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
PERIODIC ORAL EVALUATION - ESTABLISHED PATIENT
Low
$1
Average
$130
Median
$130
High
$956
Each hospital's average Humana rate, under the methodology and billing class chosen below.
333 hospitals; the 90th percentile is 2.1× 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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373 hospital rates
iThe hospitals that file a Humana 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 CLEARLAKE HOSPITAL INC Clearlake, CA percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 1 | $119 | $119 | — | — | — | $119 – $119 |
| 3 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 4 | AdventHealth Deland Deland, FL fee schedule · outpatient | 2 | $150 | $150 | $5 | 3% | — | $145 – $155 |
| 5 | AdventHealth Orlando Winter Park, FL fee schedule · outpatient | 1 | $146 | $146 | — | — | — | $146 – $146 |
| 6 | Adventhealth Daytona Beach Port Orange, FL fee schedule · outpatient | 2 | $148 | $148 | $4 | 2% | — | $145 – $152 |
| 7 | Adventhealth Fish Memorial Deltona, FL fee schedule · outpatient | 2 | $150 | $150 | $5 | 3% | — | $145 – $155 |
| 8 | Adventhealth Hendersonville Hendersonville, NC fee schedule · outpatient | 1 | $129 | $129 | — | — | — | $129 – $129 |
| 9 | Adventhealth North Pinellas Palm Harbor, FL fee schedule · outpatient | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 10 | Adventhealth Palm Coast Palm Coast, FL fee schedule · outpatient | 2 | $150 | $150 | $5 | 3% | — | $145 – $155 |
| 11 | Adventhealth Redmond Rome, GA fee schedule · outpatient | 1 | $385 | $385 | — | — | — | $385 – $385 |
| 12 | Adventhealth Sebring Sebring, FL fee schedule · outpatient | 1 | $143 | $143 | — | — | — | $143 – $143 |
| 13 | Adventhealth Waterman Tavares, FL fee schedule · outpatient | 1 | $141 | $141 | — | — | — | $141 – $141 |
| 14 | Amisub of South Carolina, Inc. Fort Mill, SC fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 15 | Aspirus St. Luke’s Hospital Duluth, MN fee schedule · outpatient | 1 | $145 | $145 | — | — | — | $145 – $145 |
| 16 | Aurelia Osborn Fox Memorial Society Oneonta, NY facility · fee schedule · outpatient | 1 | $163 | $163 | — | — | — | $163 – $163 |
| 17 | BAPTIST HOSPITAL OF MIAMI PLANTATION, FL fee schedule · both | 2 | $152 | $152 | — | — | — | $152 – $152 |
| 18 | Baptist Medical Center of Nassau, INC Yulee, FL facility · case rate · outpatient | 1 | $82 | $82 | — | — | — | $82 – $82 |
| 19 | Bartow Regional Medical Center Bartow, FL facility · case rate · outpatient | 2 | $148 | $148 | $14 | 9% | — | $134 – $162 |
| 20 | Baycare Hospital Wesley Chapel Chapel, FL facility · case rate · outpatient | 2 | $148 | $148 | $14 | 9% | — | $134 – $162 |
| 21 | Baylor Scott & White All Saints Medical Center - Fort Worth Fort Worth, TX facility · fee schedule · outpatient | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 22 | Baylor Scott & White All Saints Medical Center - Fort Worth Fort Worth, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 23 | Baylor Scott & White Heart and Vascular Hospital - Dallas Dallas, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 24 | Baylor Scott & White Heart and Vascular Hospital - Waxahachie Waxahachie, TX facility · fee schedule · outpatient | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 25 | Baylor Scott & White Heart and Vascular Hospital - Waxahachie Waxahachie, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $42 | $42 | — | — | — | $42 – $42 |
← Payers reporting HCPCS D0120 · Snapshot 20261111T120946Z-9134e7f7