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
HC VISIT NEW PATIENT LEVEL 4
Low
$71
Average
$237
Median
$173
High
$1.7k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
102 hospitals; the 90th percentile is 2.3× 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
189 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 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 3 | $189 | $169 | $35 | 20% | 2,019–2,028 | $109 – $189 |
| 2 | Mercy Medical Center-Clinton Inc Clinton, IA professional · fee schedule · both | 3 | $161 | $144 | $29 | 20% | 70–88 | $93 – $161 |
| 3 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 3 | $189 | $169 | $35 | 20% | 33–42 | $109 – $189 |
| 4 | Avera St. Anthony's Hospital O'Neill, NE inpatient | 1 | $305 | $305 | — | — | 26 | $305 – $305 |
| 5 | Avera St. Anthony's Hospital O'Neill, NE percent of total billed charges · inpatientfrom % of charges | 1 | $216 | $216 | $1 | 0% | 26 | $215 – $217 |
| 6 | Avera McKennan Hospital Sioux Falls, SD case rate · outpatient | 2 | $208 | $208 | — | — | 22 | $208 – $208 |
| 7 | Avera Queen of Peace Mitchell, SD outpatient | 1 | $124 | $124 | — | — | 22 | $124 – $124 |
| 8 | Avera Queen of Peace Mitchell, SD case rate · outpatient | 1 | $124 | $124 | — | — | 22 | $124 – $124 |
| 9 | Avera St. Anthony's Hospital O'Neill, NE outpatient | 1 | $78 | $78 | — | — | 21 | $78 – $78 |
| 10 | Avera St. Anthony's Hospital O'Neill, NE percent of total billed charges · outpatientfrom % of charges | 1 | $216 | $216 | $1 | 0% | 21 | $215 – $217 |
| 11 | Sanford USD Medical Center Sioux Falls, SD other · outpatient | 1 | $263 | $263 | — | — | 21 | $263 – $263 |
| 12 | Morrison Community Hospital District Morrison, IL facility · fee schedule · both | 2 | $253 | $253 | $115 | 46% | 17 | $138 – $369 |
| 13 | Avera Behavioral Health Hospital Sioux Falls, SD inpatient | 2 | $25 | $25 | — | — | 6–60 | $25 – $25 |
| 14 | Avera McKennan Hospital Sioux Falls, SD inpatient | 2 | $32 | $32 | — | — | 6–60 | $32 – $32 |
| 15 | Avera Specialty Hospital Sioux Falls, SD inpatient | 2 | $25 | $25 | — | — | 6–60 | $25 – $25 |
| 16 | Sanford Aberdeen Medical Center Aberdeen, SD other · outpatient | 1 | $263 | $263 | — | — | 4–40 | $263 – $263 |
| 17 | Avera Merrill Pioneer Rock Rapids, IA case rate · outpatient | 2 | $189 | $189 | — | — | 2–20 | $189 – $189 |
| 18 | Central Community Hospital Elkader, IA professional · fee schedule · outpatient | 3 | $203 | $187 | $28 | 15% | 2–20 | $139 – $203 |
| 19 | Osceola Regional Health Center Sibley, IA case rate · outpatient | 2 | $122 | $122 | — | — | 2–20 | $122 – $122 |
| 20 | Sioux Center Health Sioux Center, IA case rate · outpatient | 2 | $122 | $122 | — | — | 2–20 | $122 – $122 |
| 21 | Avera Creighton Hospital Creighton, NE inpatient | 1 | $267 | $267 | — | — | 1–10 | $267 – $267 |
| 22 | Avera Creighton Hospital Creighton, NE outpatient | 1 | $25 | $25 | — | — | 1–10 | $25 – $25 |
| 23 | Avera Creighton Hospital Creighton, NE percent of total billed charges · inpatientfrom % of charges | 1 | $297 | $297 | — | — | 1–10 | $297 – $297 |
| 24 | Avera Creighton Hospital Creighton, NE percent of total billed charges · outpatientfrom % of charges | 1 | $297 | $297 | — | — | 1–10 | $297 – $297 |
| 25 | Avera Gregory Hospital Gregory, SD outpatient | 1 | $124 | $124 | — | — | 1–10 | $124 – $124 |
← Payers reporting CPT 99204 · Snapshot 20261111T120946Z-9134e7f7