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
$93
Average
$296
Median
$188
High
$979
Each hospital's average Carefirst rate, under the methodology and billing class chosen below.
49 hospitals; the 90th percentile is 3.5× 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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83 hospital rates
iThe hospitals that file a Carefirst 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 Joseph Mercy Ann Arbor Ypsilanti, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $118 | $118 | $5 | 5% | 2–20 | $113 – $124 |
| 2 | University of Virginia Prince William Medical Center Manassas, VA percent of total billed charges · bothfrom % of charges | 2 | $166 | $166 | — | — | 2–20 | $166 – $166 |
| 3 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 3 | $155 | $147 | $21 | 15% | 1–10 | $100 – $160 |
| 4 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 2 | $184 | $178 | $7 | 4% | 1–10 | $170 – $184 |
| 5 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 1 | $181 | $181 | — | — | — | $181 – $181 |
| 6 | Children's National Hospital Washington, DC facility · percent of total billed charges · inpatientfrom % of charges | 1 | $182 | $182 | — | — | — | $182 – $182 |
| 7 | Children's National Hospital Washington, DC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $220 | $220 | $68 | 31% | — | $152 – $288 |
| 8 | Children's National Hospital Washington, DC professional · fee schedule · both | 3 | $113 | $130 | $33 | 25% | — | $102 – $176 |
| 9 | Children's National Rehabilitation and Specialized Care Washington, DC facility · percent of total billed charges · inpatientfrom % of charges | 2 | $350 | $350 | $15 | 4% | — | $335 – $365 |
| 10 | Children's National Rehabilitation and Specialized Care Washington, DC facility · percent of total billed charges · outpatientfrom % of charges | 2 | $350 | $350 | $15 | 4% | — | $335 – $365 |
| 11 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $181 | $181 | — | — | — | $181 – $181 |
| 12 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 3 | $155 | $147 | $21 | 15% | — | $100 – $160 |
| 13 | Holy Cross Germantown Hospital Germantown, MD professional · percent of total billed charges · bothfrom % of charges | 1 | $307 | $307 | — | — | — | $307 – $307 |
| 14 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 15 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · both | 3 | $149 | $142 | $23 | 16% | — | $113 – $163 |
| 16 | Holy Cross Hospital-Silver Spring Silver Spring, MD professional · percent of total billed charges · bothfrom % of charges | 1 | $307 | $307 | — | — | — | $307 – $307 |
| 17 | Inova Alexandria Hospital Alexandria, VA other · both | 2 | $408 | $408 | $11 | 3% | — | $397 – $419 |
| 18 | Inova Fair Oaks Hospital Fairfax, VA other · both | 2 | $408 | $408 | $11 | 3% | — | $397 – $419 |
| 19 | Inova Fairfax Hospital Falls Church, VA other · both | 2 | $408 | $408 | $11 | 3% | — | $397 – $419 |
| 20 | Inova Loudoun Hospital Leesburg, VA other · both | 2 | $408 | $408 | $11 | 3% | — | $397 – $419 |
| 21 | Inova Mount Vernon Hospital Alexandria, VA other · both | 2 | $408 | $408 | $11 | 3% | — | $397 – $419 |
| 22 | Johnson Memorial Hospital Stafford Springs, CT facility · case rate · both | 1 | $328 | $328 | — | — | — | $328 – $328 |
| 23 | Johnson Memorial Hospital Stafford Springs, CT professional · fee schedule · inpatient | 3 | $110 | $99 | $21 | 21% | — | $70 – $117 |
| 24 | Johnson Memorial Hospital Stafford Springs, CT professional · fee schedule · outpatient | 3 | $117 | $105 | $26 | 24% | — | $70 – $138 |
| 25 | MedStar Franklin Square Medical Center Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 3 | $510 | $510 | — | — | — | $510 – $510 |
← Payers reporting CPT 90791 · Snapshot 20261111T120946Z-9134e7f7