57% | — | $10 – $38 |
| 16 | HAWARDEN REGIONAL HEALTHCARE HARWARDEN, IA other · outpatient | 2 | $16 | $16 | $6 | 38% | — | $10 – $22 |
| 17 | Hegg Health Center Rock Valley, IA percent of total billed charges · inpatientfrom % of charges | 2 | $29 | $29 | — | — | — | $29 – $29 |
| 18 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · outpatientfrom % of charges | 1 | $176 | $176 | — | — | — | $176 – $176 |
| 19 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 20 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · both | 2 | $32 | $29 | $4 | 14% | — | $24 – $32 |
| 21 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · outpatientfrom % of charges | 1 | $172 | $172 | — | — | — | $172 – $172 |
| 22 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $90 | $90 | — | — | — | $90 – $90 |
| 23 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · inpatient | 2 | $28 | $26 | $3 | 11% | — | $22 – $28 |
| 24 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · outpatient | 2 | $24 | $22 | $2 | 11% | — | $18 – $24 |
| 25 | Mercy Health Lakeshore Campus Shelby, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $28 | $28 | $9 | 30% | — | $20 – $37 |
← Payers reporting CPT 90460 · Snapshot 20261111T120946Z-9134e7f7