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
Md/oth eval acut kid no esrd
Low
$636
Average
$1.2k
Median
$1.2k
High
$2.3k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
23 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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25 hospital rates
iThe hospitals that file a Aetna 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 | Baxter County Regional Hospital, Inc. Home, AR facility · percent of total billed charges · inpatientfrom % of charges | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 2 | Baxter County Regional Hospital, Inc. Home, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 3 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 1 | $1.7k | $1.7k | $17 | 1% | — | $1.7k – $1.8k |
| 4 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 2 | $628 | $812 | $261 | 32% | — | $628 – $1.2k |
| 5 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 6 | Cheshire Medical Center Keene, NH facility · case rate · outpatient | 1 | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 7 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $715 | $715 | — | — | — | $715 – $715 |
| 8 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · fee schedule · outpatient | 1 | $678 | $678 | — | — | — | $678 – $678 |
| 9 | Clinton Memorial Hospital Wilmington, OH fee schedule · outpatient | 1 | $1.7k | $1.7k | $17 | 1% | — | $1.7k – $1.8k |
| 10 | Connecticut Children's Hartford, CT percent of total billed charges · bothfrom % of charges | 2 | $1.0k | $1.0k | $296 | 29% | — | $699 – $1.4k |
| 11 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 12 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $655 | $655 | — | — | — | $655 – $655 |
| 13 | Loyola University Medical Center Maywood, IL facility · case rate · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 14 | MARTIN MEMORIAL MEDICAL CENTER INC Port St Lucie, FL facility · case rate · outpatient | 2 | $655 | $655 | $60 | 9% | — | $596 – $715 |
| 15 | MacNeal Hospital Berwyn, IL facility · case rate · outpatient | 1 | $873 | $873 | — | — | — | $873 – $873 |
| 16 | McCullough-Hyde Memorial Hospital, Inc. Oxford, OH facility · fee schedule · outpatient | 1 | $1.7k | $1.7k | $17 | 1% | — | $1.7k – $1.8k |
| 17 | Riverside Hospital Inc Newport News, VA fee schedule · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 18 | Riverside Middle Peninsula Hospital, Inc Gloucester, VA fee schedule · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 19 | SHORE HEALTH SERVICES INC. Onancock, VA fee schedule · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 20 | ST MARYS HOSPITAL MEDICAL CENTER OF GREEN BAY INC HOSPITAL SISTERS GREEN BAY, WI percent of total billed charges · bothfrom % of charges | 2 | $773 | $773 | — | — | — | $773 – $773 |
| 21 | ST NICHOLAS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS Sheboygan, WI percent of total billed charges · bothfrom % of charges | 1 | $773 | $773 | — | — | — | $773 – $773 |
| 22 | ST VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS Oconto Falls, WI percent of total billed charges · bothfrom % of charges | 2 | $636 | $636 | $137 | 22% | — | $499 – $773 |
| 23 | The Good Samaritan Hospital of Cincinnati, OH Cincinnati, OH facility · fee schedule · outpatient | 1 | $1.7k | $1.7k | $17 | 1% | — | $1.7k – $1.8k |
| 24 | VCU HEALTH TAPPAHANNOCK HOSPITAL Tappahannock, VA case rate · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 25 | VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM AUTHORITY Richmond, VA case rate · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
← Payers reporting HCPCS G0492 · Snapshot 20261112T181611Z-3fa9fb76