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
$5
Average
$175
Median
$169
High
$713
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
468 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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612 hospital rates
iThe hospitals that file a WellCare 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 | 1 | $190 | $190 | — | — | 161 | $190 – $190 |
| 2 | North Carolina Baptist Hospital Winston Salem, NC percent of total billed charges · outpatientfrom % of charges | 1 | $71 | $71 | — | — | 118 | $71 – $71 |
| 3 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 1 | $68 | $68 | — | — | 118 | $68 – $68 |
| 4 | ARH Tug Valley Health Services, Inc. Paintsville, KY other · outpatient | 2 | $106 | $106 | $5 | 5% | 33–42 | $101 – $111 |
| 5 | ROBERT PACKER HOSPITAL Sayre, PA facility · other · outpatient | 3 | $214 | $202 | $18 | 9% | 19 | $176 – $214 |
| 6 | Carolinas Medical Center Davidson, NC percent of total billed charges · outpatientfrom % of charges | 1 | $31 | $31 | — | — | 18 | $31 – $31 |
| 7 | Pitt County Memorial Hospital, Inc. Greenville, NC percent of total billed charges · bothfrom % of charges | 1 | $122 | $122 | — | — | 16 | $122 – $122 |
| 8 | Pitt County Memorial Hospital, Inc. Washington, NC percent of total billed charges · bothfrom % of charges | 1 | $122 | $122 | — | — | 16 | $122 – $122 |
| 9 | Fairview Bethesda Hospital St. Paul, MN other · inpatient | 1 | $163 | $163 | — | — | 5–50 | $163 – $163 |
| 10 | Fairview Health Services Minneapolis, MN other · inpatient | 1 | $163 | $163 | — | — | 4–40 | $163 – $163 |
| 11 | HMH Carrier Behavioral Health Inc Belle Mead, NJ facility · percent of total billed charges · outpatientfrom % of charges | 2 | $348 | $348 | — | — | 2–20 | $348 – $348 |
| 12 | The University of Texas Medical Branch Webster, TX other · both | 1 | $169 | $169 | — | — | 2–20 | $169 – $169 |
| 13 | Appalachian Regional Healthcare, Inc. Hazard, KY percent of total billed charges · outpatientfrom % of charges | 1 | $84 | $84 | — | — | 1–10 | $84 – $84 |
| 14 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges | 1 | $20 | $20 | — | — | 1–10 | $20 – $20 |
| 15 | BAPTIST HEALTHCARE SYSTEM INC. Louisville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $122 | $122 | — | — | 1–10 | $122 – $122 |
| 16 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $31 | $31 | — | — | 1–10 | $31 – $31 |
| 17 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 2 | $143 | $143 | $7 | 5% | 1–10 | $136 – $150 |
| 18 | Columbus Regional Healthcare System, Inc Whiteville, NC percent of total billed charges · outpatientfrom % of charges | 1 | $56 | $56 | — | — | 1–10 | $56 – $56 |
| 19 | HARTFORD HOSPITAL HARTFORD, CT other · outpatient | 1 | $74 | $74 | — | — | 1–10 | $74 – $74 |
| 20 | HOSPITAL OF CENTRAL CONNECTICUT AT NEW BRITAIN D/B/A THE HOSPITAL OF CENTRAL CONNECTICUT SOUTHINGTON, CT other · outpatient | 1 | $74 | $74 | — | — | 1–10 | $74 – $74 |
| 21 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 2 | $150 | $150 | $19 | 13% | 1–10 | $131 – $170 |
| 22 | Parkland Health Dallas, TX professional · fee schedule · both | 1 | $121 | $121 | — | — | 1–10 | $121 – $121 |
| 23 | Rumford Hospital Rumford, ME percent of total billed charges · outpatientfrom % of charges | 1 | $330 | $330 | — | — | 1–10 | $330 – $330 |
| 24 | SVMC HOLDINGS INC D/B/A ST VINCENT�S MEDICAL CENTER BRIDGEPORT, CT other · outpatient | 1 | $74 | $74 | — | — | 1–10 | $74 – $74 |
| 25 | Saint Francis Hospital and Medical Center Hartford, CT professional · fee schedule · outpatient | 2 | $96 | $96 | $45 | 47% | 1–10 | $51 – $141 |
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