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 Visit Annual Well W/ Ppps Subsequent Visit
Low
$0
Average
$5.0k
Median
$142
High
$4775.2k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
995 hospitals; the 90th percentile is 2.3× 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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1,540 hospital rates
iThe hospitals that file a Aetna 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 Francis Hospital and Medical Center Hartford, CT professional · fee schedule · both | 3 | $143 | $142 | $0 | 0% | 2,398–2,407 | $142 – $143 |
| 2 | St Peters Hospital Albany, NY professional · fee schedule · outpatient | 2 | $205 | $174 | $43 | 25% | 804–813 | $113 – $205 |
| 3 | Beaufort Memorial Hospital Beaufort, SC professional · percent of total billed charges · bothfrom % of charges | 2 | $129 | $129 | — | — | 731 | $129 – $129 |
| 4 | Samaritan Hospital Troy, NY professional · fee schedule · both | 2 | $241 | $205 | $51 | 25% | 578–587 | $133 – $241 |
| 5 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $139 | $139 | — | — | 517 | $139 – $139 |
| 6 | Mercy Hospital Southeast Girardeau, MO professional · fee schedule · outpatient | 3 | $148 | $148 | $19 | 13% | 347 | $129 – $167 |
| 7 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 4 | $97 | $97 | $32 | 33% | 311–320 | $64 – $131 |
| 8 | Mercy Fitzgerald Hospital Darby, PA professional · fee schedule · outpatient | 3 | $186 | $226 | $82 | 36% | 251 | $140 – $360 |
| 9 | West Virginia Health Care Cooperative Inc. Summersville, WV professional · percent of total billed charges · outpatientfrom % of charges | 1 | $138 | $143 | $6 | 4% | 243–270 | $138 – $150 |
| 10 | University Medical Center of Southern Nevada Las Vegas, NV percent of total billed charges · outpatientfrom % of charges | 1 | $105 | $105 | — | — | 242 | $105 – $105 |
| 11 | Harrison Community Hospital, Inc. Cadiz, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $139 | $139 | — | — | 216 | $139 – $139 |
| 12 | Mount Carmel St Ann's Lewis Center, OH professional · fee schedule · both | 2 | $113 | $129 | $49 | 38% | 168–177 | $65 – $193 |
| 13 | Mercy Hospitals East Communities Washington, MO professional · fee schedule · outpatient | 3 | $135 | $177 | $63 | 36% | 130 | $129 – $266 |
| 14 | Monument Health Rapid City Hospital Inc City, SD percent of total billed charges · outpatientfrom % of charges | 1 | $422 | $422 | — | — | 125 | $422 – $422 |
| 15 | University of New Mexico Hospital | UNM Sandoval Regional Medical Center - A Campus of UNM Hospital Rio Rancho, NM facility · percent of total billed charges · outpatientfrom % of charges | 1 | $91 | $91 | $8 | 8% | 117 | $83 – $99 |
| 16 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · outpatient | 4 | $136 | $139 | $29 | 21% | 114 | $110 – $170 |
| 17 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 4 | $136 | $139 | $29 | 21% | 104 | $110 – $170 |
| 18 | St Mary Mercy Livonia Livonia, MI professional · fee schedule · outpatient | 4 | $118 | $125 | $48 | 39% | 93 | $68 – $200 |
| 19 | Saint Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · both | 3 | $129 | $130 | $4 | 3% | 73 | $128 – $136 |
| 20 | Pana Community Hospital Association Pana, IL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $187 | $187 | $15 | 8% | 59 | $172 – $202 |
| 21 | Mon Health Medical Center Morgantown, WV percent of total billed charges · outpatientfrom % of charges | 1 | $214 | $214 | — | — | 50 | $214 – $214 |
| 22 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · both | 5 | $171 | $166 | $31 | 19% | 39 | $140 – $233 |
| 23 | Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient | 4 | $195 | $197 | $41 | 21% | 37 | $130 – $256 |
| 24 | Barnesville Hospital Association, Inc. Barnesville, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $139 | $139 | — | — | 31–58 | $139 – $139 |
| 25 | Lake Charles Memorial Hospital Charles., LA fee schedule · outpatient | 1 | $280 | $280 | $156 | 56% | 29 | $123 – $436 |
← Payers reporting HCPCS G0439 · Snapshot 20261111T120946Z-9134e7f7