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
facility
Low
$0
Average
$25
Median
$7
High
$763
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
74 hospitals; the 90th percentile is 214.9× 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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109 hospital rates
iThe hospitals that file a Wellmark 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 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · outpatient | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · inpatientfrom % of charges | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 4 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · outpatientfrom % of charges | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 5 | Avera Behavioral Health Hospital Sioux Falls, SD fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 6 | Avera Holy Family Hospital Estherville, IA fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 7 | Avera Holy Family Hospital Estherville, IA percent of total billed charges · inpatientfrom % of charges | 2 | $100 | $100 | — | — | — | $100 – $100 |
| 8 | Avera McKennan Hospital Sioux Falls, SD fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 9 | Avera Queen of Peace Mitchell, SD fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 10 | Avera Specialty Hospital Sioux Falls, SD fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 11 | Avera St. Luke's Aberdeen, SD fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 12 | Avera St. Mary's Hospital Pierre, SD fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 13 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 2 | $5 | $5 | $2 | 33% | — | $3 – $6 |
| 14 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · fee schedule · both | 2 | $6 | $6 | — | — | — | $6 – $6 |
| 15 | Central Community Hospital Elkader, IA facility · fee schedule · both | 2 | $6 | $6 | — | — | — | $6 – $6 |
| 16 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 17 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 18 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · outpatient | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 19 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 20 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · outpatient | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 21 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 2 | $6 | $6 | — | — | — | $6 – $6 |
| 22 | Floyd Valley Healthcare Le Mars, IA fee schedule · outpatient | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 23 | Floyd Valley Healthcare Le Mars, IA percent of total billed charges · inpatientfrom % of charges | 2 | $16 | $16 | $2 | 10% | — | $14 – $17 |
| 24 | Grinnell Regional Medical Center Grinnell, IA fee schedule · both | 3 | $0 | $0 | — | — | — | $0 – $0 |
| 25 | Grinnell Regional Medical Center Grinnell, IA fee schedule · outpatient | 3 | $0 | $0 | — | — | — | $0 – $0 |
← Payers reporting HCPCS J2290 · Snapshot 20261111T120946Z-9134e7f7