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
$5.7k
Median
$146
High
$5218.8k
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
951 hospitals; the 90th percentile is 2.6× 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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1,643 hospital rates
iThe hospitals that file a UnitedHealthcare 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 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 3 | $162 | $186 | $41 | 22% | 168–177 | $153 – $244 |
| 2 | Mercy Hospital Southeast Girardeau, MO professional · fee schedule · outpatient | 5 | $197 | $195 | $31 | 16% | 76–85 | $151 – $231 |
| 3 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · other · both | 1 | $141 | $141 | — | — | 67 | $141 – $141 |
| 4 | Saint Alphonsus Regional Medical Center - Boise Boise, ID facility · other · outpatient | 1 | $141 | $141 | — | — | 67 | $141 – $141 |
| 5 | Samaritan Hospital Troy, NY professional · percent of total billed charges · bothfrom % of charges | 1 | $424 | $424 | — | — | 65–74 | $424 – $424 |
| 6 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 2 | $192 | $192 | $80 | 42% | 58–67 | $111 – $272 |
| 7 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · percent of total billed charges · bothfrom % of charges | 3 | $277 | $277 | — | — | 58–67 | $277 – $277 |
| 8 | St Peters Hospital Albany, NY professional · percent of total billed charges · bothfrom % of charges | 1 | $424 | $424 | — | — | 57–66 | $424 – $424 |
| 9 | Beaufort Memorial Hospital Beaufort, SC professional · percent of total billed charges · bothfrom % of charges | 1 | $167 | $167 | — | — | 53 | $167 – $167 |
| 10 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · outpatient | 3 | $173 | $219 | $70 | 32% | 38 | $165 – $318 |
| 11 | Saint Francis Hospital and Medical Center Hartford, CT professional · fee schedule · both | 3 | $212 | $187 | $49 | 26% | 25–43 | $119 – $230 |
| 12 | Samaritan Hospital Troy, NY facility · other · both | 2 | $276 | $276 | $107 | 39% | 23 | $169 – $382 |
| 13 | Samaritan Hospital Troy, NY facility · other · outpatient | 2 | $276 | $276 | $107 | 39% | 23 | $169 – $382 |
| 14 | Grand Itasca Clinic and Hospital Grand Rapids, MN facility · other · inpatient | 1 | $135 | $135 | — | — | 20 | $135 – $135 |
| 15 | Range Regional Health Services Hibbing, MN facility · other · inpatient | 1 | $135 | $135 | — | — | 20 | $135 – $135 |
| 16 | Holy Cross Hospital-Silver Spring Silver Spring, MD professional · percent of total billed charges · bothfrom % of charges | 1 | $277 | $277 | — | — | 19 | $277 – $277 |
| 17 | Massachusetts General Hospital Boston, MA other · both | 1 | $150 | $150 | — | — | 16 | $150 – $150 |
| 18 | HOLLAND COMMUNITY HOSPITAL Holland, MI percent of total billed charges · outpatientfrom % of charges | 1 | $68 | $68 | — | — | 11 | $68 – $68 |
| 19 | MVHS, Inc. Utica, NY percent of total billed charges · bothfrom % of charges | 3 | $118 | $162 | $65 | 40% | 4–40 | $118 – $283 |
| 20 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 2 | $144 | $182 | $99 | 55% | 3–30 | $69 – $380 |
| 21 | Northern Hospital District of Surry County Mount Airy, NC facility · fee schedule · both | 1 | $115 | $115 | — | — | 3–30 | $115 – $115 |
| 22 | CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO other · inpatient | 2 | $127 | $127 | — | — | 2–20 | $127 – $127 |
| 23 | Mercy Hospitals East Communities Washington, MO professional · fee schedule · outpatient | 3 | $193 | $188 | $10 | 5% | 2–20 | $172 – $195 |
| 24 | Monument Health Network Inc Sturgis, SD percent of total billed charges · outpatientfrom % of charges | 2 | $205 | $205 | $124 | 60% | 2–20 | $81 – $328 |
| 25 | Samaritan Medical Center Watertown, NY facility · other · inpatient | 1 | $168 | $168 | — | — | 2–20 | $168 – $168 |
← Payers reporting HCPCS G0402 · Snapshot 20261111T120946Z-9134e7f7