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
$61
Average
$236
Median
$259
High
$411
Each hospital's average Medical Mutual rate, under the methodology and billing class chosen below.
45 hospitals; the 90th percentile is 2.8× 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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61 hospital rates
iThe hospitals that file a Medical Mutual 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 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 1 | $353 | $353 | — | — | — | $353 – $353 |
| 2 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 3 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 1 | $132 | $132 | — | — | — | $132 – $132 |
| 4 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · outpatient | 1 | $353 | $353 | — | — | — | $353 – $353 |
| 5 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $106 | $106 | — | — | — | $106 – $106 |
| 6 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 7 | Covenant Medical Center Inc Waterloo, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 8 | Fisher-Titus Medical Center Norwalk, OH facility · fee schedule · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 9 | GROVE CITY MEDICAL CENTER GROVE CITY, PA fee schedule · outpatient | 1 | $353 | $353 | — | — | — | $353 – $353 |
| 10 | JEFFERSON REGIONAL MEDICAL CENTER JEFFERSON HILLS, PA fee schedule · outpatient | 1 | $305 | $305 | — | — | — | $305 – $305 |
| 11 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 3 | $314 | $316 | $3 | 1% | — | $314 – $320 |
| 12 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 4 | $324 | $323 | $42 | 13% | — | $271 – $373 |
| 13 | Mayo Clinic Arizona Phoenix, AZ professional · percent of total billed charges · outpatientfrom % of charges | 3 | $413 | $429 | $49 | 11% | — | $380 – $495 |
| 14 | Mayo Clinic Health System Mankato 56001-4752 facility · percent of total billed charges · bothfrom % of charges | 1 | $314 | $314 | — | — | — | $314 – $314 |
| 15 | Mayo Clinic Health System Mankato 56001-4752 professional · percent of total billed charges · outpatientfrom % of charges | 1 | $314 | $314 | — | — | — | $314 – $314 |
| 16 | Mayo Clinic Health System Lake City 55041-1143 facility · percent of total billed charges · bothfrom % of charges | 1 | $314 | $314 | — | — | — | $314 – $314 |
| 17 | Mayo Clinic Health System Lake City 55041-1143 professional · percent of total billed charges · outpatientfrom % of charges | 1 | $314 | $314 | — | — | — | $314 – $314 |
| 18 | Mayo Clinic Health System Saint James 56081-5550 facility · percent of total billed charges · bothfrom % of charges | 1 | $314 | $314 | — | — | — | $314 – $314 |
| 19 | Mayo Clinic Health System Saint James 56081-5550 professional · percent of total billed charges · outpatientfrom % of charges | 1 | $314 | $314 | — | — | — | $314 – $314 |
| 20 | Mayo Clinic Health System Fairmont 56031-4575 facility · percent of total billed charges · bothfrom % of charges | 1 | $314 | $314 | — | — | — | $314 – $314 |
| 21 | Mayo Clinic Health System Fairmont 56031-4575 professional · percent of total billed charges · outpatientfrom % of charges | 1 | $314 | $314 | — | — | — | $314 – $314 |
| 22 | Mayo Clinic Health System Osseo, WI facility · percent of total billed charges · bothfrom % of charges | 3 | $181 | $182 | $1 | 1% | — | $181 – $183 |
| 23 | Mayo Clinic Health System Menomonie, WI facility · percent of total billed charges · bothfrom % of charges | 3 | $181 | $182 | $1 | 1% | — | $181 – $183 |
| 24 | Mayo Clinic Health System St, NE facility · percent of total billed charges · bothfrom % of charges | 1 | $314 | $314 | — | — | — | $314 – $314 |
| 25 | Mayo Clinic Health System St, NE professional · percent of total billed charges · outpatientfrom % of charges | 1 | $314 | $314 | — | — | — | $314 – $314 |
← Payers reporting HCPCS G0249 · Snapshot 20261111T120946Z-9134e7f7