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
$0
Average
$258
Median
$192
High
$4.7k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
712 hospitals; the 90th percentile is 3.6× 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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1,026 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · outpatient | 5 | $326 | $255 | $81 | 32% | 100–127 | $162 – $326 |
| 2 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · other · both | 1 | $141 | $141 | — | — | 53 | $141 – $141 |
| 3 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · other · outpatient | 1 | $141 | $141 | — | — | 53 | $141 – $141 |
| 4 | St Mary Mercy Livonia Livonia, MI professional · fee schedule · outpatient | 3 | $265 | $231 | $44 | 19% | 21–30 | $172 – $265 |
| 5 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · other · both | 1 | $131 | $131 | — | — | 19 | $131 – $131 |
| 6 | St Joseph Mercy Ann Arbor Ypsilanti, MI facility · other · outpatient | 2 | $102 | $102 | $28 | 27% | 19 | $74 – $131 |
| 7 | Beaufort Memorial Hospital Beaufort, SC professional · percent of total billed charges · bothfrom % of charges | 1 | $167 | $167 | — | — | 14 | $167 – $167 |
| 8 | Massachusetts General Hospital Boston, MA other · both | 1 | $153 | $153 | — | — | 12 | $153 – $153 |
| 9 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 3 | $186 | $174 | $14 | 8% | 4–40 | $153 – $186 |
| 10 | Baystate Wing Hospital Palmer, MA percent of total billed charges · bothfrom % of charges | 3 | $141 | $141 | — | — | 3–30 | $141 – $141 |
| 11 | Brigham and Women's Hospital Boston, MA other · both | 1 | $153 | $153 | — | — | 2–20 | $153 – $153 |
| 12 | City Hospital, Inc. Martinsburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $107 | $107 | — | — | 2–20 | $107 – $107 |
| 13 | Mayo Clinic Rochester, MN professional · fee schedule · outpatient | 5 | $171 | $169 | $15 | 9% | 2–20 | $150 – $199 |
| 14 | Mayo Clinic Health System Mankato 56001-4752 professional · fee schedule · outpatient | 4 | $173 | $160 | $24 | 15% | 2–20 | $131 – $182 |
| 15 | Mayo Clinic Health System Owatonna 55060-5503 professional · fee schedule · outpatient | 5 | $176 | $163 | $23 | 14% | 2–20 | $131 – $182 |
| 16 | Mayo Clinic Health System Eau Claire 54703-5270 professional · fee schedule · outpatient | 4 | $176 | $243 | $86 | 35% | 2–20 | $167 – $349 |
| 17 | Mercy Health Saint Marys Rockford, MI facility · other · outpatient | 2 | $130 | $111 | $26 | 24% | 2–20 | $74 – $130 |
| 18 | Saint Francis Hospital and Medical Center Hartford, CT professional · fee schedule · both | 2 | $185 | $161 | $33 | 20% | 2–20 | $116 – $185 |
| 19 | Baystate Wing Hospital Palmer, MA fee schedule · both | 1 | $141 | $141 | — | — | 1–10 | $141 – $141 |
| 20 | Benefis Hospitals Inc Helena, MT other · outpatient | 1 | $136 | $136 | — | — | 1–10 | $136 – $136 |
| 21 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 2 | $223 | $182 | $55 | 30% | 1–10 | $107 – $223 |
| 22 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $182 | $182 | — | — | 1–10 | $182 – $182 |
| 23 | Lake Charles Memorial Hospital Charles., LA fee schedule · outpatient | 2 | $118 | $118 | $8 | 7% | 1–10 | $110 – $126 |
| 24 | Lake Charles Memorial Hospital Charles., LA other · outpatient | 1 | $149 | $149 | — | — | 1–10 | $149 – $149 |
| 25 | Little Falls Hospital Falls, NY professional · other · outpatient | 5 | $264 | $264 | — | — | 1–10 | $264 – $264 |
← Payers reporting HCPCS G0402 · Snapshot 20261111T120946Z-9134e7f7