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 UnitedHealthcare 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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2,323 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | ACADIAN MEDICAL CENTER EUNICE, LA percent of total billed charges · bothfrom % of charges | 2 | $91.55 | $28.44 – $175.01 |
| 2 | AGH LAVEEN LLC Phoenix, AZ fee schedule · outpatient | 1 | $140.79 | $140.79 – $140.79 |
| 3 | AGH MESA LLC Mesa, AZ fee schedule · outpatient | 1 | $140.79 | $140.79 – $140.79 |
| 4 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $60.30 | $60.30 – $60.30 |
| 5 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 1 | $119.07 | $119.07 – $119.07 |
| 6 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · other · outpatient | 1 | $0.01 | $0.01 – $0.01 |
| 7 | ALASKA REGIONAL HOSPITAL Anchorage, AK case rate · outpatient | 1 | $4,060 | $4,060 – $4,060 |
| 8 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · percent of total billed charges · inpatientfrom % of charges | 1 | $90.00 | $90.00 – $90.00 |
| 9 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY facility · percent of total billed charges · outpatientfrom % of charges | 1 | $96.00 | $96.00 – $96.00 |
| 10 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · percent of total billed charges · outpatientfrom % of charges | 8 | $151.19 | $103.25 – $191.75 |
| 11 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 6 | $199.21 | $117.95 – $391.66 |
| 12 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 2 | $150.04 | $148.70 – $151.38 |
| 13 | ARH Mary Breckinridge Health Services, Inc Barbourville, KY percent of total billed charges · outpatientfrom % of charges | 2 | $101.65 | $74.82 – $115.07 |
| 14 | ARH Mary Breckinridge Health Services, Inc Hayden, KY percent of total billed charges · outpatientfrom % of charges | 2 | $109.22 | $49.02 – $139.32 |
| 15 | ATHOL MEMORIAL HOSPITAL INCORPORATED Athol, MA percent of total billed charges · outpatientfrom % of charges | 1 | $119.78 | $119.78 – $119.78 |
| 16 | Acadia Hospital Bangor, ME facility · case rate · outpatient | 1 | $127.22 | $127.22 – $127.22 |
| 17 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $127.12 | $127.12 – $127.12 |
| 18 | AdventHealth Avista Louisville, CO fee schedule · outpatient | 1 | $139.16 | $139.16 – $139.16 |
| 19 | AdventHealth Deland Deland, FL fee schedule · outpatient | 1 | $145.98 | $145.98 – $145.98 |
| 20 | AdventHealth Littleton Littleton, CO fee schedule · outpatient | 1 | $137.63 | $137.63 – $137.63 |
| 21 | AdventHealth New Smyrna Beach New Smyrna Beach, FL fee schedule · outpatient | 1 | $145.98 | $145.98 – $145.98 |
| 22 | AdventHealth Parker Aurora, CO fee schedule · outpatient | 1 | $137.63 | $137.63 – $137.63 |
| 23 | AdventHealth Porter Denver, CO fee schedule · outpatient | 1 | $137.63 | $137.63 – $137.63 |
| 24 | Adventhealth Daytona Beach Port Orange, FL fee schedule · outpatient | 1 | $145.98 | $145.98 – $145.98 |
| 25 | Adventhealth Fish Memorial Deltona, FL fee schedule · outpatient | 1 | $145.98 | $145.98 – $145.98 |
← Payers reporting HCPCS G0463 · Snapshot 20261108T203506Z-bb90dbab