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
Intake Evaluation Php
Low
$30
Average
$357
Median
$267
High
$6.6k
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
380 hospitals; the 90th percentile is 3.4× 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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791 hospital rates
iThe hospitals that file a Anthem 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 | Childrens Hospital Colorado Aurora, CO other · both | 2 | $917 | $917 | $498 | 54% | 688 | $419 – $1.4k |
| 2 | HARTFORD HOSPITAL HARTFORD, CT case rate · outpatient | 2 | $337 | $337 | $48 | 14% | 323 | $289 – $385 |
| 3 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 6 | $202 | $184 | $18 | 10% | 214–232 | $162 – $202 |
| 4 | THE CHARLOTTE HUNGERFORD HOSPITAL TORRINGTON, CT case rate · outpatient | 2 | $325 | $325 | $47 | 14% | 108 | $278 – $371 |
| 5 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · outpatientfrom % of charges | 5 | $547 | $481 | $106 | 22% | 95 | $273 – $547 |
| 6 | Fairfield Medical Center 401 N Ewing St facility · percent of total billed charges · outpatientfrom % of charges | 3 | $13.1k | $13.2k | $12.9k | 98% | 60 | $285 – $26.3k |
| 7 | HOSPITAL OF CENTRAL CONNECTICUT AT NEW BRITAIN D/B/A THE HOSPITAL OF CENTRAL CONNECTICUT SOUTHINGTON, CT case rate · outpatient | 2 | $361 | $361 | $52 | 14% | 57–66 | $309 – $413 |
| 8 | Columbus Regional Hospital Columbus, IN percent of total billed charges · bothfrom % of charges | 2 | $424 | $424 | $10 | 2% | 53–62 | $414 – $434 |
| 9 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 4 | $176 | $191 | $80 | 42% | 44–89 | $67 – $389 |
| 10 | St Peters Hospital Albany, NY facility · other · both | 2 | $618 | $612 | $23 | 4% | 42–420 | $524 – $618 |
| 11 | The Medical Center of Central Georgia Inc Macon, GA percent of total billed charges · bothfrom % of charges | 1 | $214 | $214 | — | — | 29 | $214 – $214 |
| 12 | University of Virginia Prince William Medical Center Manassas, VA other · both | 3 | $299 | $257 | $70 | 27% | 24–42 | $159 – $314 |
| 13 | University of Virginia Medical Center Charlottesville, VA other · both | 2 | $189 | $189 | $11 | 6% | 22–31 | $177 – $200 |
| 14 | THE WILLIAM W BACKUS HOSPITAL PLAINFIELD, CT case rate · outpatient | 2 | $351 | $351 | $50 | 14% | 21–39 | $301 – $401 |
| 15 | Brattleboro Retreat Brattleboro, VT outpatient | 1 | $143 | $143 | — | — | 17 | $143 – $143 |
| 16 | MaineHealth Westbrook, ME percent of total billed charges · outpatientfrom % of charges | 1 | $174 | $174 | — | — | 17 | $174 – $174 |
| 17 | Mount Carmel East Reynoldsburg, OH professional · percent of total billed charges · bothfrom % of charges | 1 | $364 | $364 | — | — | 13–22 | $364 – $364 |
| 18 | Eskenazi Health Indianapolis, IN facility · case rate · both | 1 | $495 | $495 | — | — | 12 | $495 – $495 |
| 19 | Eskenazi Health Indianapolis, IN facility · case rate · outpatient | 1 | $495 | $495 | — | — | 12 | $495 – $495 |
| 20 | SVMC HOLDINGS INC D/B/A ST VINCENT�S MEDICAL CENTER BRIDGEPORT, CT case rate · outpatient | 2 | $369 | $369 | $53 | 14% | 12–21 | $316 – $422 |
| 21 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 3 | $160 | $138 | $28 | 20% | 9–90 | $100 – $160 |
| 22 | Community Memorial Hospital of Menomonee Falls Inc Menomonee Falls, WI other · inpatient | 2 | $184 | $184 | $23 | 13% | 4–40 | $161 – $207 |
| 23 | Community Memorial Hospital of Menomonee Falls Inc Menomonee Falls, WI percent of total billed charges · outpatientfrom % of charges | 2 | $184 | $184 | $23 | 13% | 4–40 | $161 – $207 |
| 24 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 2 | $184 | $182 | $6 | 3% | 4–40 | $170 – $184 |
| 25 | Mount Carmel St Ann's Lewis Center, OH professional · percent of total billed charges · bothfrom % of charges | 1 | $364 | $364 | — | — | 2–20 | $364 – $364 |
← Payers reporting CPT 90791 · Snapshot 20261111T120946Z-9134e7f7