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
MODSED SAMEPHYS/QHP 5/>YR INIT
Low
$10
Average
$166
Median
$152
High
$2.1k
Each hospital's average Sanford Health Plan rate, under the methodology and billing class chosen below.
93 hospitals; the 90th percentile is 22.6× 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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202 hospital rates
iThe hospitals that file a Sanford Health Plan 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 | Fairview Health Services Minneapolis, MN percent of total billed charges · inpatientfrom % of charges | 1 | $482 | $481 | $1 | 0% | 4–40 | $480 – $482 |
| 2 | Fairview Health Services Minneapolis, MN percent of total billed charges · outpatientfrom % of charges | 1 | $482 | $481 | $1 | 0% | 4–40 | $480 – $482 |
| 3 | Fairview Health Services Minneapolis, MN percent of total billed charges · bothfrom % of charges | 1 | $123 | $123 | $0 | 0% | 2–20 | $123 – $123 |
| 4 | Grand Itasca Clinic and Hospital Grand Rapids, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $482 | $482 | $0 | 0% | 2–20 | $481 – $482 |
| 5 | Grand Itasca Clinic and Hospital Grand Rapids, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $482 | $482 | $0 | 0% | 2–20 | $481 – $482 |
| 6 | Range Regional Health Services Hibbing, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $482 | $482 | $0 | 0% | 2–20 | $481 – $482 |
| 7 | Range Regional Health Services Hibbing, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $482 | $482 | $0 | 0% | 2–20 | $481 – $482 |
| 8 | Sanford Aberdeen Medical Center Aberdeen, SD percent of total billed charges · outpatientfrom % of charges | 4 | $231 | $232 | $24 | 10% | 2–20 | $199 – $267 |
| 9 | Sanford Bemidji Medical Center Bemidji, MN percent of total billed charges · outpatientfrom % of charges | 4 | $149 | $150 | $16 | 10% | 2–20 | $129 – $172 |
| 10 | Astera Health Wadena, MN fee schedule · inpatient | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 11 | Astera Health Wadena, MN fee schedule · outpatient | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 12 | Astera Health Wadena, MN percent of total billed charges · inpatientfrom % of charges | 1 | $537 | $537 | — | — | — | $537 – $537 |
| 13 | Astera Health Wadena, MN percent of total billed charges · outpatientfrom % of charges | 1 | $4.8k | $4.8k | $4.3k | 89% | — | $537 – $9.1k |
| 14 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · inpatient | 2 | $14 | $14 | $4 | 27% | — | $10 – $18 |
| 15 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient | 2 | $14 | $14 | $4 | 27% | — | $10 – $18 |
| 16 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA professional · fee schedule · inpatient | 2 | $14 | $14 | $4 | 27% | — | $10 – $18 |
| 17 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA professional · fee schedule · outpatient | 2 | $14 | $14 | $4 | 27% | — | $10 – $18 |
| 18 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · inpatient | 2 | $14 | $14 | $4 | 27% | — | $10 – $18 |
| 19 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · outpatient | 2 | $14 | $14 | $4 | 27% | — | $10 – $18 |
| 20 | Essentia Health Ada 201 9th St W Ada, MN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $217 | $217 | $6 | 3% | — | $212 – $223 |
| 21 | Essentia Health Duluth Duluth, MN facility · percent of total billed charges · inpatientfrom % of charges | 2 | $217 | $217 | $6 | 3% | — | $212 – $223 |
| 22 | Essentia Health Duluth Duluth, MN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $217 | $217 | $6 | 3% | — | $212 – $223 |
| 23 | Essentia Health Fargo 3000 32nd Ave S Fargo, ND facility · percent of total billed charges · inpatientfrom % of charges | 2 | $88 | $88 | $2 | 3% | — | $86 – $91 |
| 24 | Essentia Health Fargo 3000 32nd Ave S Fargo, ND facility · percent of total billed charges · outpatientfrom % of charges | 2 | $88 | $88 | $2 | 3% | — | $86 – $91 |
| 25 | Essentia Health Fosston 900 Hilligoss Blvd SE Fosston, MN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $217 | $217 | $6 | 3% | — | $212 – $223 |
← Payers reporting CPT 99152 · Snapshot 20261113T090226Z-3ce6c0b8