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
PR PREV MED NEW PAT 65+ YRS
Low
$81
Average
$293
Median
$208
High
$1.8k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
46 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.
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69 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 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 3 | $208 | $208 | — | — | — | $208 – $208 |
| 2 | Avera Gregory Hospital Gregory, SD fee schedule · both | 1 | $217 | $217 | — | — | — | $217 – $217 |
| 3 | Avera Missouri River Health Center Gettysburg, SD fee schedule · both | 1 | $217 | $217 | — | — | — | $217 – $217 |
| 4 | Avera Missouri River Health Center Gettysburg, SD percent of total billed charges · inpatientfrom % of charges | 1 | $249 | $249 | — | — | — | $249 – $249 |
| 5 | Avera Missouri River Health Center Gettysburg, SD percent of total billed charges · outpatientfrom % of charges | 1 | $249 | $249 | — | — | — | $249 – $249 |
| 6 | Avera Sacred Heart Hospital Yankton, SD fee schedule · both | 1 | $217 | $217 | — | — | — | $217 – $217 |
| 7 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 3 | $208 | $208 | — | — | — | $208 – $208 |
| 8 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 3 | $208 | $208 | — | — | — | $208 – $208 |
| 9 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · inpatient | 3 | $208 | $182 | $46 | 26% | — | $101 – $208 |
| 10 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · outpatient | 3 | $208 | $182 | $46 | 26% | — | $101 – $208 |
| 11 | Freeman Regional Health Svcs. Freeman, SD fee schedule · both | 1 | $217 | $217 | — | — | — | $217 – $217 |
| 12 | Freeman Regional Health Svcs. Freeman, SD percent of total billed charges · inpatientfrom % of charges | 1 | $249 | $249 | — | — | — | $249 – $249 |
| 13 | Freeman Regional Health Svcs. Freeman, SD percent of total billed charges · outpatientfrom % of charges | 1 | $249 | $249 | — | — | — | $249 – $249 |
| 14 | Grinnell Regional Medical Center Grinnell, IA fee schedule · both | 3 | $208 | $208 | — | — | — | $208 – $208 |
| 15 | HAWARDEN REGIONAL HEALTHCARE HARWARDEN, IA other · outpatient | 2 | $178 | $178 | — | — | — | $178 – $178 |
| 16 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 17 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · inpatient | 1 | $150 | $150 | — | — | — | $150 – $150 |
| 18 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · outpatient | 1 | $155 | $155 | — | — | — | $155 – $155 |
| 19 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $462 | $462 | — | — | — | $462 – $462 |
| 20 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · both | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 21 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · inpatient | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 22 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 1 | $161 | $161 | — | — | — | $161 – $161 |
| 23 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · both | 1 | $209 | $209 | — | — | — | $209 – $209 |
| 24 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · both | 1 | $190 | $190 | — | — | — | $190 – $190 |
| 25 | Mercy Health Services-Iowa Corp. Mason City, IA professional · fee schedule · inpatient | 3 | $208 | $182 | $46 | 26% | — | $101 – $208 |
← Payers reporting CPT 99387 · Snapshot 20261111T120946Z-9134e7f7