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
$5
Average
$143
Median
$138
High
$365
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
377 hospitals; the 90th percentile is 1.6× 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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517 hospital rates
iThe hospitals that file a WellCare 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 | St Peters Hospital Albany, NY professional · percent of total billed charges · bothfrom % of charges | 1 | $424 | $424 | — | — | 14 | $424 – $424 |
| 2 | Samaritan Hospital Troy, NY professional · percent of total billed charges · bothfrom % of charges | 1 | $424 | $424 | — | — | 12 | $424 – $424 |
| 3 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 1 | $109 | $109 | — | — | 11 | $109 – $109 |
| 4 | MVHS, Inc. Utica, NY fee schedule · outpatient | 1 | $98 | $98 | — | — | 1–10 | $98 – $98 |
| 5 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 1 | $173 | $173 | — | — | 1–10 | $173 – $173 |
| 6 | North Carolina Baptist Hospital Winston Salem, NC other · outpatient | 1 | $154 | $154 | — | — | 1–10 | $154 – $154 |
| 7 | Saint Francis Hospital and Medical Center Hartford, CT professional · fee schedule · both | 1 | $119 | $119 | — | — | 1–10 | $119 – $119 |
| 8 | Samaritan Hospital Troy, NY facility · other · both | 2 | $224 | $224 | $42 | 19% | 1–10 | $182 – $266 |
| 9 | Samaritan Hospital Troy, NY facility · other · outpatient | 2 | $224 | $224 | $42 | 19% | 1–10 | $182 – $266 |
| 10 | St Mary Mercy Livonia Livonia, MI professional · fee schedule · outpatient | 1 | $181 | $181 | — | — | 1–10 | $181 – $181 |
| 11 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY fee schedule · outpatient | 1 | $123 | $123 | — | — | — | $123 – $123 |
| 12 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 2 | $144 | $144 | $3 | 2% | — | $141 – $147 |
| 13 | ARH Tug Valley Health Services, Inc. Paintsville, KY other · outpatient | 2 | $85 | $85 | $4 | 5% | — | $81 – $89 |
| 14 | Acadia Hospital Bangor, ME facility · fee schedule · outpatient | 1 | $127 | $127 | — | — | — | $127 – $127 |
| 15 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $140 | $140 | $16 | 12% | — | $123 – $156 |
| 16 | Adventhealth Carrollwood Tampa, FL fee schedule · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 17 | Adventhealth North Pinellas Palm Harbor, FL fee schedule · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 18 | Adventhealth Port Charlotte Port Charlotte, FL fee schedule · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 19 | Adventhealth Tampa Brandon, FL fee schedule · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 20 | Adventhealth Wesley Chapel Lutz, FL fee schedule · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 21 | Adventhealth Zephyrhills Zephyrhills, FL fee schedule · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 22 | Agnesian Healthcare Inc. Fond Du Lac, WI fee schedule · outpatient | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 23 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 1 | $131 | $131 | — | — | — | $131 – $131 |
| 24 | AnMed Health Anderson, SC professional · fee schedule · inpatient | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 25 | AnMed Health Anderson, SC professional · fee schedule · outpatient | 1 | $124 | $124 | — | — | — | $124 – $124 |
← Payers reporting HCPCS G0402 · Snapshot 20261111T120946Z-9134e7f7