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
$204
Median
$142
High
$7.9k
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
593 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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847 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 Alphonsus Regional Medical Center - Boise Boise, ID professional · fee schedule · both | 3 | $128 | $128 | $1 | 1% | 2,887–2,941 | $128 – $130 |
| 2 | Mayo Clinic Rochester, MN professional · fee schedule · outpatient | 5 | $143 | $144 | $6 | 4% | 876 | $137 – $157 |
| 3 | Mayo Clinic Health System Owatonna 55060-5503 professional · fee schedule · outpatient | 5 | $139 | $128 | $18 | 14% | 671–680 | $103 – $143 |
| 4 | St Mary Mercy Livonia Livonia, MI professional · fee schedule · outpatient | 3 | $120 | $137 | $53 | 39% | 671 | $68 – $208 |
| 5 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · outpatient | 3 | $177 | $153 | $32 | 21% | 659–668 | $110 – $177 |
| 6 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 3 | $177 | $153 | $32 | 21% | 626 | $110 – $177 |
| 7 | Lake Charles Memorial Hospital Charles., LA fee schedule · outpatient | 2 | $105 | $105 | $18 | 17% | 510 | $87 – $123 |
| 8 | Lake Charles Memorial Hospital Charles., LA other · outpatient | 1 | $117 | $117 | — | — | 510 | $117 – $117 |
| 9 | Mayo Clinic Health System Mankato 56001-4752 professional · fee schedule · outpatient | 4 | $137 | $126 | $19 | 15% | 359 | $103 – $143 |
| 10 | Mercy Fitzgerald Hospital Darby, PA professional · fee schedule · outpatient | 3 | $160 | $162 | $19 | 12% | 292–310 | $138 – $183 |
| 11 | Beaufort Memorial Hospital Beaufort, SC professional · percent of total billed charges · bothfrom % of charges | 1 | $129 | $129 | — | — | 259 | $129 – $129 |
| 12 | Mayo Clinic Health System St, NE professional · fee schedule · outpatient | 4 | $142 | $141 | $3 | 2% | 258–267 | $137 – $143 |
| 13 | Mayo Clinic Health System Eau Claire 54703-5270 professional · fee schedule · outpatient | 4 | $138 | $218 | $101 | 46% | 224–233 | $132 – $342 |
| 14 | Mayo Clinic Health System Waseca 56093-2811 facility · percent of total billed charges · bothfrom % of charges | 8 | $170 | $151 | $40 | 26% | 197–206 | $78 – $184 |
| 15 | Mayo Clinic Health System Barron, WI facility · percent of total billed charges · bothfrom % of charges | 4 | $325 | $287 | $80 | 28% | 186–195 | $111 – $335 |
| 16 | Mercy Hospital Southeast Girardeau, MO professional · fee schedule · outpatient | 4 | $95 | $102 | $15 | 15% | 182–191 | $92 – $129 |
| 17 | Mayo Clinic Health System Lake City 55041-1143 facility · percent of total billed charges · bothfrom % of charges | 12 | $170 | $159 | $27 | 17% | 166–193 | $108 – $186 |
| 18 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 2 | $106 | $116 | $42 | 36% | 155–227 | $64 – $170 |
| 19 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · percent of total billed charges · bothfrom % of charges | 8 | $170 | $152 | $37 | 25% | 142–160 | $84 – $184 |
| 20 | Mayo Clinic Health System Bloomer, WI facility · percent of total billed charges · bothfrom % of charges | 4 | $325 | $289 | $75 | 26% | 126–135 | $126 – $335 |
| 21 | Pembina County Memorial Hospital Association Cavalier, ND facility · fee schedule · both | 1 | $211 | $211 | — | — | 120 | $211 – $211 |
| 22 | Mayo Clinic Health System Menomonie, WI facility · percent of total billed charges · bothfrom % of charges | 4 | $325 | $287 | $81 | 28% | 111 | $109 – $335 |
| 23 | Mayo Clinic Health System Saint James 56081-5550 facility · percent of total billed charges · bothfrom % of charges | 8 | $170 | $156 | $30 | 19% | 104–122 | $101 – $184 |
| 24 | FHN Memorial Hospital Freeport, IL percent of total billed charges · outpatientfrom % of charges | 1 | $168 | $168 | — | — | 86 | $168 – $168 |
| 25 | Mayo Clinic Health System Osseo, WI facility · percent of total billed charges · bothfrom % of charges | 4 | $325 | $287 | $79 | 28% | 35 | $113 – $335 |
← Payers reporting HCPCS G0439 · Snapshot 20261111T120946Z-9134e7f7