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 Phcs 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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118 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | AHS Hillcrest Medical Center, LLC Tulsa, OK facility · percent of total billed charges · bothfrom % of charges | 2 | $1,137 | $727.08 – $1,849 |
| 2 | AHS Southcrest Hospital, LLC Tulsa, OK facility · percent of total billed charges · bothfrom % of charges | 2 | $642.79 | $450.00 – $848.00 |
| 3 | Alton Memorial Hospital Alton, IL percent of total billed charges · bothfrom % of charges | 2 | $375.68 | $189.00 – $580.00 |
| 4 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · bothfrom % of charges | 1 | $461.13 | $461.13 – $461.13 |
| 5 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · outpatientfrom % of charges | 1 | $404.61 | $17.67 – $751.40 |
| 6 | BAPTIST HEALTHCARE SYSTEM INC Lexington, KY percent of total billed charges · bothfrom % of charges | 1 | $378.61 | $378.61 – $378.61 |
| 7 | BAPTIST HEALTHCARE SYSTEM INC Lexington, KY percent of total billed charges · outpatientfrom % of charges | 1 | $332.21 | $14.51 – $616.94 |
| 8 | BAPTIST HEALTHCARE SYSTEM INC Grange, KY percent of total billed charges · bothfrom % of charges | 1 | $339.78 | $339.78 – $339.78 |
| 9 | BAPTIST HEALTHCARE SYSTEM INC Grange, KY percent of total billed charges · outpatientfrom % of charges | 1 | $298.13 | $13.02 – $553.67 |
| 10 | BAPTIST HEALTHCARE SYSTEM INC Paducah, KY percent of total billed charges · bothfrom % of charges | 1 | $180.57 | $180.57 – $180.57 |
| 11 | BAPTIST HEALTHCARE SYSTEM INC Paducah, KY percent of total billed charges · outpatientfrom % of charges | 1 | $158.44 | $6.92 – $294.23 |
| 12 | BAPTIST HEALTHCARE SYSTEM INC. Louisville, KY percent of total billed charges · bothfrom % of charges | 1 | $339.78 | $339.78 – $339.78 |
| 13 | BAPTIST HEALTHCARE SYSTEM INC. Louisville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $298.13 | $13.02 – $553.67 |
| 14 | BETHESDA HOSPITAL BOYNTON BEACH, FL percent of total billed charges · bothfrom % of charges | 1 | $173.70 | $173.70 – $173.70 |
| 15 | BSA Hospital Amarillo, TX facility · percent of total billed charges · bothfrom % of charges | 2 | $467.74 | $285.60 – $730.10 |
| 16 | Barnes Jewish Hospital St. Louis, MO percent of total billed charges · bothfrom % of charges | 2 | $452.54 | $186.00 – $1,032 |
| 17 | Barnes Jewish St. Peters Hospital St. Peters, MO percent of total billed charges · bothfrom % of charges | 2 | $363.44 | $189.00 – $580.00 |
| 18 | Boulder Community Health Lafayette, CO facility · percent of total billed charges · inpatientfrom % of charges | 1 | $315.79 | $315.79 – $315.79 |
| 19 | Boulder Community Health Lafayette, CO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $319.90 | $319.90 – $319.90 |
| 20 | Brandon HMA LLC Brandon, MS facility · percent of total billed charges · inpatientfrom % of charges | 1 | $1,149 | $1,106 – $1,250 |
| 21 | Brandon HMA LLC Brandon, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1,149 | $1,106 – $1,250 |
| 22 | CLOVIS COMMUNITY MEDICAL CENTER Clovis, CA facility · fee schedule · inpatient | 1 | $332.86 | $213.35 – $510.00 |
| 23 | Christian Hospital St. Louis, MO percent of total billed charges · bothfrom % of charges | 2 | $375.68 | $189.00 – $580.00 |
| 24 | Crestview Hospital Corporation Crestview, FL facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1,077 | $336.65 – $2,554 |
| 25 | Deaconess Health System Union County Hospital Morganfield, KY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $190.62 | $120.60 – $342.00 |
← Payers reporting HCPCS G0463 · Snapshot 20261108T203506Z-bb90dbab