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
Cocm by rhc/fqhc 60 min mo
Low
$48
Average
$141
Median
$136
High
$277
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
44 hospitals; the 90th percentile is 2.2× 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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44 hospital rates
iThe hospitals that file a WellCare 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 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 1 | $148 | $148 | — | — | — | $148 – $148 |
| 2 | Bexar County Hospital District San Antonio, TX fee schedule · outpatient | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 3 | Columbus Regional Healthcare System, Inc Whiteville, NC fee schedule · outpatient | 1 | $133 | $133 | — | — | — | $133 – $133 |
| 4 | Deaconess Illinois Crossroads Inc Mount Vernon, IL facility · case rate · outpatient | 2 | $135 | $135 | — | — | — | $135 – $135 |
| 5 | Deaconess Regional Healthcare Services Illinois Inc Marion, IL facility · case rate · outpatient | 2 | $134 | $134 | $2 | 1% | — | $132 – $135 |
| 6 | Fairview Bethesda Hospital St. Paul, MN fee schedule · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 7 | Fairview Health Services Edina, MN fee schedule · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 8 | Fairview Health Services Minneapolis, MN fee schedule · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 9 | Fairview Health Services Burnsville, MN fee schedule · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 10 | Fairview Health Services Wyoming, MN fee schedule · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 11 | Fairview Health Services Princeton, MN fee schedule · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 12 | Floyd Healthcare Management Inc Rome, GA case rate · outpatient | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 13 | Froedtert Bluemound Rehabilitation Hospital Wauwatosa, WI case rate · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 14 | Froedtert Memorial Lutheran Hospital Inc Milwaukee, WI case rate · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 15 | Grand Itasca Clinic and Hospital Grand Rapids, MN facility · fee schedule · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 16 | HealthEast St John's Hospital Maplewood, MN fee schedule · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 17 | HealthEast Woodwinds Hospital Woodbury, MN fee schedule · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 18 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 19 | Jennie Stuart Medical Center Hopkinsville, KY facility · case rate · outpatient | 1 | $173 | $173 | $42 | 25% | — | $130 – $215 |
| 20 | MaineHealth Brunswick, ME fee schedule · outpatient | 1 | $143 | $143 | — | — | — | $143 – $143 |
| 21 | MaineHealth Rockport, ME fee schedule · outpatient | 1 | $143 | $143 | — | — | — | $143 – $143 |
| 22 | MaineHealth Belfast, ME fee schedule · both | 1 | $168 | $168 | — | — | — | $168 – $168 |
| 23 | MaineHealth Farmington, ME fee schedule · both | 1 | $162 | $162 | — | — | — | $162 – $162 |
| 24 | MaineHealth Portland, ME fee schedule · outpatient | 1 | $143 | $143 | — | — | — | $143 – $143 |
| 25 | MaineHealth Biddeford, ME fee schedule · outpatient | 1 | $143 | $143 | — | — | — | $143 – $143 |
← Payers reporting HCPCS G0512 · Snapshot 20261112T124536Z-e251e855