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
$6
Average
$312
Median
$236
High
$8.0k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
826 hospitals; the 90th percentile is 3.6× 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.
Filter by billing methodology
Filter by billing class
1,326 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 7 | $439 | $444 | $15 | 3% | 898–907 | $429 – $473 |
| 2 | Baystate Franklin Medical Center Greenfield, MA facility · percent of total billed charges · bothfrom % of charges | 3 | $137 | $137 | — | — | 855 | $137 – $137 |
| 3 | West Virginia University Hospitals, Inc. Morgantown, WV professional · percent of total billed charges · outpatientfrom % of charges | 2 | $533 | $533 | — | — | 488–515 | $533 – $533 |
| 4 | Baystate Medical Center Springfield, MA percent of total billed charges · bothfrom % of charges | 3 | $143 | $143 | — | — | 420 | $143 – $143 |
| 5 | Mayo Clinic Arizona Phoenix, AZ professional · percent of total billed charges · outpatientfrom % of charges | 5 | $410 | $430 | $35 | 8% | 399–417 | $410 – $491 |
| 6 | The Carle Foundation Hospital Urbana, IL percent of total billed charges · outpatientfrom % of charges | 2 | $389 | $389 | — | — | 332 | $389 – $389 |
| 7 | Methodist Medical Center of Illinois Peoria, IL percent of total billed charges · outpatientfrom % of charges | 4 | $270 | $268 | $7 | 2% | 294 | $256 – $274 |
| 8 | Baystate Franklin Medical Center Greenfield, MA facility · fee schedule · both | 1 | $137 | $137 | — | — | 285 | $137 – $137 |
| 9 | Brigham and Women's Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 2 | $355 | $355 | $26 | 7% | 265 | $329 – $381 |
| 10 | City Hospital, Inc. Martinsburg, WV professional · percent of total billed charges · outpatientfrom % of charges | 1 | $122 | $122 | — | — | 199 | $122 – $122 |
| 11 | LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD PALO ALTO, CA fee schedule · both | 1 | $518 | $518 | — | — | 183 | $518 – $518 |
| 12 | St Peters Hospital Albany, NY facility · other · both | 3 | $146 | $169 | $102 | 60% | 179–1,520 | $146 – $618 |
| 13 | Baystate Medical Center Springfield, MA fee schedule · both | 1 | $143 | $143 | — | — | 140 | $143 – $143 |
| 14 | Mayo Clinic Health System Mankato 56001-4752 professional · percent of total billed charges · outpatientfrom % of charges | 7 | $501 | $505 | $23 | 4% | 133–151 | $478 – $545 |
| 15 | Spaulding Rehabilitation Hospital Boston Charlestown, MA percent of total billed charges · outpatientfrom % of charges | 1 | $358 | $358 | — | — | 96 | $358 – $358 |
| 16 | St Joseph Mercy Chelsea Chelsea, MI professional · fee schedule · both | 5 | $217 | $195 | $25 | 13% | 91 | $164 – $217 |
| 17 | Salem Hospital Salem, MA percent of total billed charges · outpatientfrom % of charges | 3 | $316 | $313 | $3 | 1% | 71–89 | $309 – $316 |
| 18 | Massachusetts General Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 2 | $355 | $355 | $26 | 7% | 65 | $329 – $381 |
| 19 | Mayo Clinic Health System Sparta, WI professional · percent of total billed charges · outpatientfrom % of charges | 6 | $499 | $499 | $22 | 4% | 62–80 | $456 – $526 |
| 20 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 3 | $160 | $141 | $27 | 19% | 61–151 | $100 – $160 |
| 21 | Baystate Wing Hospital Palmer, MA percent of total billed charges · bothfrom % of charges | 3 | $148 | $148 | — | — | 60 | $148 – $148 |
| 22 | LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD PALO ALTO, CA fee schedule · outpatient | 2 | $654 | $654 | — | — | 60–69 | $654 – $654 |
| 23 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC fee schedule · both | 4 | $323 | $364 | $98 | 27% | 56–74 | $249 – $497 |
| 24 | St Luke's Magic Valley Regional Medical Center, LTD Jerome, ID other · outpatient | 1 | $112 | $112 | $51 | 46% | 53 | $61 – $164 |
| 25 | Northwestern Medicine Kishwaukee Hospital DeKalb, IL other · outpatient | 1 | $133 | $133 | — | — | 51 | $133 – $133 |
← Payers reporting CPT 90791 · Snapshot 20261111T120946Z-9134e7f7