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
Unrelat prac follow up visit
Low
$14
Average
$36
Median
$26
High
$63
Each hospital's average MultiPlan rate, under the methodology and billing class chosen below.
12 hospitals; the 90th percentile is 4.2× 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.
Filter by billing methodology
Filter by billing class
13 hospital rates
iThe hospitals that file a MultiPlan 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 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA percent of total billed charges · outpatientfrom % of charges | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 3 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 4 | Cleveland Clinic Mercy Hospital Canton, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 5 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL professional · percent of total billed charges · outpatientfrom % of charges | 1 | $35 | $35 | — | — | — | $35 – $35 |
| 6 | LODI MEMORIAL HOSPITAL ASSOCIATION INC Lodi, CA percent of total billed charges · outpatientfrom % of charges | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 7 | Montefiore Medical Center Bronx, NY percent of total billed charges · bothfrom % of charges | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 8 | THE UNION HOSPITAL ASSOCIATION Dover, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 9 | The Cleveland Clinic Foundation Brunswick, OH professional · percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 10 | UPMC Cole Coudersport, PA facility · percent of total billed charges · inpatientfrom % of charges | 2 | $14 | $14 | — | — | — | $14 – $14 |
| 11 | UPMC Cole Coudersport, PA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $14 | $14 | — | — | — | $14 – $14 |
| 12 | University of Illinois Hospital & Clinics Chicago, IL professional · fee schedule · both | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 13 | Valley County Hospital NE 68862-1240; 400 S 23rd St Ord, NE professional · fee schedule · both | 1 | $23 | $23 | — | — | — | $23 – $23 |
← Payers reporting HCPCS G0559 · Snapshot 20261112T124536Z-e251e855