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
$23
Average
$192
Median
$158
High
$424
Each hospital's average Medica rate, under the methodology and billing class chosen below.
139 hospitals; the 90th percentile is 3.9× 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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283 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 | Monument Health Rapid City Hospital Inc City, SD percent of total billed charges · outpatientfrom % of charges | 3 | $99 | $153 | $88 | 57% | 36 | $83 – $278 |
| 2 | Grand Itasca Clinic and Hospital Grand Rapids, MN facility · other · inpatient | 1 | $126 | $126 | — | — | 25–250 | $126 – $126 |
| 3 | Range Regional Health Services Hibbing, MN facility · other · inpatient | 1 | $126 | $126 | — | — | 25–250 | $126 – $126 |
| 4 | WINNESHIEK MEDICAL CENTER Decorah, IA percent of total billed charges · outpatientfrom % of charges | 3 | $48 | $48 | $1 | 2% | 3–30 | $48 – $49 |
| 5 | Monument Health Network Inc Spearfish, SD percent of total billed charges · outpatientfrom % of charges | 3 | $125 | $167 | $79 | 47% | 2–20 | $99 – $278 |
| 6 | Monument Health Network Inc Deadwood, SD percent of total billed charges · outpatientfrom % of charges | 3 | $113 | $180 | $105 | 58% | 2–20 | $100 – $328 |
| 7 | Monument Health Network Inc Custer, SD percent of total billed charges · outpatientfrom % of charges | 3 | $113 | $176 | $108 | 62% | 2–20 | $87 – $328 |
| 8 | Brookings Health System Brookings, SD percent of total billed charges · outpatientfrom % of charges | 1 | $39 | $32 | $9 | 27% | 1–10 | $21 – $39 |
| 9 | Mayo Clinic Rochester, MN professional · fee schedule · outpatient | 2 | $168 | $168 | $14 | 8% | 1–10 | $152 – $185 |
| 10 | Mayo Clinic Health System Mankato 56001-4752 professional · fee schedule · outpatient | 3 | $182 | $181 | $2 | 1% | 1–10 | $178 – $182 |
| 11 | Mayo Clinic Health System Owatonna 55060-5503 professional · fee schedule · outpatient | 4 | $180 | $163 | $25 | 15% | 1–10 | $129 – $182 |
| 12 | Mayo Clinic Health System Eau Claire 54703-5270 professional · fee schedule · outpatient | 2 | $186 | $186 | $13 | 7% | 1–10 | $172 – $199 |
| 13 | Pipestone County Medical Center Pipestone, MN percent of total billed charges · outpatientfrom % of charges | 2 | $95 | $95 | $9 | 10% | 1–10 | $86 – $104 |
| 14 | Allina Health Systems Ulm, MN facility · fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 15 | Allina Health Systems Ulm, MN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 16 | Allina Health Systems Ulm, MN facility · percent of total billed charges · outpatientfrom % of charges | 4 | $26 | $25 | $9 | 37% | — | $13 – $35 |
| 17 | Altru Hospital Grand Forks, ND facility · fee schedule · outpatient | 4 | $109 | $131 | $62 | 47% | — | $77 – $228 |
| 18 | Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient | 4 | $109 | $131 | $62 | 47% | — | $77 – $228 |
| 19 | Amery Hospital Amery, WI facility · fee schedule · both | 2 | $294 | $247 | $67 | 27% | — | $152 – $294 |
| 20 | Amery Hospital Amery, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 21 | Avera Behavioral Health Hospital Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 2 | $71 | $71 | $5 | 8% | — | $66 – $76 |
| 22 | Avera Creighton Hospital Creighton, NE fee schedule · both | 2 | $278 | $278 | — | — | — | $278 – $278 |
| 23 | Avera DeSmet De Smet, SD fee schedule · both | 2 | $278 | $278 | — | — | — | $278 – $278 |
| 24 | Avera DeSmet De Smet, SD percent of total billed charges · inpatientfrom % of charges | 2 | $118 | $118 | $10 | 9% | — | $108 – $128 |
| 25 | Avera DeSmet De Smet, SD percent of total billed charges · outpatientfrom % of charges | 2 | $121 | $121 | $10 | 9% | — | $110 – $131 |
← Payers reporting HCPCS G0402 · Snapshot 20261111T120946Z-9134e7f7