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
PR Provision Test Material(S) and Equipment Home Inr
Low
$74
Average
$274
Median
$216
High
$1.2k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
508 hospitals; the 90th percentile is 4.0× 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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581 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Mayo Clinic Arizona Phoenix, AZ professional · percent of total billed charges · outpatientfrom % of charges | 5 | $413 | $433 | $36 | 8% | 613–622 | $413 – $495 |
| 2 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 8 | $297 | $299 | $10 | 3% | 341 | $290 – $320 |
| 3 | Mayo Clinic Rochester, MN professional · fee schedule · outpatient | 5 | $71 | $71 | $3 | 4% | 285 | $67 – $78 |
| 4 | Mayo Clinic Health System Eau Claire 54703-5270 facility · percent of total billed charges · bothfrom % of charges | 5 | $178 | $158 | $49 | 31% | 153–162 | $39 – $185 |
| 5 | Mayo Clinic Health System Owatonna 55060-5503 professional · fee schedule · outpatient | 5 | $60 | $58 | $9 | 15% | 140–149 | $46 – $71 |
| 6 | Mayo Clinic Health System Eau Claire 54703-5270 facility · other · both | 1 | $145 | $145 | — | — | 115 | $145 – $145 |
| 7 | Mayo Clinic Health System Owatonna 55060-5503 professional · percent of total billed charges · outpatientfrom % of charges | 7 | $294 | $297 | $13 | 4% | 75 | $281 – $320 |
| 8 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 3 | $88 | $81 | $16 | 19% | 69–96 | $59 – $103 |
| 9 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · percent of total billed charges · bothfrom % of charges | 8 | $295 | $264 | $65 | 25% | 67 | $145 – $320 |
| 10 | Mayo Clinic Health System Mankato 56001-4752 facility · other · both | 2 | $159 | $160 | $1 | 1% | 47 | $159 – $162 |
| 11 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · fee schedule · both | 1 | $145 | $145 | — | — | 24 | $145 – $145 |
| 12 | Mayo Clinic Health System Mankato 56001-4752 facility · percent of total billed charges · bothfrom % of charges | 6 | $295 | $299 | $13 | 4% | 19–37 | $281 – $320 |
| 13 | Mayo Clinic Health System Lake City 55041-1143 facility · percent of total billed charges · bothfrom % of charges | 10 | $295 | $281 | $44 | 16% | 12 | $188 – $323 |
| 14 | Mayo Clinic Health System Mankato 56001-4752 professional · fee schedule · outpatient | 4 | $67 | $62 | $9 | 15% | 2–20 | $51 – $71 |
| 15 | Mayo Clinic Health System Waseca 56093-2811 facility · percent of total billed charges · bothfrom % of charges | 8 | $295 | $262 | $69 | 26% | 2–20 | $135 – $320 |
| 16 | Mayo Clinic Health System Mankato 56001-4752 professional · percent of total billed charges · outpatientfrom % of charges | 6 | $297 | $297 | $14 | 5% | 1–10 | $281 – $320 |
| 17 | Mayo Clinic Health System Lake City 55041-1143 facility · fee schedule · both | 1 | $145 | $145 | — | — | 1–10 | $145 – $145 |
| 18 | Mayo Clinic Health System Fairmont 56031-4575 facility · other · both | 2 | $159 | $160 | $1 | 1% | 1–10 | $159 – $162 |
| 19 | Mayo Clinic Health System Menomonie, WI facility · percent of total billed charges · bothfrom % of charges | 4 | $180 | $158 | $45 | 28% | 1–10 | $60 – $185 |
| 20 | Mayo Clinic Health System Red Wing 55066-2848 professional · fee schedule · outpatient | 4 | $70 | $70 | $1 | 2% | 1–10 | $67 – $71 |
| 21 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · fee schedule · outpatient | 4 | $143 | $124 | $39 | 32% | — | $56 – $153 |
| 22 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 23 | ATHOL MEMORIAL HOSPITAL INCORPORATED Athol, MA fee schedule · outpatient | 3 | $185 | $182 | $4 | 2% | — | $177 – $185 |
| 24 | AdventHealth Avista Louisville, CO fee schedule · outpatient | 2 | $129 | $129 | $14 | 11% | — | $116 – $143 |
| 25 | AdventHealth Castle Rock Castle Rock, CO fee schedule · outpatient | 2 | $129 | $129 | $13 | 10% | — | $116 – $142 |
← Payers reporting HCPCS G0249 · Snapshot 20261111T120946Z-9134e7f7