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
PR Assessment Emotional/Behavioral per Instrument Brief
Low
$4
Average
$61
Median
$23
High
$511
Each hospital's average Premera rate, under the methodology and billing class chosen below.
50 hospitals; the 90th percentile is 19.7× 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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80 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 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · both | 1 | $9 | $9 | — | — | 26–35 | $9 – $9 |
| 2 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 1 | $7 | $7 | — | — | 16–25 | $7 – $7 |
| 3 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · both | 1 | $6 | $6 | — | — | 14–23 | $6 – $6 |
| 4 | Mount Carmel East Reynoldsburg, OH professional · percent of total billed charges · bothfrom % of charges | 1 | $11 | $11 | — | — | 12–21 | $11 – $11 |
| 5 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 1 | $8 | $8 | — | — | 2–20 | $8 – $8 |
| 6 | Samaritan Hospital Troy, NY professional · percent of total billed charges · bothfrom % of charges | 1 | $12 | $12 | — | — | 2–20 | $12 – $12 |
| 7 | St Mary Mercy Livonia Livonia, MI professional · fee schedule · both | 1 | $7 | $7 | — | — | 2–20 | $7 – $7 |
| 8 | St Peters Hospital Albany, NY professional · percent of total billed charges · bothfrom % of charges | 1 | $12 | $12 | — | — | 2–20 | $12 – $12 |
| 9 | The Mercy Hospital Inc Springfield, MA professional · fee schedule · both | 1 | $8 | $8 | — | — | 2–20 | $8 – $8 |
| 10 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · both | 1 | $6 | $6 | — | — | 1–10 | $6 – $6 |
| 11 | Mount Carmel St Ann's Lewis Center, OH professional · percent of total billed charges · bothfrom % of charges | 1 | $11 | $11 | — | — | 1–10 | $11 – $11 |
| 12 | Saint Francis Hospital and Medical Center Hartford, CT professional · fee schedule · both | 1 | $10 | $10 | — | — | 1–10 | $10 – $10 |
| 13 | St. Francis Hospital Inc Wilmington, DE professional · fee schedule · outpatient | 1 | $6 | $6 | — | — | 1–10 | $6 – $6 |
| 14 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · inpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 15 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 16 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 17 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 18 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 19 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 20 | Diley Ridge Medical Center Canal Winchester, OH facility · other · both | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 21 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 4 | $148 | $136 | $44 | 33% | — | $64 – $184 |
| 22 | Holy Cross Germantown Hospital Germantown, MD professional · percent of total billed charges · bothfrom % of charges | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 23 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 24 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · outpatient | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 25 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · both | 1 | $8 | $8 | — | — | — | $8 – $8 |
← Payers reporting CPT 96127 · Snapshot 20261111T120946Z-9134e7f7