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
Est Eval Visit Level 5 - Psych|PROCEDURE PERFORMED ON INFANTS LESS THAN 4 KG
The hospitals that file a Medcost 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.
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96 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Aiken Regional Medical Centers North Augusta, SC percent of total billed charges · bothfrom % of charges | 1 | $622.00 | $39.77 – $2,152 |
| 2 | Alleghany County Memorial Hospital, Inc Sparta, NC facility · percent of total billed charges · inpatientfrom % of charges | 1 | $230.00 | $230.00 – $230.00 |
| 3 | Alleghany County Memorial Hospital, Inc Sparta, NC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $230.00 | $230.00 – $230.00 |
| 4 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · inpatientfrom % of charges | 2 | $298.13 | $103.37 – $708.98 |
| 5 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges | 2 | $298.13 | $103.37 – $708.98 |
| 6 | Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · inpatientfrom % of charges | 2 | $274.69 | $87.25 – $699.35 |
| 7 | Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · outpatientfrom % of charges | 2 | $300.82 | $107.07 – $699.35 |
| 8 | Atrium Health Hospitals Inc Wadesboro, NC percent of total billed charges · inpatientfrom % of charges | 2 | $374.31 | $109.85 – $1,005 |
| 9 | Atrium Health Hospitals Inc Wadesboro, NC percent of total billed charges · outpatientfrom % of charges | 2 | $374.31 | $109.85 – $1,005 |
| 10 | Beaufort Memorial Hospital Beaufort, SC facility · case rate · outpatient | 1 | $118.56 | $118.56 – $118.56 |
| 11 | Bristol Regional Medical Center BRISTOL, VA percent of total billed charges · bothfrom % of charges | 1 | $122.99 | $59.96 – $207.97 |
| 12 | Carolinas Medical Center Charlotte, NC percent of total billed charges · inpatientfrom % of charges | 2 | $270.78 | $96.14 – $630.92 |
| 13 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 2 | $270.78 | $96.14 – $630.92 |
| 14 | Carolinas Medical Center Charlotte, NC percent of total billed charges · inpatientfrom % of charges | 2 | $270.78 | $96.14 – $630.92 |
| 15 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 2 | $270.78 | $96.14 – $630.92 |
| 16 | Carolinas Medical Center Davidson, NC percent of total billed charges · inpatientfrom % of charges | 1 | $151.38 | $57.43 – $331.50 |
| 17 | Carolinas Medical Center Davidson, NC percent of total billed charges · outpatientfrom % of charges | 1 | $156.27 | $59.28 – $342.19 |
| 18 | Carolinas Medical Center Charlotte, NC percent of total billed charges · inpatientfrom % of charges | 2 | $261.51 | $90.77 – $621.29 |
| 19 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 2 | $261.51 | $90.77 – $621.29 |
| 20 | Columbus Regional Healthcare System, Inc Whiteville, NC percent of total billed charges · inpatientfrom % of charges | 1 | $191.65 | $191.65 – $191.65 |
| 21 | Columbus Regional Healthcare System, Inc Whiteville, NC percent of total billed charges · outpatientfrom % of charges | 1 | $191.65 | $191.65 – $191.65 |
| 22 | Conway Hospital, Inc. Conway, SC facility · percent of total billed charges · inpatientfrom % of charges | 1 | $246.45 | $67.00 – $460.22 |
| 23 | Conway Hospital, Inc. Conway, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $246.45 | $67.00 – $460.22 |
| 24 | Dickenson Community Hospital CLINTWOOD, VA percent of total billed charges · bothfrom % of charges | 1 | $57.87 | $28.35 – $97.65 |
| 25 | Diley Ridge Medical Center Canal Winchester, OH facility · percent of total billed charges · bothfrom % of charges | 1 | $148.04 | $77.06 – $275.53 |
← Payers reporting HCPCS G0463 · Snapshot 20261108T203506Z-bb90dbab