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
$734
Average
$734
Median
$734
High
$734
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3 hospital rates
iThe hospitals that file a First Health 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 | ST MARYS HOSPITAL MEDICAL CENTER OF GREEN BAY INC HOSPITAL SISTERS GREEN BAY, WI percent of total billed charges · bothfrom % of charges | 1 | $734 | $734 | — | — | — | $734 – $734 |
| 2 | 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 | $734 | $734 | — | — | — | $734 – $734 |
| 3 | 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 | 1 | $734 | $734 | — | — | — | $734 – $734 |
← Payers reporting HCPCS G0492 · Snapshot 20261112T181611Z-3fa9fb76