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 Exam Init Preventive Phys New Visit During 1st 12 Mo of Mcare Enrollment
Low
$5
Average
$171
Median
$139
High
$424
Each hospital's average Amerihealth Caritas rate, under the methodology and billing class chosen below.
51 hospitals; the 90th percentile is 11.6× 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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64 hospital rates
iThe hospitals that file a Amerihealth Caritas 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 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges | 1 | $36 | $36 | — | — | — | $36 – $36 |
| 2 | Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · outpatientfrom % of charges | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 3 | Atrium Health Hospitals Inc Wadesboro, NC percent of total billed charges · outpatientfrom % of charges | 1 | $38 | $38 | — | — | — | $38 – $38 |
| 4 | Bay Park Community Hospital Oregon, OH facility · other · outpatient | 1 | $290 | $290 | — | — | — | $290 – $290 |
| 5 | Bayhealth Hospital, Sussex Campus Milton, DE fee schedule · outpatient | 1 | $147 | $147 | — | — | — | $147 – $147 |
| 6 | Bayhealth Medical Center, Kent Campus Dover, DE fee schedule · outpatient | 1 | $151 | $151 | — | — | — | $151 – $151 |
| 7 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 8 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 9 | Carolinas Medical Center Davidson, NC percent of total billed charges · outpatientfrom % of charges | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 10 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 11 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · percent of total billed charges · bothfrom % of charges | 1 | $277 | $277 | — | — | — | $277 – $277 |
| 12 | Central Community Hospital Elkader, IA professional · percent of total billed charges · inpatientfrom % of charges | 1 | $277 | $277 | — | — | — | $277 – $277 |
| 13 | Central Community Hospital Elkader, IA professional · percent of total billed charges · outpatientfrom % of charges | 1 | $425 | $425 | — | — | — | $425 – $425 |
| 14 | Cheshire Medical Center Keene, NH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $66 | $66 | — | — | — | $66 – $66 |
| 15 | Children's Hospital of the King's Daughters Norfolk, VA facility · percent of total billed charges · outpatientfrom % of charges | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 16 | Covenant Medical Center Inc Waterloo, IA professional · percent of total billed charges · bothfrom % of charges | 1 | $404 | $404 | — | — | — | $404 – $404 |
| 17 | HOSPITAL SERVICE DISTRICT #2 OF LASALLE PARISH JENA, LA fee schedule · both | 1 | $93 | $93 | — | — | — | $93 – $93 |
| 18 | Henry Ford Health System West Bloomfield, MI facility · fee schedule · outpatient | 1 | $130 | $130 | — | — | — | $130 – $130 |
| 19 | Henry Ford Health System West Bloomfield, MI professional · fee schedule · outpatient | 2 | $144 | $144 | $29 | 20% | — | $115 – $172 |
| 20 | Henry Ford Health System Plymouth, MI facility · fee schedule · outpatient | 1 | $130 | $130 | — | — | — | $130 – $130 |
| 21 | Henry Ford Health System Plymouth, MI professional · fee schedule · outpatient | 2 | $144 | $144 | $29 | 20% | — | $115 – $172 |
| 22 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI facility · fee schedule · outpatient | 1 | $130 | $130 | — | — | — | $130 – $130 |
| 23 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI professional · fee schedule · outpatient | 2 | $144 | $144 | $29 | 20% | — | $115 – $172 |
| 24 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI facility · fee schedule · outpatient | 1 | $130 | $130 | — | — | — | $130 – $130 |
| 25 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI professional · fee schedule · outpatient | 2 | $144 | $144 | $29 | 20% | — | $115 – $172 |
← Payers reporting HCPCS G0402 · Snapshot 20261111T120946Z-9134e7f7