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
$8
Average
$169
Median
$141
High
$424
Each hospital's average Ucare rate, under the methodology and billing class chosen below.
100 hospitals; the 90th percentile is 2.2× 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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159 hospital rates
iThe hospitals that file a Ucare 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 | Grand Itasca Clinic and Hospital Grand Rapids, MN facility · other · inpatient | 2 | $135 | $135 | — | — | 57–282 | $135 – $135 |
| 2 | Range Regional Health Services Hibbing, MN facility · other · inpatient | 2 | $135 | $135 | — | — | 57–282 | $135 – $135 |
| 3 | Mayo Clinic Rochester, MN professional · fee schedule · outpatient | 4 | $151 | $154 | $24 | 15% | 2–20 | $120 – $199 |
| 4 | Mayo Clinic Health System Fairmont 56031-4575 facility · other · both | 2 | $179 | $179 | $9 | 5% | 1–10 | $170 – $188 |
| 5 | Allina Health Systems Ulm, MN facility · percent of total billed charges · outpatientfrom % of charges | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 6 | Alomere Health Alexandria, MN facility · fee schedule · outpatient | 1 | $158 | $158 | — | — | — | $158 – $158 |
| 7 | Aspirus St. Luke’s Hospital Duluth, MN fee schedule · both | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 8 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 3 | $112 | $135 | $42 | 32% | — | $98 – $194 |
| 9 | Central Community Hospital Elkader, IA professional · fee schedule · inpatient | 3 | $112 | $135 | $42 | 32% | — | $98 – $194 |
| 10 | Central Community Hospital Elkader, IA professional · fee schedule · outpatient | 3 | $148 | $177 | $57 | 32% | — | $126 – $257 |
| 11 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 3 | $112 | $135 | $42 | 32% | — | $98 – $194 |
| 12 | Essentia Health Ada 201 9th St W Ada, MN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $179 | $179 | $28 | 16% | — | $151 – $207 |
| 13 | Essentia Health Duluth Duluth, MN facility · fee schedule · outpatient | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 14 | Essentia Health Fargo 3000 32nd Ave S Fargo, ND facility · fee schedule · outpatient | 1 | $129 | $129 | — | — | — | $129 – $129 |
| 15 | Essentia Health Fosston 900 Hilligoss Blvd SE Fosston, MN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $182 | $182 | $25 | 14% | — | $158 – $207 |
| 16 | Essentia Health Holy Trinity Hospital Graceville, MN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $201 | $201 | $6 | 3% | — | $195 – $207 |
| 17 | Essentia Health Northern Pines 5211 Highway 110 Aurora, MN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $165 | $165 | $42 | 26% | — | $123 – $207 |
| 18 | Essentia Health Sandstone 705 Lundorff Dr Sandstone, MN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $178 | $178 | $30 | 17% | — | $148 – $207 |
| 19 | Essentia Health St Marys Hospital-Superior 3500 Tower Ave Superior, WI facility · percent of total billed charges · outpatientfrom % of charges | 2 | $154 | $154 | $53 | 35% | — | $101 – $207 |
| 20 | Essentia Health St. Joseph's Medical Center Brainerd, MN facility · fee schedule · outpatient | 1 | $138 | $138 | — | — | — | $138 – $138 |
| 21 | Essentia Health St. Mary's - Detroit Lakes 1027 Washington Ave. Detroit Lakes, MN facility · fee schedule · outpatient | 1 | $135 | $135 | — | — | — | $135 – $135 |
| 22 | Essentia Health St. Mary's Children's Hospital Duluth, MN facility · fee schedule · outpatient | 1 | $129 | $129 | — | — | — | $129 – $129 |
| 23 | Essentia Health St. Mary's Medical Center Duluth, MN facility · fee schedule · outpatient | 1 | $129 | $129 | — | — | — | $129 – $129 |
| 24 | Essentia Health Virginia 901 9th St N Virginia, MN facility · fee schedule · outpatient | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 25 | Fairview Bethesda Hospital St. Paul, MN fee schedule · both | 4 | $225 | $220 | $110 | 50% | — | $91 – $337 |
← Payers reporting HCPCS G0402 · Snapshot 20261111T120946Z-9134e7f7