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
$40
Average
$209
Median
$181
High
$722
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
127 hospitals; the 90th percentile is 3.5× 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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199 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 | $108 | $108 | — | — | 424 | $108 – $108 |
| 2 | Sioux Center Health Sioux Center, IA case rate · outpatient | 2 | $168 | $168 | — | — | 200 | $168 – $168 |
| 3 | Spencer Municipal Hospital Spencer, IA fee schedule · outpatient | 3 | $204 | $174 | $57 | 33% | 159–168 | $95 – $224 |
| 4 | Avera St. Luke's Aberdeen, SD outpatient | 1 | $100 | $100 | — | — | 85 | $100 – $100 |
| 5 | Avera St. Luke's Aberdeen, SD case rate · outpatient | 1 | $100 | $100 | — | — | 85 | $100 – $100 |
| 6 | Lakes Regional Hospital Spirit Lake, IA case rate · outpatient | 2 | $96 | $96 | — | — | 80 | $96 – $96 |
| 7 | Avera Sacred Heart Hospital Yankton, SD outpatient | 1 | $100 | $100 | — | — | 68 | $100 – $100 |
| 8 | Avera Sacred Heart Hospital Yankton, SD percent of total billed charges · outpatientfrom % of charges | 1 | $356 | $356 | — | — | 68 | $356 – $356 |
| 9 | Sanford USD Medical Center Sioux Falls, SD other · outpatient | 1 | $211 | $211 | — | — | 57 | $211 – $211 |
| 10 | Spencer Municipal Hospital Spencer, IA fee schedule · inpatient | 3 | $204 | $174 | $57 | 33% | 42 | $95 – $224 |
| 11 | Avera Holy Family Hospital Estherville, IA case rate · outpatient | 2 | $221 | $221 | — | — | 32 | $221 – $221 |
| 12 | Osceola Regional Health Center Sibley, IA case rate · outpatient | 2 | $217 | $217 | — | — | 28 | $217 – $217 |
| 13 | Avera Behavioral Health Hospital Sioux Falls, SD case rate · outpatient | 2 | $100 | $100 | — | — | 2–20 | $100 – $100 |
| 14 | Avera McKennan Hospital Sioux Falls, SD inpatient | 2 | $68 | $68 | — | — | 2–20 | $68 – $68 |
| 15 | Avera Merrill Pioneer Rock Rapids, IA case rate · outpatient | 2 | $339 | $339 | — | — | 2–20 | $339 – $339 |
| 16 | Avera Specialty Hospital Sioux Falls, SD case rate · outpatient | 2 | $100 | $100 | — | — | 2–20 | $100 – $100 |
| 17 | Monument Health Network Inc Deadwood, SD percent of total billed charges · outpatientfrom % of charges | 2 | $185 | $185 | $87 | 47% | 2–20 | $98 – $272 |
| 18 | Monument Health Network Inc Sturgis, SD percent of total billed charges · outpatientfrom % of charges | 2 | $170 | $170 | $89 | 53% | 2–20 | $81 – $259 |
| 19 | Monument Health Network Inc Custer, SD percent of total billed charges · outpatientfrom % of charges | 2 | $190 | $190 | $106 | 56% | 2–20 | $84 – $295 |
| 20 | Pella Regional Health Center Pella, IA other · outpatient | 2 | $192 | $192 | $12 | 6% | 2–20 | $179 – $204 |
| 21 | Regional Health Services of Howard County Cresco, IA case rate · outpatient | 2 | $109 | $109 | — | — | 2–20 | $109 – $109 |
| 22 | Sanford Sheldon Medical Center Sheldon, IA other · outpatient | 2 | $209 | $209 | $10 | 5% | 2–20 | $199 – $219 |
| 23 | Avera DeSmet De Smet, SD outpatient | 1 | $271 | $271 | — | — | 1–10 | $271 – $271 |
| 24 | Avera DeSmet De Smet, SD percent of total billed charges · outpatientfrom % of charges | 1 | $281 | $281 | — | — | 1–10 | $281 – $281 |
| 25 | Avera Dell Rapids Hospital Dell Rapids, SD outpatient | 1 | $308 | $308 | — | — | 1–10 | $308 – $308 |
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