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
MODERATE COMPLEXITY PT EVALUATION
Low
$66
Average
$96
Median
$96
High
$155
Each hospital's average Clover rate, under the methodology and billing class chosen below.
106 hospitals; the 90th percentile is 1.2× 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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120 hospital rates
iThe hospitals that file a Clover 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 | Inspira Medical Center Elmer Elmer, NJ other · outpatient | 1 | $105 | $105 | — | — | 25 | $105 – $105 |
| 2 | Higgins General Hospital Bremen, GA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $67 | $67 | — | — | 1–10 | $67 – $67 |
| 3 | Inspira Medical Center Mannington Salem, NJ other · outpatient | 1 | $105 | $105 | — | — | 1–10 | $105 – $105 |
| 4 | Affinity Hospital LLC Birmingham, AL facility · fee schedule · outpatient | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 5 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $94 | $94 | — | — | — | $94 – $94 |
| 6 | CRAWFORD LONG HOSPITAL Atlanta, GA facility · fee schedule · outpatient | 1 | $98 | $98 | — | — | — | $98 – $98 |
| 7 | Capital Health System Inc Trenton, NJ case rate · outpatient | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 8 | Capital Health System Inc Browns Mills, NJ case rate · outpatient | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 9 | Central Georgia Rehabilitation LLC Macon, GA fee schedule · both | 1 | $95 | $95 | — | — | — | $95 – $95 |
| 10 | Central Georgia Rehabilitation LLC Macon, GA fee schedule · outpatient | 1 | $95 | $95 | — | — | — | $95 – $95 |
| 11 | Conway Hospital, Inc. Conway, SC facility · fee schedule · outpatient | 1 | $94 | $94 | — | — | — | $94 – $94 |
| 12 | Conway Hospital, Inc. Conway, SC professional · fee schedule · outpatient | 1 | $94 | $94 | — | — | — | $94 – $94 |
| 13 | DEKALB MEDICAL CENTER, INC Lithonia, GA facility · fee schedule · outpatient | 1 | $98 | $98 | — | — | — | $98 – $98 |
| 14 | DEKALB MEDICAL CENTER, INC Decatur, GA facility · fee schedule · outpatient | 1 | $98 | $98 | — | — | — | $98 – $98 |
| 15 | Donalsonville Hospital Donalsonville, GA fee schedule · both | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 16 | EHCA JOHN'S CREEK, LLC Johns Creek, GA facility · fee schedule · outpatient | 1 | $98 | $98 | — | — | — | $98 – $98 |
| 17 | EMORY UNIVERSITY Atlanta, GA facility · fee schedule · outpatient | 1 | $98 | $98 | — | — | — | $98 – $98 |
| 18 | East Georgia Regional Medical Center LLC Statesboro, GA facility · fee schedule · outpatient | 1 | $92 | $92 | — | — | — | $92 – $92 |
| 19 | FAIRVIEW PARK HOSPITAL DUBLIN, GA fee schedule · outpatient | 1 | $92 | $92 | $6 | 6% | — | $86 – $98 |
| 20 | Floyd Healthcare Management Inc Rome, GA case rate · outpatient | 1 | $95 | $95 | — | — | — | $95 – $95 |
| 21 | Foley Hospital Company LLC Foley, AL facility · fee schedule · outpatient | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 22 | Gadsden Regional Medical Center LLC Gadsden, AL facility · fee schedule · outpatient | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 23 | Grady Memorial Hospital Atlanta, GA facility · fee schedule · outpatient | 1 | $103 | $103 | — | — | — | $103 – $103 |
| 24 | Grady Memorial Hospital Atlanta, GA professional · fee schedule · outpatient | 1 | $103 | $103 | — | — | — | $103 – $103 |
| 25 | HCA Healthcare Live Oak Mental Health and Wellness Ladson, SC fee schedule · outpatient | 1 | $93 | $93 | $6 | 6% | — | $87 – $99 |
← Payers reporting CPT 97162 · Snapshot 20261111T120946Z-9134e7f7