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
Prolong Inpt Eval Add15 M
Low
$24
Average
$70
Median
$31
High
$337
Each hospital's average Sanford Health Plan rate, under the methodology and billing class chosen below.
54 hospitals; the 90th percentile is 5.3× 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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77 hospital rates
iThe hospitals that file a Sanford Health Plan 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 | Astera Health Wadena, MN fee schedule · inpatient | 1 | $658 | $658 | — | — | — | $658 – $658 |
| 2 | Astera Health Wadena, MN fee schedule · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 3 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · inpatient | 2 | $35 | $35 | $9 | 27% | — | $26 – $44 |
| 4 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient | 2 | $35 | $35 | $9 | 27% | — | $26 – $44 |
| 5 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · inpatient | 2 | $35 | $35 | $9 | 27% | — | $26 – $44 |
| 6 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · outpatient | 2 | $35 | $35 | $9 | 27% | — | $26 – $44 |
| 7 | Fairview Bethesda Hospital St. Paul, MN fee schedule · both | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 8 | Fairview Health Services Edina, MN fee schedule · both | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 9 | Fairview Health Services Minneapolis, MN fee schedule · both | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 10 | Fairview Health Services Burnsville, MN fee schedule · both | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 11 | Fairview Health Services Wyoming, MN fee schedule · both | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 12 | Fairview Health Services Princeton, MN fee schedule · both | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 13 | Grand Itasca Clinic and Hospital Grand Rapids, MN professional · fee schedule · both | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 14 | HealthEast St John's Hospital Maplewood, MN fee schedule · both | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 15 | HealthEast Woodwinds Hospital Woodbury, MN fee schedule · both | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 16 | Marshfield Medical Center - Dickinson Iron Mountain, MI facility · percent of total billed charges · inpatientfrom % of charges | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 17 | Marshfield Medical Center - Dickinson Iron Mountain, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 18 | Mayo Clinic Health System Mankato 56001-4752 professional · percent of total billed charges · outpatientfrom % of charges | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 19 | Mayo Clinic Health System Lake City 55041-1143 professional · percent of total billed charges · outpatientfrom % of charges | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 20 | Mayo Clinic Health System Saint James 56081-5550 professional · percent of total billed charges · outpatientfrom % of charges | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 21 | Mayo Clinic Health System Fairmont 56031-4575 professional · percent of total billed charges · outpatientfrom % of charges | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 22 | Mayo Clinic Health System Osseo, WI professional · percent of total billed charges · outpatientfrom % of charges | 1 | $145 | $145 | — | — | — | $145 – $145 |
| 23 | Mayo Clinic Health System Menomonie, WI professional · percent of total billed charges · outpatientfrom % of charges | 1 | $145 | $145 | — | — | — | $145 – $145 |
| 24 | Mayo Clinic Health System St, NE professional · percent of total billed charges · outpatientfrom % of charges | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 25 | Mayo Clinic Health System Owatonna 55060-5503 professional · percent of total billed charges · outpatientfrom % of charges | 1 | $126 | $126 | — | — | — | $126 – $126 |
← Payers reporting HCPCS G0316 · Snapshot 20261112T124536Z-e251e855