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
$14
Average
$149
Median
$53
High
$537
Each hospital's average Premera rate, under the methodology and billing class chosen below.
29 hospitals; the 90th percentile is 19.3× 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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45 hospital rates
iThe hospitals that file a Premera 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 | St Mary Mercy Livonia Livonia, MI professional · fee schedule · outpatient | 1 | $19 | $19 | — | — | 12–21 | $19 – $19 |
| 2 | Tacoma General Allenmore Hospital Bremerton, WA percent of total billed charges · outpatientfrom % of charges | 4 | $328 | $328 | — | — | 4–40 | $328 – $328 |
| 3 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 1 | $19 | $19 | — | — | 2–20 | $19 – $19 |
| 4 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 1 | $27 | $27 | — | — | 1–10 | $27 – $27 |
| 5 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · outpatientfrom % of charges | 3 | $550 | $537 | $20 | 4% | — | $501 – $550 |
| 6 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · inpatient | 1 | $235 | $235 | — | — | — | $235 – $235 |
| 7 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · outpatient | 1 | $235 | $235 | — | — | — | $235 – $235 |
| 8 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 9 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 10 | Good Samaritan Hospital Puyallup, WA percent of total billed charges · outpatientfrom % of charges | 4 | $328 | $328 | — | — | — | $328 – $328 |
| 11 | Mary Bridge Children's Hospital Tacoma, WA percent of total billed charges · outpatientfrom % of charges | 4 | $328 | $328 | — | — | — | $328 – $328 |
| 12 | Mercy Health Hackley Campus Muskogen, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 13 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · inpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 14 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 15 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · inpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 16 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 17 | Mercy Health Saint Marys Rockford, MI facility · percent of total billed charges · bothfrom % of charges | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 18 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · inpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 19 | Mercy Health Services-Iowa Corp. Mason City, IA professional · fee schedule · both | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 20 | Mercy Medical Center - New Hampton New Hampton, IA professional · fee schedule · inpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 21 | Mercy Medical Center - New Hampton New Hampton, IA professional · fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 22 | MultiCare Auburn Medical Center Auburn, WA percent of total billed charges · outpatientfrom % of charges | 4 | $328 | $328 | — | — | — | $328 – $328 |
| 23 | MultiCare Capital Medical Center Lacey, WA percent of total billed charges · outpatientfrom % of charges | 4 | $328 | $328 | — | — | — | $328 – $328 |
| 24 | MultiCare Covington Medical Center Covington, WA percent of total billed charges · outpatientfrom % of charges | 4 | $328 | $328 | — | — | — | $328 – $328 |
| 25 | PORTLAND ADVENTIST MEDICAL CENTER Portland, OR percent of total billed charges · outpatientfrom % of charges | 1 | $95 | $95 | — | — | — | $95 – $95 |
← Payers reporting CPT 96110 · Snapshot 20261111T120946Z-9134e7f7