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
$57
Average
$141
Median
$135
High
$373
Each hospital's average Ucare rate, under the methodology and billing class chosen below.
58 hospitals; the 90th percentile is 3.0× 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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97 hospital rates
iThe hospitals that file a Ucare 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 Rochester, MN professional · fee schedule · outpatient | 4 | $64 | $65 | $9 | 13% | 122–131 | $55 – $78 |
| 2 | Mayo Clinic Health System Mankato 56001-4752 facility · other · both | 2 | $179 | $179 | $9 | 5% | 16 | $170 – $188 |
| 3 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · percent of total billed charges · bothfrom % of charges | 4 | $152 | $148 | $81 | 55% | 12 | $69 – $290 |
| 4 | Mayo Clinic Health System Lake City 55041-1143 facility · percent of total billed charges · bothfrom % of charges | 4 | $198 | $167 | $86 | 52% | 2–20 | $69 – $290 |
| 5 | Mayo Clinic Health System Mankato 56001-4752 facility · percent of total billed charges · bothfrom % of charges | 2 | $180 | $180 | $111 | 62% | 1–10 | $69 – $290 |
| 6 | Mayo Clinic Health System Fairmont 56031-4575 facility · other · both | 2 | $179 | $179 | $9 | 5% | 1–10 | $170 – $188 |
| 7 | Mayo Clinic Health System Fairmont 56031-4575 facility · percent of total billed charges · bothfrom % of charges | 2 | $180 | $180 | $111 | 62% | 1–10 | $69 – $290 |
| 8 | Mayo Clinic Health System Waseca 56093-2811 facility · percent of total billed charges · bothfrom % of charges | 4 | $142 | $144 | $81 | 56% | 1–10 | $69 – $290 |
| 9 | Sanford Tracy Hospital Tracy, MN percent of total billed charges · outpatientfrom % of charges | 2 | $226 | $226 | $80 | 36% | 1–10 | $145 – $306 |
| 10 | Sanford USD Medical Center Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 1 | $228 | $228 | — | — | 1–10 | $228 – $228 |
| 11 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $158 | $158 | — | — | — | $158 – $158 |
| 12 | Aspirus St. Luke’s Hospital Duluth, MN fee schedule · both | 2 | $57 | $57 | $7 | 13% | — | $49 – $64 |
| 13 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 3 | $68 | $78 | $29 | 37% | — | $49 – $118 |
| 14 | Essentia Health Duluth Duluth, MN facility · fee schedule · outpatient | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 15 | Essentia Health Fargo 3000 32nd Ave S Fargo, ND facility · fee schedule · outpatient | 1 | $129 | $129 | — | — | — | $129 – $129 |
| 16 | Essentia Health St. Joseph's Medical Center Brainerd, MN facility · fee schedule · outpatient | 1 | $138 | $138 | — | — | — | $138 – $138 |
| 17 | Essentia Health St. Mary's - Detroit Lakes 1027 Washington Ave. Detroit Lakes, MN facility · fee schedule · outpatient | 1 | $135 | $135 | — | — | — | $135 – $135 |
| 18 | Essentia Health St. Mary's Children's Hospital Duluth, MN facility · fee schedule · outpatient | 1 | $129 | $129 | — | — | — | $129 – $129 |
| 19 | Essentia Health St. Mary's Medical Center Duluth, MN facility · fee schedule · outpatient | 1 | $129 | $129 | — | — | — | $129 – $129 |
| 20 | Essentia Health Virginia 901 9th St N Virginia, MN facility · fee schedule · outpatient | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 21 | Fairview Bethesda Hospital St. Paul, MN fee schedule · both | 4 | $114 | $111 | $55 | 50% | — | $46 – $170 |
| 22 | Fairview Bethesda Hospital St. Paul, MN fee schedule · outpatient | 4 | $178 | $195 | $69 | 36% | — | $130 – $295 |
| 23 | Fairview Health Services Edina, MN fee schedule · both | 4 | $114 | $111 | $55 | 50% | — | $46 – $170 |
| 24 | Fairview Health Services Edina, MN fee schedule · outpatient | 4 | $179 | $196 | $70 | 36% | — | $130 – $295 |
| 25 | Fairview Health Services Minneapolis, MN fee schedule · both | 6 | $114 | $110 | $58 | 53% | — | $46 – $170 |
← Payers reporting HCPCS G0249 · Snapshot 20261111T120946Z-9134e7f7