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
$121
Average
$399
Median
$321
High
$5.8k
Each hospital's average Medical Mutual rate, under the methodology and billing class chosen below.
86 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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165 hospital rates
iThe hospitals that file a Medical Mutual 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 | Fairfield Medical Center 401 N Ewing St facility · percent of total billed charges · outpatientfrom % of charges | 2 | $369 | $11.4k | $15.6k | 138% | 11 | $248 – $33.5k |
| 2 | Mount Carmel East Reynoldsburg, OH professional · percent of total billed charges · bothfrom % of charges | 1 | $364 | $364 | — | — | 1–10 | $364 – $364 |
| 3 | St Joseph Mercy Chelsea Chelsea, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $222 | $222 | — | — | 1–10 | $222 – $222 |
| 4 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 1 | $440 | $440 | — | — | — | $440 – $440 |
| 5 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $169 | $169 | — | — | — | $169 – $169 |
| 6 | AnMed Health Anderson, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $349 | $349 | — | — | — | $349 – $349 |
| 7 | AnMed Health Cannon Pickens, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $349 | $349 | — | — | — | $349 – $349 |
| 8 | AnMed Piedmont Piedmont, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $349 | $349 | — | — | — | $349 – $349 |
| 9 | Benefis Hospitals Inc Helena, MT fee schedule · outpatient | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 10 | Benefis Hospitals Inc Helena, MT percent of total billed charges · inpatientfrom % of charges | 1 | $307 | $302 | $20 | 7% | — | $276 – $324 |
| 11 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 1 | $176 | $176 | — | — | — | $176 – $176 |
| 12 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · outpatient | 1 | $440 | $440 | — | — | — | $440 – $440 |
| 13 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · per diem · both | 1 | $227 | $227 | — | — | — | $227 – $227 |
| 14 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 15 | Columbus Regional Hospital Columbus, IN percent of total billed charges · bothfrom % of charges | 1 | $422 | $422 | — | — | — | $422 – $422 |
| 16 | Covenant Medical Center Inc Waterloo, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $766 | $766 | — | — | — | $766 – $766 |
| 17 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 18 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $154 | $154 | $22 | 14% | — | $132 – $175 |
| 19 | Dupont Hospital LLC Wayne, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $154 | $154 | $22 | 14% | — | $132 – $175 |
| 20 | Fairfield Medical Center 401 N Ewing St facility · fee schedule · outpatient | 1 | $3.1k | $3.1k | $2.9k | 95% | — | $168 – $6.0k |
| 21 | Fairfield Medical Center 401 N Ewing St facility · percent of total billed charges · inpatientfrom % of charges | 2 | $308 | $308 | $61 | 20% | — | $248 – $369 |
| 22 | Fisher-Titus Medical Center Norwalk, OH facility · fee schedule · outpatient | 1 | $151 | $151 | — | — | — | $151 – $151 |
| 23 | Fisher-Titus Medical Center Norwalk, OH professional · fee schedule · both | 1 | $142 | $142 | — | — | — | $142 – $142 |
| 24 | Fisher-Titus Medical Center Norwalk, OH professional · percent of total billed charges · inpatientfrom % of charges | 1 | $164 | $163 | $9 | 5% | — | $152 – $173 |
| 25 | Fisher-Titus Medical Center Norwalk, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $111 | $110 | $6 | 5% | — | $103 – $117 |
← Payers reporting CPT 90791 · Snapshot 20261111T120946Z-9134e7f7