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
Travel Clinic-Prev Med Cnsl Spx 30 Min
Low
$1
Average
$81
Median
$81
High
$227
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
40 hospitals; the 90th percentile is 6.1× 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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49 hospital rates
iThe hospitals that file a Medicaid 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 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $122 | $122 | $33 | 27% | — | $89 – $154 |
| 2 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $122 | $122 | $33 | 27% | — | $89 – $154 |
| 3 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $89 | $89 | — | — | — | $89 – $89 |
| 4 | Berkshire Medical Center Great Barrington, MA facility · fee schedule · outpatient | 2 | $112 | $112 | — | — | — | $112 – $112 |
| 5 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $67 | $67 | — | — | — | $67 – $67 |
| 6 | Chapman Global Medical Center Orange, CA facility · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 7 | Chilton Medical Center Pompton Plains, NJ percent of total billed charges · bothfrom % of charges | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 8 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 9 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL professional · fee schedule · outpatient | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 10 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH LAFAYETTE LAFAYETTE, IN per diem · both | 2 | $175 | $175 | $16 | 9% | — | $159 – $191 |
| 11 | Fairview Hospital Great Barrington, MA facility · fee schedule · outpatient | 2 | $227 | $227 | — | — | — | $227 – $227 |
| 12 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $33 | $33 | — | — | — | $33 – $33 |
| 13 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 14 | Geisinger Wyoming Valley Wilkes-Barre, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 15 | HANFORD COMMUNITY HOSPITAL Selma, CA fee schedule · outpatient | 1 | $89 | $89 | — | — | — | $89 – $89 |
| 16 | HealthAlliance - Clinton Hospital MA 01453; 201 Highland St Clinton, MA fee schedule · both | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 17 | HealthAlliance - Clinton Hospital MA 01453; 201 Highland St Clinton, MA percent of total billed charges · bothfrom % of charges | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 18 | Hemet Global Medical Center Hemet, CA facility · fee schedule · outpatient | 1 | $26 | $26 | — | — | — | $26 – $26 |
| 19 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $96 | $96 | — | — | — | $96 – $96 |
| 20 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $43 | $43 | — | — | — | $43 – $43 |
| 21 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL professional · fee schedule · outpatient | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 22 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $103 | $112 | $27 | 24% | — | $89 – $154 |
| 23 | Mercy Hospital Oklahoma City Inc City, OK facility · fee schedule · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 24 | Mercy Hospital South Louis, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 25 | Mercy Hospital Southeast Girardeau, MO professional · fee schedule · inpatient | 1 | $77 | $77 | — | — | — | $77 – $77 |
← Payers reporting CPT 99402 · Snapshot 20261112T181611Z-3fa9fb76