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
UNLISTED PREVENTIVE SERVICE
Low
$13
Average
$815
Median
$55
High
$25k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
33 hospitals; the 90th percentile is 3.1× 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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35 hospital rates
iThe hospitals that file a Molina 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 2 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 3 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $98 | $98 | — | — | — | $98 – $98 |
| 4 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 5 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 6 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 7 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 8 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 2 | $47 | $49 | $17 | 35% | — | $29 – $73 |
| 9 | Columbia Lutheran Charities Astoria, OR professional · fee schedule · both | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 10 | Columbia Lutheran Charities Astoria, OR professional · percent of total billed charges · bothfrom % of charges | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 11 | F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient | 2 | $44 | $44 | $13 | 29% | — | $31 – $56 |
| 12 | Fairfield Medical Center 401 N Ewing St facility · other · outpatient | 1 | $25k | $25k | — | — | — | $25k – $25k |
| 13 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $58 | $58 | — | — | — | $58 – $58 |
| 14 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $40 | $40 | — | — | — | $40 – $40 |
| 15 | LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient | 1 | $94 | $94 | — | — | — | $94 – $94 |
| 16 | LUTHERAN HOSPITAL Cleveland, OH facility · case rate · outpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 17 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · case rate · outpatient | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 18 | MEDINA HOSPITAL Medina, OH facility · case rate · outpatient | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 19 | Memorial Hosp of Wm F & Gertrude F Jones A/K/A Jones Memorial Hosp Wellsville, NY fee schedule · outpatient | 2 | $42 | $42 | $14 | 34% | — | $28 – $56 |
| 20 | Mercy Hospitals East Communities dba Mercy Hospital Washington Washington, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 21 | Montefiore New Rochelle Hospital New Rochelle, NY fee schedule · outpatient | 4 | $25 | $33 | $13 | 40% | — | $25 – $55 |
| 22 | NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC Toledo, OH facility · other · outpatient | 1 | $72 | $72 | — | — | — | $72 – $72 |
| 23 | Nationwide Children's Hospital Columbus, OH facility · other · outpatient | 1 | $98 | $98 | — | — | — | $98 – $98 |
| 24 | Nicholas H. Noyes Memorial Hospital Dansville, NY fee schedule · outpatient | 2 | $41 | $41 | $16 | 38% | — | $25 – $56 |
| 25 | Northwest Texas Healthcare System Amarillo, TX percent of total billed charges · bothfrom % of charges | 1 | $50 | $50 | — | — | — | $50 – $50 |
← Payers reporting CPT 99429 · Snapshot 20261113T090226Z-3ce6c0b8