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
$105
Average
$224
Median
$176
High
$518
Each hospital's average Regence rate, under the methodology and billing class chosen below.
82 hospitals; the 90th percentile is 3.0× 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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145 hospital rates
iThe hospitals that file a Regence 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 facility · other · both | 1 | $144 | $144 | — | — | 1–10 | $144 – $144 |
| 2 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · other · outpatient | 1 | $144 | $144 | — | — | 1–10 | $144 – $144 |
| 3 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · outpatient | 5 | $270 | $256 | $69 | 27% | 1–10 | $162 – $326 |
| 4 | ALBANY GENERAL HOSPITAL Albany, OR facility · fee schedule · outpatient | 1 | $479 | $479 | — | — | — | $479 – $479 |
| 5 | CATHOLIC HEALTH INITIATIVES COLORADO West Valley City, UT fee schedule · outpatient | 4 | $126 | $126 | — | — | — | $126 – $126 |
| 6 | CATHOLIC HEALTH INITIATIVES COLORADO West Jordan, UT fee schedule · outpatient | 4 | $126 | $126 | — | — | — | $126 – $126 |
| 7 | CATHOLIC HEALTH INITIATIVES COLORADO Lehi, UT fee schedule · outpatient | 4 | $126 | $126 | — | — | — | $126 – $126 |
| 8 | CATHOLIC HEALTH INITIATIVES COLORADO Layton, UT fee schedule · outpatient | 4 | $126 | $126 | — | — | — | $126 – $126 |
| 9 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 4 | $126 | $126 | — | — | — | $126 – $126 |
| 10 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 2 | $223 | $184 | $55 | 30% | — | $107 – $223 |
| 11 | Central Community Hospital Elkader, IA professional · fee schedule · inpatient | 2 | $223 | $184 | $55 | 30% | — | $107 – $223 |
| 12 | Central Community Hospital Elkader, IA professional · fee schedule · outpatient | 2 | $242 | $207 | $50 | 24% | — | $137 – $242 |
| 13 | Central Washington Health Services Association Wenatchee, WA other · outpatient | 1 | $179 | $179 | — | — | — | $179 – $179 |
| 14 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · outpatientfrom % of charges | 2 | $154 | $154 | $1 | 0% | — | $154 – $155 |
| 15 | Clallam County Public Hospital District 2 DBA Olympic Medical Center Port Angeles, WA fee schedule · outpatient | 1 | $167 | $167 | — | — | — | $167 – $167 |
| 16 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 2 | $158 | $175 | $94 | 54% | — | $69 – $356 |
| 17 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 18 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 19 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 2 | $223 | $184 | $55 | 30% | — | $107 – $223 |
| 20 | GOOD SAMARITAN HOSPITAL CORVALLIS Corvallis, OR facility · fee schedule · outpatient | 1 | $465 | $465 | — | — | — | $465 – $465 |
| 21 | GRITMAN MEDICAL CENTER INC Moscow, ID facility · fee schedule · both | 2 | $240 | $215 | $120 | 56% | — | $30 – $329 |
| 22 | GRITMAN MEDICAL CENTER INC Moscow, ID professional · fee schedule · outpatient | 1 | $221 | $221 | $27 | 12% | — | $194 – $248 |
| 23 | Good Samaritan Hospital Puyallup, WA fee schedule · outpatient | 1 | $157 | $157 | — | — | — | $157 – $157 |
| 24 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both | 1 | $763 | $763 | — | — | — | $763 – $763 |
| 25 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · outpatient | 1 | $763 | $763 | — | — | — | $763 – $763 |
← Payers reporting HCPCS G0402 · Snapshot 20261111T120946Z-9134e7f7