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
$52
Average
$250
Median
$183
High
$1.8k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
76 hospitals; the 90th percentile is 3.1× 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.
Filter by billing methodology
Filter by billing class
165 hospital rates
iThe hospitals that file a Wellmark 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 | Sioux Center Health Sioux Center, IA case rate · outpatient | 2 | $123 | $123 | — | — | 50 | $123 – $123 |
| 2 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both | 3 | $223 | $194 | $50 | 26% | 38–56 | $108 – $223 |
| 3 | Monument Health Network Inc Sturgis, SD percent of total billed charges · outpatientfrom % of charges | 2 | $175 | $175 | $92 | 53% | 38 | $83 – $267 |
| 4 | Monument Health Network Inc Deadwood, SD percent of total billed charges · outpatientfrom % of charges | 2 | $191 | $191 | $90 | 47% | 28 | $100 – $281 |
| 5 | Avera Holy Family Hospital Estherville, IA case rate · outpatient | 2 | $120 | $120 | — | — | 2–20 | $120 – $120 |
| 6 | Lakes Regional Hospital Spirit Lake, IA case rate · outpatient | 2 | $72 | $72 | — | — | 2–20 | $72 – $72 |
| 7 | Monument Health Network Inc Custer, SD percent of total billed charges · outpatientfrom % of charges | 2 | $195 | $195 | $109 | 56% | 2–20 | $87 – $304 |
| 8 | Avera Hand County Hospital Miller, SD outpatient | 1 | $212 | $212 | — | — | 1–10 | $212 – $212 |
| 9 | Avera Hand County Hospital Miller, SD percent of total billed charges · outpatientfrom % of charges | 1 | $114 | $114 | — | — | 1–10 | $114 – $114 |
| 10 | Avera Missouri River Health Center Gettysburg, SD outpatient | 1 | $83 | $83 | — | — | 1–10 | $83 – $83 |
| 11 | Avera Missouri River Health Center Gettysburg, SD percent of total billed charges · outpatientfrom % of charges | 1 | $137 | $137 | — | — | 1–10 | $137 – $137 |
| 12 | Avera St. Mary's Hospital Pierre, SD outpatient | 1 | $139 | $139 | — | — | 1–10 | $139 – $139 |
| 13 | Avera St. Mary's Hospital Pierre, SD case rate · outpatient | 1 | $139 | $139 | — | — | 1–10 | $139 – $139 |
| 14 | Mercy Health Services-Iowa Corp. Mason City, IA facility · other · both | 1 | $142 | $142 | — | — | 1–10 | $142 – $142 |
| 15 | Mercy Health Services-Iowa Corp. Mason City, IA facility · other · outpatient | 1 | $142 | $142 | — | — | 1–10 | $142 – $142 |
| 16 | Spencer Municipal Hospital Spencer, IA case rate · outpatient | 1 | $122 | $122 | — | — | 1–10 | $122 – $122 |
| 17 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 18 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 4 | $223 | $198 | $44 | 22% | — | $122 – $223 |
| 19 | Avera Creighton Hospital Creighton, NE percent of total billed charges · bothfrom % of charges | 1 | $367 | $367 | — | — | — | $367 – $367 |
| 20 | Avera DeSmet De Smet, SD fee schedule · both | 1 | $232 | $232 | — | — | — | $232 – $232 |
| 21 | Avera DeSmet De Smet, SD percent of total billed charges · inpatientfrom % of charges | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 22 | Avera DeSmet De Smet, SD percent of total billed charges · outpatientfrom % of charges | 1 | $121 | $121 | — | — | — | $121 – $121 |
| 23 | Avera Dell Rapids Hospital Dell Rapids, SD fee schedule · both | 1 | $232 | $232 | — | — | — | $232 – $232 |
| 24 | Avera Dell Rapids Hospital Dell Rapids, SD percent of total billed charges · inpatientfrom % of charges | 1 | $110 | $110 | — | — | — | $110 – $110 |
| 25 | Avera Dell Rapids Hospital Dell Rapids, SD percent of total billed charges · outpatientfrom % of charges | 1 | $110 | $110 | — | — | — | $110 – $110 |
← Payers reporting HCPCS G0402 · Snapshot 20261111T120946Z-9134e7f7