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
Intake act w/med exam
Low
$0
Average
$245
Median
$201
High
$702
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
26 payers; the 90th percentile is 3.3× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield facility · fee schedule · outpatient · +9 other terms | 35 | $534 | $423 | $368 | 87% | — | $11 – $1.4k |
| 2 | Molina facility · case rate · outpatient · +5 other terms | 29 | $187 | $196 | $45 | 23% | — | $110 – $342 |
| 3 | Aetna fee schedule · outpatient · +8 other terms | 23 | $193 | $355 | $325 | 92% | — | $173 – $1.7k |
| 4 | UnitedHealthcare facility · case rate · outpatient · +8 other terms | 18 | $180 | $194 | $45 | 23% | — | $110 – $309 |
| 5 | Humana fee schedule · outpatient · +7 other terms | 16 | $341 | $443 | $216 | 49% | — | $187 – $752 |
| 6 | Anthem facility · case rate · outpatient · +7 other terms | 15 | $179 | $194 | $48 | 24% | — | $107 – $303 |
| 7 | Caresource facility · case rate · outpatient · +1 other terms | 15 | $182 | $195 | $47 | 24% | — | $107 – $309 |
| 8 | Highmark fee schedule · outpatient · +3 other terms | 13 | $190 | $194 | $33 | 17% | — | $178 – $539 |
| 9 | Optum facility · case rate · outpatient · +1 other terms | 13 | $162 | $180 | $40 | 22% | — | $149 – $274 |
| 10 | Bcbs Nj fee schedule · outpatient | 12 | $460 | $460 | — | — | — | $460 – $460 |
| 11 | Cigna professional · fee schedule · outpatient · +4 other terms | 9 | $66 | $66 | — | — | — | $66 – $66 |
| 12 | Bcbs Mn fee schedule · both · +2 other terms | 8 | $181 | $181 | $2 | 1% | — | $179 – $183 |
| 13 | Aetna Better Health fee schedule · inpatient · +2 other terms | 7 | $193 | $193 | — | — | — | $193 – $193 |
| 14 | Amerihealth Caritas facility · case rate · outpatient · +2 other terms | 7 | $173 | $175 | $6 | 3% | — | $173 – $189 |
| 15 | First Health professional · fee schedule · both · +4 other terms | 3 | $191 | $191 | — | — | — | $191 – $191 |
| 16 | WellCare fee schedule · both · +3 other terms | 3 | $222 | $219 | $4 | 2% | — | $213 – $222 |
| 17 | Wellmark facility · case rate · outpatient | 3 | $579 | $508 | $160 | 32% | — | $236 – $639 |
| 18 | Medicaid fee schedule · outpatient · +3 other terms | 2 | $204 | $204 | — | — | — | $204 – $204 |
| 19 | MultiPlan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms | 2 | $204 | $204 | — | — | — | $204 – $204 |
| 20 | Ambetter fee schedule · both · +1 other terms | 1 | $203 | $203 | — | — | — | $203 – $203 |
| 21 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 22 | Bcbs Nv fee schedule · outpatient | 1 | $186 | $186 | — | — | — | $186 – $186 |
| 23 | Bcbs Vt professional · fee schedule · outpatient | 1 | $183 | $183 | — | — | — | $183 – $183 |
| 24 | Excellus fee schedule · outpatient · +1 other terms | 1 | $167 | $167 | — | — | — | $167 – $167 |
| 25 | Healthpartners facility · fee schedule · outpatient | 1 | $702 | $702 | — | — | — | $702 – $702 |
← Hospitals reporting HCPCS G2076 · Snapshot 20261111T120946Z-9134e7f7