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
$53
Average
$207
Median
$148
High
$938
Each hospital's average Caresource rate, under the methodology and billing class chosen below.
75 hospitals; the 90th percentile is 4.4× 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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85 hospital rates
iThe hospitals that file a Caresource 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 | $53 | $53 | — | — | — | $53 – $53 |
| 2 | Adena Fayette Medical Center Washington Court House, OH facility · case rate · outpatient | 1 | $272 | $272 | — | — | — | $272 – $272 |
| 3 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 2 | $192 | $192 | $62 | 32% | — | $130 – $254 |
| 4 | BAPTIST HEALTHCARE SYSTEM INC Albany, IN other · outpatient | 1 | $211 | $211 | — | — | — | $211 – $211 |
| 5 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY other · outpatient | 1 | $844 | $844 | — | — | — | $844 – $844 |
| 6 | BAPTIST HEALTHCARE SYSTEM INC Lexington, KY other · outpatient | 1 | $938 | $938 | — | — | — | $938 – $938 |
| 7 | BAPTIST HEALTHCARE SYSTEM INC Richmond, KY other · outpatient | 1 | $844 | $844 | — | — | — | $844 – $844 |
| 8 | BAPTIST HEALTHCARE SYSTEM INC Grange, KY other · outpatient | 1 | $844 | $844 | — | — | — | $844 – $844 |
| 9 | BAPTIST HEALTHCARE SYSTEM INC Paducah, KY other · outpatient | 1 | $844 | $844 | — | — | — | $844 – $844 |
| 10 | BAPTIST HEALTHCARE SYSTEM INC. Louisville, KY other · outpatient | 1 | $844 | $844 | — | — | — | $844 – $844 |
| 11 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 12 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 13 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 14 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 15 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $65 | $65 | — | — | — | $65 – $65 |
| 16 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 2 | $81 | $81 | $22 | 27% | — | $59 – $103 |
| 17 | Central Georgia Rehabilitation LLC Macon, GA fee schedule · both | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 18 | Central Georgia Rehabilitation LLC Macon, GA fee schedule · outpatient | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 19 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 20 | Clinton Memorial Hospital Wilmington, OH fee schedule · outpatient | 1 | $167 | $167 | — | — | — | $167 – $167 |
| 21 | Deaconess Health System Henderson Hospital Henderson, KY facility · case rate · outpatient | 1 | $174 | $174 | — | — | — | $174 – $174 |
| 22 | Deaconess Hospital, Inc Newburgh, IN facility · case rate · outpatient | 1 | $195 | $195 | — | — | — | $195 – $195 |
| 23 | Deaconess Hospital, Inc Newburgh, IN facility · case rate · outpatient | 2 | $147 | $147 | $29 | 20% | — | $118 – $177 |
| 24 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 25 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $39 | $39 | — | — | — | $39 – $39 |
← Payers reporting HCPCS G0249 · Snapshot 20261111T120946Z-9134e7f7