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
Interogation Device Eval (Remote); S/D/M Pm/Icd
Low
$30
Average
$257
Median
$52
High
$8.7k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
50 hospitals; the 90th percentile is 4.3× 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 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 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · other · both | 1 | $36 | $36 | — | — | 90 | $36 – $36 |
| 2 | St Peters Hospital Albany, NY professional · percent of total billed charges · bothfrom % of charges | 1 | $57 | $57 | — | — | 1–10 | $57 – $57 |
| 3 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · inpatient | 2 | $55 | $55 | — | — | — | $55 – $55 |
| 4 | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · inpatient | 2 | $52 | $52 | — | — | — | $52 – $52 |
| 5 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 6 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 4 | $40 | $36 | $11 | 30% | — | $18 – $47 |
| 7 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · inpatientfrom % of charges | 1 | $644 | $644 | — | — | — | $644 – $644 |
| 8 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · outpatientfrom % of charges | 1 | $644 | $644 | — | — | — | $644 – $644 |
| 9 | Avera Heart Hospital Sioux Falls, SD case rate · outpatient | 2 | $87 | $87 | — | — | — | $87 – $87 |
| 10 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 2 | $38 | $38 | — | — | — | $38 – $38 |
| 11 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 3 | $40 | $39 | $7 | 17% | — | $29 – $47 |
| 12 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · fee schedule · both | 2 | $38 | $38 | — | — | — | $38 – $38 |
| 13 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · other · both | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 14 | Central Iowa Hospital Corporation Des Moines, IA case rate · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 15 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 4 | $40 | $36 | $11 | 30% | — | $18 – $47 |
| 16 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 4 | $40 | $36 | $11 | 30% | — | $18 – $47 |
| 17 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 2 | $38 | $38 | — | — | — | $38 – $38 |
| 18 | Covenant Medical Center Inc Waterloo, IA facility · other · both | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 19 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · inpatient | 3 | $40 | $39 | $7 | 17% | — | $29 – $47 |
| 20 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · outpatient | 3 | $40 | $39 | $7 | 17% | — | $29 – $47 |
| 21 | Grinnell Regional Medical Center Grinnell, IA case rate · outpatient | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 22 | Grinnell Regional Medical Center Grinnell, IA fee schedule · both | 4 | $40 | $36 | $11 | 30% | — | $18 – $47 |
| 23 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · case rate · outpatient | 2 | $87 | $87 | $4 | 5% | — | $83 – $91 |
| 24 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · case rate · both | 1 | $21.8k | $21.8k | — | — | — | $21.8k – $21.8k |
| 25 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · both | 2 | $29 | $30 | $1 | 5% | — | $29 – $32 |
← Payers reporting CPT 93296 · Snapshot 20261111T120946Z-9134e7f7