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
$96
Average
$217
Median
$177
High
$428
Each hospital's average Excellus rate, under the methodology and billing class chosen below.
49 hospitals; the 90th percentile is 2.6× 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.
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86 hospital rates
iThe hospitals that file a Excellus 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 | Samaritan Medical Center Watertown, NY facility · other · inpatient | 2 | $191 | $191 | $13 | 7% | 21–39 | $179 – $204 |
| 2 | Samaritan Medical Center Watertown, NY professional · other · both | 2 | $191 | $191 | $13 | 7% | 20–29 | $179 – $204 |
| 3 | Samaritan Medical Center Watertown, NY facility · other · outpatient | 1 | $179 | $179 | — | — | 19 | $179 – $179 |
| 4 | MVHS, Inc. Utica, NY percent of total billed charges · bothfrom % of charges | 3 | $93 | $151 | $71 | 47% | 17–35 | $93 – $238 |
| 5 | St Peters Hospital Albany, NY facility · other · both | 1 | $146 | $146 | — | — | 15–150 | $146 – $146 |
| 6 | St Peters Hospital Albany, NY professional · percent of total billed charges · bothfrom % of charges | 1 | $307 | $307 | — | — | 2–20 | $307 – $307 |
| 7 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 2 | $177 | $177 | $7 | 4% | 1–10 | $170 – $184 |
| 8 | Samaritan Hospital Troy, NY facility · other · both | 1 | $146 | $146 | — | — | 1–10 | $146 – $146 |
| 9 | CLIFTON-FINE HEALTHCARE CORPORATION STAR LAKE, NY fee schedule · outpatient | 2 | $428 | $428 | $250 | 58% | — | $178 – $678 |
| 10 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 1 | $181 | $181 | — | — | — | $181 – $181 |
| 11 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 3 | $150 | $137 | $26 | 19% | — | $100 – $160 |
| 12 | Champlain Valley Physicians Hospital Medical Center Plattsburgh, NY professional · fee schedule · both | 3 | $182 | $172 | $22 | 13% | — | $141 – $193 |
| 13 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 14 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $181 | $181 | — | — | — | $181 – $181 |
| 15 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 3 | $150 | $137 | $26 | 19% | — | $100 – $160 |
| 16 | Crouse Hospital Syracuse, NY fee schedule · outpatient | 4 | $296 | $289 | $109 | 38% | — | $167 – $398 |
| 17 | Elizabethtown Community Hospital Elizabethtown, NY professional · fee schedule · both | 3 | $182 | $172 | $22 | 13% | — | $141 – $193 |
| 18 | F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient | 5 | $146 | $172 | $115 | 67% | — | $44 – $612 |
| 19 | Highland Hospital Rochester, NY fee schedule · outpatient | 7 | $54 | $185 | $151 | 81% | — | $54 – $419 |
| 20 | Holy Cross Germantown Hospital Germantown, MD professional · percent of total billed charges · bothfrom % of charges | 1 | $307 | $307 | — | — | — | $307 – $307 |
| 21 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 22 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · both | 3 | $135 | $137 | $21 | 15% | — | $113 – $163 |
| 23 | Holy Cross Hospital-Silver Spring Silver Spring, MD professional · percent of total billed charges · bothfrom % of charges | 1 | $307 | $307 | — | — | — | $307 – $307 |
| 24 | Johnson Memorial Hospital Stafford Springs, CT facility · case rate · both | 1 | $328 | $328 | — | — | — | $328 – $328 |
| 25 | Johnson Memorial Hospital Stafford Springs, CT professional · fee schedule · inpatient | 3 | $103 | $97 | $20 | 20% | — | $70 – $117 |
← Payers reporting CPT 90791 · Snapshot 20261111T120946Z-9134e7f7