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
Ot Eval Mod Complex
Low
$52
Average
$202
Median
$173
High
$1.1k
Each hospital's average Ambetter rate, under the methodology and billing class chosen below.
447 hospitals; the 90th percentile is 2.6× 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.
Filter by billing methodology
Filter by billing class
543 hospital rates
iThe hospitals that file a Ambetter 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 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $134 | $134 | — | — | 142 | $134 – $134 |
| 2 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS other · outpatient | 1 | $236 | $236 | — | — | 116 | $236 – $236 |
| 3 | Central Georgia Rehabilitation LLC Macon, GA percent of total billed charges · outpatientfrom % of charges | 1 | $141 | $141 | — | — | 58 | $141 – $141 |
| 4 | Arkansas Childrens Hospital Little Rock, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $314 | $314 | — | — | 2–20 | $314 – $314 |
| 5 | Hospital Authority of Miller County Colquitt, GA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $125 | $125 | — | — | 2–20 | $125 – $125 |
| 6 | Hutchinson Regional Medical Center, Inc. Hutchinson, KS facility · fee schedule · both | 1 | $191 | $191 | — | — | 2–20 | $191 – $191 |
| 7 | OKTIBBEHA COUNTY HOSPITAL STARKVILLE, MS other · outpatient | 1 | $103 | $103 | — | — | 2–20 | $103 – $103 |
| 8 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER CANTON, MS other · outpatient | 1 | $236 | $236 | — | — | 1–10 | $236 – $236 |
| 9 | Ste. Genevieve County Memorial Hospital Ste. Genevieve, MO percent of total billed charges · outpatientfrom % of charges | 1 | $82 | $82 | — | — | 1–10 | $82 – $82 |
| 10 | The Medical Center of Central Georgia Inc Macon, GA percent of total billed charges · outpatientfrom % of charges | 1 | $174 | $174 | — | — | 1–10 | $174 – $174 |
| 11 | The Medical Center of Peach County Inc Byron, GA percent of total billed charges · outpatientfrom % of charges | 1 | $77 | $77 | — | — | 1–10 | $77 – $77 |
| 12 | UMMC HOLMES COUNTY LEXINGTON, MS percent of total billed charges · outpatientfrom % of charges | 1 | $125 | $125 | — | — | 1–10 | $125 – $125 |
| 13 | VALLEY REGIONAL HOSPITAL CLAREMONT, NH percent of total billed charges · bothfrom % of charges | 1 | $220 | $201 | $62 | 31% | 1–10 | $104 – $269 |
| 14 | Advocate Childrens Hospital Oak Lawn Oak Lawn, IL facility · case rate · outpatient | 1 | $150 | $150 | — | — | — | $150 – $150 |
| 15 | Advocate Childrens Hospital Park Ridge Park Ridge, IL facility · case rate · outpatient | 1 | $150 | $150 | — | — | — | $150 – $150 |
| 16 | Advocate Christ Medical Center Oak Lawn, IL facility · case rate · outpatient | 1 | $150 | $150 | — | — | — | $150 – $150 |
| 17 | Advocate Condell Medical Center Libertyville, IL case rate · outpatient | 1 | $150 | $150 | — | — | — | $150 – $150 |
| 18 | Advocate Good Samaritan Hospital Downers Grove, IL case rate · outpatient | 1 | $150 | $150 | — | — | — | $150 – $150 |
| 19 | Advocate Good Shepherd Hospital Barrington, IL case rate · outpatient | 1 | $150 | $150 | — | — | — | $150 – $150 |
| 20 | Advocate Illinois Masonic Medical Center Chicago, IL case rate · outpatient | 1 | $150 | $150 | — | — | — | $150 – $150 |
| 21 | Advocate Lutheran General Hospital Park Ridge, IL case rate · outpatient | 1 | $150 | $150 | — | — | — | $150 – $150 |
| 22 | Advocate Sherman Hospital Elgin, IL case rate · outpatient | 1 | $150 | $150 | — | — | — | $150 – $150 |
| 23 | Advocate South Suburban Hospital Hazel Crest, IL case rate · outpatient | 1 | $150 | $150 | — | — | — | $150 – $150 |
| 24 | Advocate Trinity Hospital Chicago, IL case rate · outpatient | 1 | $150 | $150 | — | — | — | $150 – $150 |
| 25 | Alexian Brothers Medical Center Village, IL other · inpatient | 1 | $168 | $168 | — | — | — | $168 – $168 |
← Payers reporting CPT 97166 · Snapshot 20261111T120946Z-9134e7f7