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
NAV SRV PEER SUP ADD 30 PR M
Low
$10
Average
$44
Median
$41
High
$175
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
101 hospitals; the 90th percentile is 1.7× 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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114 hospital rates
iThe hospitals that file a WellCare 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 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 2 | $56 | $56 | $1 | 2% | — | $54 – $57 |
| 2 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $40 | $40 | $7 | 18% | — | $33 – $47 |
| 3 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 4 | Blue Hill Memorial Hospital Hill, ME facility · case rate · outpatient | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 5 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 1 | $40 | $40 | $7 | 18% | — | $33 – $47 |
| 6 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · case rate · outpatient | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 7 | Canton-Potsdam Hospital Potsdam, NY facility · fee schedule · outpatient | 2 | $30 | $30 | — | — | — | $30 – $30 |
| 8 | Carle BroMenn Medical Center Normal, IL case rate · outpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 9 | Carle Eureka Hospital Eureka, IL case rate · outpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 10 | Charles A. Dean Memorial Hospital Greenville, ME facility · case rate · outpatient | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 11 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 1 | $40 | $40 | $7 | 18% | — | $33 – $47 |
| 12 | Columbus Regional Healthcare System, Inc Whiteville, NC fee schedule · outpatient | 1 | $46 | $46 | — | — | — | $46 – $46 |
| 13 | Conway Hospital, Inc. Conway, SC professional · fee schedule · outpatient | 1 | $39 | $39 | $7 | 18% | — | $32 – $46 |
| 14 | Deaconess Hospital, Inc Newburgh, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 15 | Deaconess Hospital, Inc Newburgh, IN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 16 | Deaconess Illinois Crossroads Inc Mount Vernon, IL facility · case rate · outpatient | 2 | $47 | $47 | — | — | — | $47 – $47 |
| 17 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL facility · case rate · outpatient | 2 | $47 | $47 | $1 | 1% | — | $46 – $47 |
| 18 | Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient | 1 | $40 | $40 | $7 | 18% | — | $33 – $47 |
| 19 | FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER Fresno, CA facility · fee schedule · outpatient | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 20 | Fairview Bethesda Hospital St. Paul, MN fee schedule · both | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 21 | Fairview Health Services Edina, MN fee schedule · both | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 22 | Fairview Health Services Minneapolis, MN fee schedule · both | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 23 | Fairview Health Services Burnsville, MN fee schedule · both | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 24 | Fairview Health Services Wyoming, MN fee schedule · both | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 25 | Fairview Health Services Princeton, MN fee schedule · both | 1 | $32 | $32 | — | — | — | $32 – $32 |
← Payers reporting HCPCS G0146 · Snapshot 20261111T120946Z-9134e7f7