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
$54
Average
$267
Median
$218
High
$3.5k
Each hospital's average Medica rate, under the methodology and billing class chosen below.
169 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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339 hospital rates
iThe hospitals that file a Medica 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 | WINNESHIEK MEDICAL CENTER Decorah, IA percent of total billed charges · outpatientfrom % of charges | 3 | $70 | $71 | $1 | 2% | 3–30 | $70 – $72 |
| 2 | Mayo Clinic Arizona Phoenix, AZ professional · percent of total billed charges · outpatientfrom % of charges | 5 | $410 | $415 | $47 | 11% | 2–20 | $369 – $491 |
| 3 | Monument Health Rapid City Hospital Inc City, SD percent of total billed charges · outpatientfrom % of charges | 3 | $113 | $174 | $100 | 57% | 2–20 | $94 – $316 |
| 4 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 7 | $447 | $448 | $9 | 2% | 1–10 | $439 – $464 |
| 5 | Mayo Clinic Health System Mankato 56001-4752 professional · percent of total billed charges · outpatientfrom % of charges | 5 | $523 | $519 | $13 | 2% | 1–10 | $495 – $534 |
| 6 | Mayo Clinic Health System Eau Claire 54703-5270 professional · fee schedule · outpatient | 2 | $176 | $172 | $25 | 14% | 1–10 | $141 – $200 |
| 7 | Mayo Clinic Health System Eau Claire 54703-5270 professional · percent of total billed charges · outpatientfrom % of charges | 8 | $474 | $465 | $35 | 7% | 1–10 | $379 – $501 |
| 8 | ALEGENT CREIGHTON HEALTH Papillion, NE case rate · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 9 | ALEGENT CREIGHTON HEALTH Papillion, NE fee schedule · outpatient | 4 | $283 | $286 | $42 | 15% | — | $227 – $347 |
| 10 | ALEGENT CREIGHTON HEALTH Omaha, NE case rate · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 11 | ALEGENT CREIGHTON HEALTH Omaha, NE fee schedule · outpatient | 4 | $283 | $286 | $42 | 15% | — | $227 – $347 |
| 12 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA case rate · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 13 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA fee schedule · outpatient | 4 | $283 | $286 | $42 | 15% | — | $227 – $347 |
| 14 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE case rate · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 15 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE case rate · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 16 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · outpatient | 4 | $283 | $286 | $42 | 15% | — | $227 – $347 |
| 17 | ALEGENT HEALTH IMMANUEL MEDICAL CENTER Omaha, NE case rate · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 18 | ALEGENT HEALTH IMMANUEL MEDICAL CENTER Omaha, NE fee schedule · outpatient | 4 | $283 | $286 | $42 | 15% | — | $227 – $347 |
| 19 | Allen Memorial Hospital Corporation Waterloo, IA percent of total billed charges · outpatientfrom % of charges | 1 | $160 | $160 | $9 | 6% | — | $151 – $169 |
| 20 | Allina Health Systems Shakopee, MN facility · case rate · outpatient | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | Allina Health Systems Shakopee, MN facility · fee schedule · outpatient | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 22 | Allina Health Systems Shakopee, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $239 | $247 | $117 | 47% | — | $102 – $485 |
| 23 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · case rate · outpatient | 7 | $0 | $0 | — | — | — | $0 – $0 |
| 24 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · fee schedule · outpatient | 1 | $192 | $192 | — | — | — | $192 – $192 |
| 25 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $223 | $211 | $82 | 39% | — | $112 – $334 |
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