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
$58
Average
$209
Median
$172
High
$1.0k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
129 hospitals; the 90th percentile is 3.6× 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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227 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 | Avera McKennan Hospital Sioux Falls, SD case rate · outpatient | 2 | $120 | $120 | — | — | 1,352 | $120 – $120 |
| 2 | Sioux Center Health Sioux Center, IA case rate · outpatient | 2 | $217 | $217 | — | — | 652 | $217 – $217 |
| 3 | Lakes Regional Hospital Spirit Lake, IA case rate · outpatient | 2 | $93 | $93 | — | — | 418 | $93 – $93 |
| 4 | Sanford USD Medical Center Sioux Falls, SD other · outpatient | 1 | $236 | $236 | — | — | 293 | $236 – $236 |
| 5 | Spencer Municipal Hospital Spencer, IA fee schedule · outpatient | 3 | $226 | $189 | $69 | 36% | 274 | $93 – $249 |
| 6 | Avera Sacred Heart Hospital Yankton, SD outpatient | 1 | $104 | $104 | — | — | 201 | $104 – $104 |
| 7 | Avera Sacred Heart Hospital Yankton, SD percent of total billed charges · outpatientfrom % of charges | 1 | $356 | $356 | — | — | 201 | $356 – $356 |
| 8 | Avera Holy Family Hospital Estherville, IA case rate · outpatient | 2 | $247 | $247 | — | — | 188 | $247 – $247 |
| 9 | Monument Health Network Inc Custer, SD percent of total billed charges · outpatientfrom % of charges | 2 | $190 | $190 | $106 | 56% | 134 | $84 – $295 |
| 10 | Osceola Regional Health Center Sibley, IA case rate · outpatient | 2 | $244 | $244 | — | — | 126 | $244 – $244 |
| 11 | Regional Health Services of Howard County Cresco, IA case rate · outpatient | 2 | $228 | $228 | — | — | 122 | $228 – $228 |
| 12 | Monument Health Network Inc Deadwood, SD percent of total billed charges · outpatientfrom % of charges | 2 | $185 | $185 | $87 | 47% | 84 | $98 – $272 |
| 13 | Monument Health Network Inc Sturgis, SD percent of total billed charges · outpatientfrom % of charges | 2 | $170 | $170 | $89 | 53% | 82 | $81 – $259 |
| 14 | Avera St. Benedicts Parkston, SD outpatient | 1 | $302 | $302 | — | — | 80 | $302 – $302 |
| 15 | Avera St. Benedicts Parkston, SD percent of total billed charges · outpatientfrom % of charges | 1 | $302 | $302 | — | — | 80 | $302 – $302 |
| 16 | Avera Merrill Pioneer Rock Rapids, IA case rate · outpatient | 2 | $247 | $247 | — | — | 74 | $247 – $247 |
| 17 | Avera Gregory Hospital Gregory, SD outpatient | 1 | $405 | $405 | — | — | 66 | $405 – $405 |
| 18 | Avera Gregory Hospital Gregory, SD percent of total billed charges · outpatientfrom % of charges | 1 | $356 | $356 | — | — | 66 | $356 – $356 |
| 19 | Avera Missouri River Health Center Gettysburg, SD outpatient | 1 | $405 | $405 | — | — | 66 | $405 – $405 |
| 20 | Avera Missouri River Health Center Gettysburg, SD percent of total billed charges · outpatientfrom % of charges | 1 | $426 | $426 | — | — | 66 | $426 – $426 |
| 21 | Avera St. Mary's Hospital Pierre, SD outpatient | 1 | $97 | $97 | — | — | 60 | $97 – $97 |
| 22 | Avera St. Mary's Hospital Pierre, SD case rate · outpatient | 1 | $97 | $97 | — | — | 60 | $97 – $97 |
| 23 | Sioux Center Health Sioux Center, IA case rate · inpatient | 2 | $126 | $126 | — | — | 58 | $126 – $126 |
| 24 | Avera Behavioral Health Hospital Sioux Falls, SD case rate · outpatient | 2 | $97 | $97 | — | — | 56 | $97 – $97 |
| 25 | Avera Specialty Hospital Sioux Falls, SD case rate · outpatient | 2 | $97 | $97 | — | — | 56 | $97 – $97 |
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