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
$1
Average
$257
Median
$310
High
$625
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
46 hospitals; the 90th percentile is 7.8× 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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57 hospital rates
iThe hospitals that file a Medicaid 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 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $368 | $368 | $48 | 13% | — | $320 – $416 |
| 2 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $368 | $368 | $48 | 13% | — | $320 – $416 |
| 3 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $320 | $320 | — | — | — | $320 – $320 |
| 4 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 1 | $100 | $100 | — | — | — | $100 – $100 |
| 5 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 1 | $81 | $81 | — | — | — | $81 – $81 |
| 6 | Allina Health Systems Ulm, MN facility · other · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 7 | Brookings Health System Brookings, SD fee schedule · outpatient | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 8 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $105 | $105 | — | — | — | $105 – $105 |
| 9 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · percent of total billed charges · bothfrom % of charges | 1 | $277 | $277 | — | — | — | $277 – $277 |
| 10 | Central Community Hospital Elkader, IA professional · percent of total billed charges · inpatientfrom % of charges | 1 | $277 | $277 | — | — | — | $277 – $277 |
| 11 | Central Community Hospital Elkader, IA professional · percent of total billed charges · outpatientfrom % of charges | 1 | $425 | $425 | — | — | — | $425 – $425 |
| 12 | Covenant Medical Center Inc Waterloo, IA professional · percent of total billed charges · bothfrom % of charges | 1 | $404 | $404 | — | — | — | $404 – $404 |
| 13 | FRANCISCAN HEALTH RENSSELAER, INC. RENSSELAER, IN per diem · both | 2 | $193 | $193 | $34 | 18% | — | $159 – $227 |
| 14 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $89 | $89 | — | — | — | $89 – $89 |
| 15 | GLENDALE ADVENTIST MEDICAL CENTER Glendale, CA fee schedule · outpatient | 1 | $348 | $348 | — | — | — | $348 – $348 |
| 16 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 17 | HANFORD COMMUNITY HOSPITAL Selma, CA fee schedule · outpatient | 1 | $320 | $320 | — | — | — | $320 – $320 |
| 18 | HealthAlliance - Clinton Hospital MA 01453; 201 Highland St Clinton, MA other · both | 1 | $162 | $162 | — | — | — | $162 – $162 |
| 19 | HealthAlliance - Clinton Hospital MA 01453; 201 Highland St Clinton, MA percent of total billed charges · bothfrom % of charges | 1 | $233 | $233 | — | — | — | $233 – $233 |
| 20 | Holy Cross Hospital-Silver Spring Silver Spring, MD professional · percent of total billed charges · bothfrom % of charges | 1 | $277 | $277 | — | — | — | $277 – $277 |
| 21 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $299 | $299 | — | — | — | $299 – $299 |
| 22 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA fee schedule · outpatient | 1 | $325 | $347 | $40 | 12% | — | $320 – $416 |
| 23 | Lake Charles Memorial Hospital Charles., LA percent of total billed charges · outpatientfrom % of charges | 1 | $45 | $45 | — | — | — | $45 – $45 |
| 24 | MELROSEWAKEFIELD HEALTHCARE Medford, MA percent of total billed charges · bothfrom % of charges | 1 | $151 | $151 | — | — | — | $151 – $151 |
| 25 | Mercy Health Services-Iowa Corp. Mason City, IA professional · percent of total billed charges · bothfrom % of charges | 1 | $404 | $404 | — | — | — | $404 – $404 |
← Payers reporting HCPCS G0402 · Snapshot 20261111T120946Z-9134e7f7