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
$426
Average
$762
Median
$732
High
$1.3k
Each hospital's average Humana rate, under the methodology and billing class chosen below.
43 hospitals; the 90th percentile is 2.1× 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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43 hospital rates
iThe hospitals that file a Humana 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 | Baptist Medical Center of Nassau, INC Yulee, FL facility · case rate · outpatient | 1 | $596 | $596 | — | — | — | $596 – $596 |
| 2 | CHRISTUS Health - Pine Street Texarkana, TX per diem · outpatient | 1 | $682 | $682 | — | — | — | $682 – $682 |
| 3 | CHRISTUS Hospital - Orange Orange, TX per diem · outpatient | 1 | $732 | $732 | — | — | — | $732 – $732 |
| 4 | CHRISTUS West Beaumont Beaumont, TX per diem · outpatient | 1 | $732 | $732 | — | — | — | $732 – $732 |
| 5 | Children's Hospital San Antonio, TX per diem · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 6 | Christus Health Southeast Texas Beaumont, TX per diem · outpatient | 1 | $732 | $732 | — | — | — | $732 – $732 |
| 7 | Christus Health Southeast Texas Port Arthur, TX per diem · outpatient | 1 | $732 | $732 | — | — | — | $732 – $732 |
| 8 | Connecticut Children's Hartford, CT percent of total billed charges · bothfrom % of charges | 1 | $1.1k | $1.1k | $306 | 28% | — | $776 – $1.4k |
| 9 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 10 | Highland Medical Center - Shreveport Shreveport, LA per diem · outpatient | 1 | $755 | $755 | — | — | — | $755 – $755 |
| 11 | NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC Toledo, OH facility · other · outpatient | 1 | $426 | $426 | — | — | — | $426 – $426 |
| 12 | Nationwide Children's Hospital Columbus, OH facility · other · outpatient | 1 | $573 | $573 | — | — | — | $573 – $573 |
| 13 | Ochsner Lake Area Hospital Lake Charles, LA per diem · outpatient | 1 | $716 | $716 | — | — | — | $716 – $716 |
| 14 | Ochsner St. Patrick Hospital Lake Charles, LA per diem · outpatient | 1 | $716 | $716 | — | — | — | $716 – $716 |
| 15 | Riverside Hospital Inc Newport News, VA fee schedule · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 16 | Riverside Middle Peninsula Hospital, Inc Gloucester, VA fee schedule · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 17 | SHORE HEALTH SERVICES INC. Onancock, VA fee schedule · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 18 | ST MARYS HOSPITAL MEDICAL CENTER OF GREEN BAY INC HOSPITAL SISTERS GREEN BAY, WI percent of total billed charges · bothfrom % of charges | 4 | $574 | $574 | $83 | 14% | — | $491 – $657 |
| 19 | ST NICHOLAS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS Sheboygan, WI percent of total billed charges · bothfrom % of charges | 4 | $491 | $532 | $72 | 14% | — | $491 – $657 |
| 20 | 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 | 4 | $574 | $574 | $83 | 14% | — | $491 – $657 |
| 21 | Santa Rosa Emergency Center - Alon San Antonio, TX per diem · outpatient | 1 | $872 | $872 | — | — | — | $872 – $872 |
| 22 | Santa Rosa Hospital - Alamo Heights San Antonio, TX per diem · outpatient | 1 | $872 | $872 | — | — | — | $872 – $872 |
| 23 | Santa Rosa Hospital - San Marcos San Marcos, TX per diem · outpatient | 1 | $693 | $693 | — | — | — | $693 – $693 |
| 24 | Santa Rosa Hospital - Westover Hills San Antonio, TX per diem · outpatient | 1 | $872 | $872 | — | — | — | $872 – $872 |
| 25 | Southeast Texas - Jasper Memorial Jasper, TX per diem · outpatient | 1 | $732 | $732 | — | — | — | $732 – $732 |
← Payers reporting HCPCS G0492 · Snapshot 20261112T181611Z-3fa9fb76