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
HC VISIT TO DETERM LDCT ELIG
Low
$16
Average
$78
Median
$66
High
$239
Each hospital's average Medica rate, under the methodology and billing class chosen below.
95 hospitals; the 90th percentile is 6.3× 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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191 hospital rates
iThe hospitals that file a Medica 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 | Grand Itasca Clinic and Hospital Grand Rapids, MN facility · other · inpatient | 1 | $91 | $91 | — | — | 3–30 | $91 – $91 |
| 2 | Range Regional Health Services Hibbing, MN facility · other · inpatient | 1 | $91 | $91 | — | — | 3–30 | $91 – $91 |
| 3 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 7 | $135 | $135 | $3 | 2% | 2–20 | $132 – $140 |
| 4 | Monument Health Rapid City Hospital Inc City, SD percent of total billed charges · outpatientfrom % of charges | 3 | $80 | $123 | $71 | 57% | 2–20 | $67 – $223 |
| 5 | Westfields Hospital New Richmond, WI facility · percent of total billed charges · bothfrom % of charges | 2 | $142 | $172 | $72 | 42% | 2–20 | $102 – $271 |
| 6 | Mayo Clinic Rochester, MN professional · fee schedule · outpatient | 2 | $27 | $28 | $2 | 8% | 1–10 | $25 – $30 |
| 7 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · fee schedule · outpatient | 1 | $109 | $109 | — | — | — | $109 – $109 |
| 8 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · per diem · outpatient | 5 | $297 | $277 | $44 | 16% | — | $191 – $313 |
| 9 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $244 | $244 | — | — | — | $244 – $244 |
| 10 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $279 | $217 | $99 | 45% | — | $78 – $293 |
| 11 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · fee schedule · outpatient | 1 | $108 | $108 | — | — | — | $108 – $108 |
| 12 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · per diem · outpatient | 5 | $297 | $277 | $44 | 16% | — | $191 – $313 |
| 13 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $244 | $244 | — | — | — | $244 – $244 |
| 14 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $279 | $217 | $99 | 45% | — | $78 – $293 |
| 15 | Allina Health Systems Minneapolis, MN facility · fee schedule · outpatient | 1 | $109 | $109 | — | — | — | $109 – $109 |
| 16 | Allina Health Systems Minneapolis, MN facility · per diem · outpatient | 5 | $286 | $274 | $43 | 16% | — | $191 – $313 |
| 17 | Allina Health Systems Minneapolis, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $244 | $244 | — | — | — | $244 – $244 |
| 18 | Allina Health Systems Minneapolis, MN facility · percent of total billed charges · outpatientfrom % of charges | 3 | $279 | $217 | $99 | 45% | — | $78 – $293 |
| 19 | Altru Hospital Grand Forks, ND facility · fee schedule · outpatient | 4 | $21 | $25 | $12 | 47% | — | $15 – $44 |
| 20 | Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient | 4 | $21 | $25 | $12 | 47% | — | $15 – $44 |
| 21 | Amery Hospital Amery, WI facility · fee schedule · both | 2 | $49 | $42 | $9 | 22% | — | $29 – $49 |
| 22 | Amery Hospital Amery, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $103 | $103 | — | — | — | $103 – $103 |
| 23 | Aspirus St. Luke’s Hospital Duluth, MN fee schedule · both | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 24 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 4 | $67 | $56 | $20 | 36% | — | $21 – $68 |
| 25 | BSA Hospital Amarillo, TX facility · percent of total billed charges · bothfrom % of charges | 1 | $197 | $197 | — | — | — | $197 – $197 |
← Payers reporting HCPCS G0296 · Snapshot 20261111T120946Z-9134e7f7