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
Mra Pelvis W&W/O Contrast
Low
$336
Average
$914
Median
$857
High
$2.4k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
35 hospitals; the 90th percentile is 5.1× 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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41 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 case rate · outpatient | 1 | $336 | $336 | — | — | — | $336 – $336 |
| 2 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 2 | $356 | $356 | — | — | — | $356 – $356 |
| 3 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · other · both | 1 | $334 | $334 | — | — | — | $334 – $334 |
| 4 | Central Iowa Hospital Corporation Des Moines, IA case rate · outpatient | 1 | $340 | $340 | — | — | — | $340 – $340 |
| 5 | Diley Ridge Medical Center Canal Winchester, OH facility · other · both | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 6 | Grinnell Regional Medical Center Grinnell, IA case rate · outpatient | 1 | $340 | $340 | — | — | — | $340 – $340 |
| 7 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · case rate · outpatient | 2 | $1.2k | $1.2k | $58 | 5% | — | $1.2k – $1.3k |
| 8 | Holy Cross Germantown Hospital Germantown, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $857 | $857 | — | — | — | $857 – $857 |
| 9 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · case rate · both | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 10 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 1 | $937 | $937 | — | — | — | $937 – $937 |
| 11 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 2 | $356 | $356 | — | — | — | $356 – $356 |
| 12 | Mercy Health Services-Iowa Corp. Mason City, IA facility · other · both | 1 | $372 | $372 | — | — | — | $372 – $372 |
| 13 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · case rate · outpatient | 1 | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 14 | MercyOne Genesis Davenport Medical Center IA 52803; 2140 53rd Avenue Bettendorf, IA facility · fee schedule · outpatient | 1 | $342 | $342 | — | — | — | $342 – $342 |
| 15 | MercyOne Genesis Davenport West Medical Center Davenport, IA facility · fee schedule · outpatient | 1 | $342 | $342 | — | — | — | $342 – $342 |
| 16 | MercyOne Genesis Silvis Medical Center Silvis, IL facility · case rate · outpatient | 1 | $503 | $503 | — | — | — | $503 – $503 |
| 17 | MercyOne Genesis Silvis Medical Center Silvis, IL facility · fee schedule · outpatient | 1 | $372 | $372 | — | — | — | $372 – $372 |
| 18 | Meriter Hospital, Inc Madison, WI case rate · outpatient | 1 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 19 | Meriter Hospital, Inc Madison, WI percent of total billed charges · inpatientfrom % of charges | 1 | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 20 | Mishawaka Medical Center Mishawaka, IN facility · other · both | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 21 | Mount Carmel East Reynoldsburg, OH facility · other · both | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 22 | Mount Carmel Grove City Grove City, OH facility · other · both | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 23 | Mount Carmel New Albany Surgical Hospital New Albany, OH facility · other · both | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 24 | Mount Carmel St Ann's Lewis Center, OH facility · other · both | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 25 | Northwest Iowa Hospital Corporation Sioux City, IA case rate · outpatient | 1 | $355 | $355 | — | — | — | $355 – $355 |
← Payers reporting HCPCS C8920 · Snapshot 20261111T120946Z-9134e7f7