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
$96
Average
$219
Median
$197
High
$1.2k
Each hospital's average Medica rate, under the methodology and billing class chosen below.
107 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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187 hospital rates
iThe hospitals that file a Medica 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 | Mayo Clinic Health System Eau Claire 54703-5270 professional · fee schedule · outpatient | 2 | $146 | $146 | $11 | 7% | 452 | $136 – $157 |
| 2 | Mayo Clinic Rochester, MN professional · fee schedule · outpatient | 2 | $143 | $143 | $3 | 2% | 92–101 | $141 – $146 |
| 3 | Mayo Clinic Health System Mankato 56001-4752 professional · fee schedule · outpatient | 3 | $143 | $143 | $1 | 1% | 88 | $141 – $143 |
| 4 | Mayo Clinic Health System Owatonna 55060-5503 professional · fee schedule · outpatient | 4 | $142 | $129 | $20 | 15% | 49–58 | $101 – $143 |
| 5 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 5 | $352 | $355 | $10 | 3% | 2–20 | $344 – $371 |
| 6 | Mayo Clinic Health System St, NE professional · fee schedule · outpatient | 2 | $142 | $142 | $1 | 1% | 2–20 | $141 – $143 |
| 7 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · percent of total billed charges · bothfrom % of charges | 9 | $171 | $150 | $39 | 26% | 1–10 | $86 – $181 |
| 8 | Pembina County Memorial Hospital Association Cavalier, ND facility · fee schedule · both | 1 | $297 | $297 | — | — | 1–10 | $297 – $297 |
| 9 | Altru Hospital Grand Forks, ND facility · fee schedule · outpatient | 4 | $110 | $133 | $63 | 47% | — | $79 – $231 |
| 10 | Altru Hospital Devils Lake Devils Lake, ND facility · fee schedule · outpatient | 4 | $110 | $133 | $63 | 47% | — | $79 – $231 |
| 11 | Amery Hospital Amery, WI facility · fee schedule · both | 2 | $175 | $175 | $21 | 12% | — | $154 – $197 |
| 12 | Aspirus St. Luke’s Hospital Duluth, MN fee schedule · both | 1 | $123 | $123 | — | — | — | $123 – $123 |
| 13 | Avera Creighton Hospital Creighton, NE fee schedule · both | 2 | $282 | $282 | — | — | — | $282 – $282 |
| 14 | Avera DeSmet De Smet, SD fee schedule · both | 2 | $282 | $282 | — | — | — | $282 – $282 |
| 15 | Avera Dell Rapids Hospital Dell Rapids, SD fee schedule · both | 2 | $282 | $282 | — | — | — | $282 – $282 |
| 16 | Avera Granite Falls Health Center Granite Falls, MN fee schedule · both | 2 | $288 | $288 | — | — | — | $288 – $288 |
| 17 | Avera Gregory Hospital Gregory, SD fee schedule · both | 2 | $282 | $282 | — | — | — | $282 – $282 |
| 18 | Avera Hand County Hospital Miller, SD fee schedule · both | 2 | $282 | $282 | — | — | — | $282 – $282 |
| 19 | Avera Holy Family Hospital Estherville, IA fee schedule · both | 2 | $282 | $282 | — | — | — | $282 – $282 |
| 20 | Avera Missouri River Health Center Gettysburg, SD fee schedule · both | 2 | $282 | $282 | — | — | — | $282 – $282 |
| 21 | Avera Queen of Peace Mitchell, SD fee schedule · both | 2 | $282 | $282 | — | — | — | $282 – $282 |
| 22 | Avera Sacred Heart Hospital Yankton, SD fee schedule · both | 2 | $282 | $282 | — | — | — | $282 – $282 |
| 23 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 4 | $310 | $274 | $88 | 32% | — | $130 – $345 |
| 24 | Black River Health Inc Black River Falls, WI facility · percent of total billed charges · bothfrom % of charges | 1 | $80 | $80 | $25 | 31% | — | $55 – $106 |
| 25 | Black River Health Inc Black River Falls, WI professional · percent of total billed charges · bothfrom % of charges | 1 | $120 | $120 | $38 | 32% | — | $82 – $158 |
← Payers reporting HCPCS G0439 · Snapshot 20261111T120946Z-9134e7f7