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
Developmental Screen W/Scoring & Doc Std Instrm
Low
$10
Average
$32
Median
$23
High
$107
Each hospital's average Excellus rate, under the methodology and billing class chosen below.
28 hospitals; the 90th percentile is 4.6× 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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50 hospital rates
iThe hospitals that file a Excellus 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 Hospital Troy, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $27 | — | — | 1–10 | $27 – $27 |
| 2 | Alice Hyde Medical Center Malone, NY professional · fee schedule · both | 2 | $15 | $15 | $1 | 6% | — | $14 – $16 |
| 3 | Champlain Valley Physicians Hospital Medical Center Plattsburgh, NY professional · fee schedule · both | 2 | $15 | $15 | $1 | 6% | — | $14 – $16 |
| 4 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 2 | $40 | $40 | $21 | 53% | — | $19 – $62 |
| 5 | Elizabethtown Community Hospital Elizabethtown, NY professional · fee schedule · both | 2 | $15 | $15 | $1 | 6% | — | $14 – $16 |
| 6 | F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient | 3 | $14 | $13 | $3 | 20% | — | $7 – $16 |
| 7 | Highland Hospital Rochester, NY fee schedule · outpatient | 4 | $40 | $107 | $117 | 109% | — | $40 – $310 |
| 8 | MVHS, Inc. Utica, NY percent of total billed charges · bothfrom % of charges | 2 | $93 | $93 | — | — | — | $93 – $93 |
| 9 | MVHS, Inc. Utica, NY percent of total billed charges · outpatientfrom % of charges | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 10 | Memorial Hosp of Wm F & Gertrude F Jones A/K/A Jones Memorial Hosp Wellsville, NY fee schedule · outpatient | 6 | $10 | $10 | $2 | 22% | — | $7 – $16 |
| 11 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 12 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · inpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 13 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · outpatient | 2 | $13 | $13 | $3 | 23% | — | $10 – $16 |
| 14 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · inpatient | 2 | $14 | $14 | $4 | 31% | — | $10 – $19 |
| 15 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 2 | $13 | $13 | $3 | 23% | — | $10 – $16 |
| 16 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 17 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · inpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 18 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 2 | $14 | $14 | $4 | 31% | — | $10 – $19 |
| 19 | Mercy Health Services-Iowa Corp. Mason City, IA professional · fee schedule · both | 2 | $40 | $40 | $21 | 53% | — | $19 – $62 |
| 20 | Mercy Medical Center - New Hampton New Hampton, IA professional · fee schedule · inpatient | 2 | $26 | $26 | $7 | 27% | — | $19 – $33 |
| 21 | Mercy Medical Center - New Hampton New Hampton, IA professional · fee schedule · outpatient | 2 | $36 | $36 | $17 | 47% | — | $19 – $52 |
| 22 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 2 | $18 | $18 | $8 | 44% | — | $10 – $27 |
| 23 | Mount Carmel Grove City Grove City, OH professional · percent of total billed charges · inpatientfrom % of charges | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 24 | Mount Carmel Grove City Grove City, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 25 | Nicholas H. Noyes Memorial Hospital Dansville, NY fee schedule · outpatient | 3 | $14 | $13 | $3 | 20% | — | $7 – $16 |
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