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
Prev Med Cnsl&/Rsk Fctr Rdctj Indv Approx 60 Min
Low
$92
Average
$223
Median
$203
High
$376
Each hospital's average Healthpartners rate, under the methodology and billing class chosen below.
16 hospitals; the 90th percentile is 1.5× 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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24 hospital rates
iThe hospitals that file a Healthpartners 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 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $376 | $376 | — | — | — | $376 – $376 |
| 2 | Black River Health Inc Black River Falls, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 3 | Black River Health Inc Black River Falls, WI professional · percent of total billed charges · bothfrom % of charges | 1 | $399 | $399 | — | — | — | $399 – $399 |
| 4 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 1 | $92 | $92 | — | — | — | $92 – $92 |
| 5 | Mayo Clinic Rochester, MN professional · fee schedule · outpatient | 1 | $168 | $168 | — | — | — | $168 – $168 |
| 6 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 3 | $284 | $286 | $6 | 2% | — | $281 – $296 |
| 7 | Mayo Clinic Arizona Phoenix, AZ professional · percent of total billed charges · outpatientfrom % of charges | 2 | $244 | $244 | $10 | 4% | — | $234 – $254 |
| 8 | ThedaCare Regional Medical Center-Berlin Inc WI 54971-9286; N2930 State Rd 22 Wautoma, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $202 | $203 | $14 | 7% | — | $187 – $221 |
| 9 | Thedacare Regional Medical Center-Appleton Inc WI 54911; W5282 Amy Ave. Appleton WI 54911-7233; 2500 E Capital Dr. Appleton, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $202 | $203 | $14 | 7% | — | $187 – $221 |
| 10 | Thedacare Regional Medical Center-Appleton Inc Fond Du Lac, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $202 | $203 | $14 | 7% | — | $187 – $221 |
| 11 | Thedacare Regional Medical Center-Appleton Inc Oshkosh, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $202 | $203 | $14 | 7% | — | $187 – $221 |
| 12 | Thedacare Regional Medical Center-Appleton Inc. Appleton, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $202 | $203 | $14 | 7% | — | $187 – $221 |
| 13 | Thedacare Regional Medical Center-New London Inc WI 54961; 370 S. Main St. Clintonville, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $202 | $203 | $14 | 7% | — | $187 – $221 |
| 14 | Thedacare Regional Medical Center-Shawano Inc Shawano, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $202 | $203 | $14 | 7% | — | $187 – $221 |
| 15 | Thedacare Regional Medical Center-Waupaca Inc Waupaca, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $194 | $194 | $8 | 4% | — | $187 – $202 |
| 16 | Thedacare Regional Medical Center-Wild Rose Inc Wild Rose, WI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $187 | $187 | — | — | — | $187 – $187 |
| 17 | University of Iowa Health Care Medical Center Iowa City, IA facility · percent of total billed charges · inpatientfrom % of charges | 3 | $270 | $277 | $60 | 22% | — | $208 – $354 |
| 18 | University of Iowa Health Care Medical Center Iowa City, IA facility · percent of total billed charges · outpatientfrom % of charges | 3 | $270 | $273 | $54 | 20% | — | $208 – $341 |
| 19 | University of Iowa Health Care Medical Center Iowa City, IA professional · fee schedule · both | 2 | $277 | $277 | $95 | 34% | — | $182 – $372 |
| 20 | University of Iowa Health Care Medical Center Iowa City, IA professional · percent of total billed charges · bothfrom % of charges | 1 | $387 | $387 | — | — | — | $387 – $387 |
| 21 | University of Iowa Health Care Medical Center Downtown Iowa City, IA facility · percent of total billed charges · inpatientfrom % of charges | 3 | $270 | $277 | $60 | 22% | — | $208 – $354 |
| 22 | University of Iowa Health Care Medical Center Downtown Iowa City, IA facility · percent of total billed charges · outpatientfrom % of charges | 3 | $270 | $273 | $54 | 20% | — | $208 – $341 |
| 23 | University of Iowa Health Care Medical Center Downtown Iowa City, IA professional · fee schedule · both | 2 | $277 | $277 | $95 | 34% | — | $182 – $372 |
| 24 | University of Iowa Health Care Medical Center Downtown Iowa City, IA professional · percent of total billed charges · bothfrom % of charges | 1 | $387 | $387 | — | — | — | $387 – $387 |
← Payers reporting CPT 99404 · Snapshot 20261112T181611Z-3fa9fb76