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
PR COMPLETED EPSDT
Low
$0
Average
$46
Median
$16
High
$120
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
35 hospitals; the 90th percentile is 12.9× 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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38 hospital rates
iThe hospitals that file a UnitedHealthcare 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 | Massachusetts General Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 2 | $22 | $22 | — | — | 18–27 | $22 – $22 |
| 2 | Brigham and Women's Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $22 | $22 | — | — | 13 | $22 – $22 |
| 3 | Brigham and Women's Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $12 | $12 | — | — | 1–10 | $12 – $12 |
| 4 | Massachusetts General Hospital Boston, MA percent of total billed charges · bothfrom % of charges | 1 | $12 | $12 | — | — | 1–10 | $12 – $12 |
| 5 | Mayo Clinic Health System Saint James 56081-5550 facility · percent of total billed charges · bothfrom % of charges | 1 | $120 | $120 | — | — | 1–10 | $120 – $120 |
| 6 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 7 | Aspirus St. Luke’s Hospital Duluth, MN fee schedule · both | 1 | $20 | $20 | — | — | — | $20 – $20 |
| 8 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 9 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 10 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 11 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 12 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 13 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 14 | Fairview Health Services Minneapolis, MN percent of total billed charges · bothfrom % of charges | 2 | $63 | $63 | — | — | — | $63 – $63 |
| 15 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 16 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 17 | HENRY HEYWOOD MEMORIAL HOSPITAL Gardner, MA fee schedule · outpatient | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 18 | LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 19 | LUTHERAN HOSPITAL Cleveland, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 20 | MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 21 | MEDINA HOSPITAL Medina, OH facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 22 | Mayo Clinic Rochester, MN professional · percent of total billed charges · outpatientfrom % of charges | 2 | $70 | $70 | — | — | — | $70 – $70 |
| 23 | Mayo Clinic Health System Mankato 56001-4752 facility · percent of total billed charges · bothfrom % of charges | 1 | $120 | $120 | — | — | — | $120 – $120 |
| 24 | Mayo Clinic Health System Lake City 55041-1143 facility · percent of total billed charges · bothfrom % of charges | 1 | $120 | $120 | — | — | — | $120 – $120 |
| 25 | Mayo Clinic Health System Fairmont 56031-4575 facility · percent of total billed charges · bothfrom % of charges | 1 | $120 | $120 | — | — | — | $120 – $120 |
← Payers reporting HCPCS S0302 · Snapshot 20261111T120946Z-9134e7f7