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
Screening Test Pure Tone Air Only
Low
$15
Average
$113
Median
$25
High
$1.8k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
46 hospitals; the 90th percentile is 6.0× 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.
Filter by billing methodology
Filter by billing class
59 hospital rates
iThe hospitals that file a Wellmark 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 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · inpatient | 2 | $21 | $21 | — | — | — | $21 – $21 |
| 2 | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · inpatient | 2 | $20 | $20 | — | — | — | $20 – $20 |
| 3 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 3 | $22 | $23 | $2 | 8% | — | $22 – $25 |
| 4 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · inpatientfrom % of charges | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 5 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · outpatientfrom % of charges | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 6 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 3 | $22 | $23 | $2 | 8% | — | $22 – $25 |
| 7 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 3 | $22 | $23 | $2 | 8% | — | $22 – $25 |
| 8 | Grinnell Regional Medical Center Grinnell, IA fee schedule · both | 3 | $22 | $23 | $2 | 8% | — | $22 – $25 |
| 9 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · case rate · outpatient | 2 | $79 | $79 | $4 | 5% | — | $75 – $83 |
| 10 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $40 | $40 | $0 | 1% | — | $39 – $40 |
| 11 | HAWARDEN REGIONAL HEALTHCARE HARWARDEN, IA other · outpatient | 2 | $15 | $15 | — | — | — | $15 – $15 |
| 12 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $106 | $106 | — | — | — | $106 – $106 |
| 13 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · inpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 14 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 15 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · both | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 16 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · inpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 17 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 18 | Mercy Medical Center - New Hampton New Hampton, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 19 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · case rate · inpatient | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 20 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · per diem · inpatient | 1 | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 21 | MercyOne Genesis DeWitt Medical Center DeWitt, IA facility · per diem · inpatient | 2 | $1.8k | $1.8k | $876 | 49% | — | $928 – $2.7k |
| 22 | MercyOne Genesis Silvis Medical Center Silvis, IL facility · case rate · inpatient | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 23 | Meriter Hospital, Inc Madison, WI percent of total billed charges · bothfrom % of charges | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 24 | Monument Health Network Inc Spearfish, SD fee schedule · outpatient | 1 | $271 | $271 | — | — | — | $271 – $271 |
| 25 | Monument Health Network Inc Spearfish, SD other · outpatient | 1 | $45 | $45 | — | — | — | $45 – $45 |
← Payers reporting CPT 92551 · Snapshot 20261111T120946Z-9134e7f7