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
Follow-up/reassessment
Low
$0
Average
$126
Median
$126
High
$563
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
37 hospitals; the 90th percentile is 26.5× 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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39 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | AnMed Health Anderson, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 2 | AnMed Health Cannon Pickens, SC facility · percent of total billed charges · outpatientfrom % of charges | 3 | $22 | $25 | $11 | 43% | — | $13 – $42 |
| 3 | AnMed Piedmont Piedmont, SC facility · percent of total billed charges · outpatientfrom % of charges | 1 | $42 | $42 | — | — | — | $42 – $42 |
| 4 | Benson Hospital Corporation Benson, AZ facility · fee schedule · outpatient | 1 | $408 | $408 | — | — | — | $408 – $408 |
| 5 | Bronson Battle Creek Hospital Battle Creek, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 6 | Bronson LakeView Hospital Paw Paw, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 7 | Bronson Methodist Hospital Kalamazoo, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 8 | Bronson South Haven Hospital South Haven, MI professional · percent of total billed charges · bothfrom % of charges | 1 | $126 | $126 | — | — | — | $126 – $126 |
| 9 | Connecticut Children's Hartford, CT percent of total billed charges · bothfrom % of charges | 2 | $145 | $145 | — | — | — | $145 – $145 |
| 10 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · outpatient | 3 | $86 | $75 | $16 | 22% | — | $52 – $87 |
| 11 | Henry Ford Health System West Bloomfield, MI professional · percent of total billed charges · outpatientfrom % of charges | 4 | $166 | $166 | — | — | — | $166 – $166 |
| 12 | Henry Ford Health System Plymouth, MI professional · percent of total billed charges · outpatientfrom % of charges | 8 | $166 | $140 | $31 | 22% | — | $102 – $166 |
| 13 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI professional · percent of total billed charges · outpatientfrom % of charges | 4 | $166 | $166 | — | — | — | $166 – $166 |
| 14 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI professional · percent of total billed charges · outpatientfrom % of charges | 4 | $166 | $166 | — | — | — | $166 – $166 |
| 15 | HonorHealth Florence Medical Center Florence, AZ facility · fee schedule · outpatient | 1 | $158 | $159 | $46 | 29% | — | $112 – $207 |
| 16 | Honorhealth Deer Valley Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $160 | $160 | $47 | 30% | — | $112 – $207 |
| 17 | Honorhealth Four Peaks Medical Center Mesa, AZ facility · fee schedule · outpatient | 1 | $158 | $159 | $46 | 29% | — | $112 – $207 |
| 18 | Honorhealth John C. Lincoln Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $160 | $160 | $47 | 30% | — | $112 – $207 |
| 19 | Honorhealth Scottsdale Osborn Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $160 | $160 | $47 | 30% | — | $112 – $207 |
| 20 | Honorhealth Scottsdale Shea Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $160 | $160 | $47 | 30% | — | $112 – $207 |
| 21 | Honorhealth Scottsdale Thompson Peak Med Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $160 | $160 | $47 | 30% | — | $112 – $207 |
| 22 | Honorhealth Sonoran Crossing Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $160 | $160 | $47 | 30% | — | $112 – $207 |
| 23 | McLeod Health Cheraw, SC fee schedule · both | 2 | $46 | $46 | $10 | 22% | — | $36 – $55 |
| 24 | McLeod Health Manning, SC percent of total billed charges · bothfrom % of charges | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 25 | Montefiore Medical Center Bronx, NY fee schedule · both | 7 | $101 | $99 | $17 | 17% | — | $64 – $119 |
← Payers reporting HCPCS S0316 · Snapshot 20261112T181611Z-3fa9fb76