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
Back school visit
Low
$0
Average
$105
Median
$95
High
$358
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
30 payers; the 90th percentile is 21381.4× 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.
Filter by billing methodology
Filter by billing class
| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Aetna fee schedule · outpatient · +8 other terms | 20 | $20 | $46 | $43 | 93% | — | $20 – $195 |
| 2 | Anthem facility · case rate · outpatient · +5 other terms | 15 | $58 | $63 | $15 | 23% | — | $39 – $98 |
| 3 | Blue Cross Blue Shield facility · fee schedule · outpatient · +6 other terms | 15 | $191 | $173 | $130 | 75% | — | $0 – $514 |
| 4 | Caresource facility · case rate · outpatient · +3 other terms | 15 | $59 | $63 | $14 | 23% | — | $39 – $100 |
| 5 | Molina facility · case rate · outpatient · +3 other terms | 15 | $58 | $63 | $15 | 23% | — | $40 – $98 |
| 6 | UnitedHealthcare facility · case rate · outpatient · +7 other terms | 15 | $59 | $64 | $15 | 23% | — | $40 – $100 |
| 7 | Wellmark fee schedule · both · +1 other terms | 13 | $378 | $378 | — | — | — | $378 – $378 |
| 8 | Optum facility · case rate · outpatient · +1 other terms | 11 | $54 | $60 | $13 | 22% | — | $49 – $89 |
| 9 | First Health professional · fee schedule · both · +2 other terms | 8 | $0 | $8 | $10 | 129% | — | $0 – $21 |
| 10 | Humana professional · fee schedule · both · +5 other terms | 8 | $0 | $0 | — | — | — | $0 – $0 |
| 11 | WellCare professional · fee schedule · both · +1 other terms | 8 | $0 | $0 | — | — | — | $0 – $0 |
| 12 | Aetna Better Health fee schedule · inpatient · +2 other terms | 7 | $20 | $20 | — | — | — | $20 – $20 |
| 13 | Bcbs Il professional · fee schedule · both | 7 | $0 | $0 | — | — | — | $0 – $0 |
| 14 | Cigna professional · fee schedule · both · +4 other terms | 5 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | Ambetter professional · fee schedule · both | 4 | $0 | $0 | — | — | — | $0 – $0 |
| 16 | Carefirst facility · percent of total billed charges · bothfrom % of charges | 3 | $214 | $213 | $43 | 20% | — | $133 – $264 |
| 17 | Excellus facility · percent of total billed charges · bothfrom % of charges | 3 | $214 | $206 | $47 | 23% | — | $133 – $264 |
| 18 | Highmark facility · percent of total billed charges · bothfrom % of charges | 3 | $214 | $219 | $39 | 18% | — | $133 – $264 |
| 19 | Kaiser facility · percent of total billed charges · bothfrom % of charges · +1 other terms | 3 | $214 | $206 | $47 | 23% | — | $133 – $264 |
| 20 | Magellan facility · percent of total billed charges · bothfrom % of charges | 3 | $91 | $105 | $20 | 19% | — | $91 – $133 |
| 21 | Premera facility · percent of total billed charges · bothfrom % of charges | 3 | $214 | $231 | $23 | 10% | — | $214 – $264 |
| 22 | Regence facility · percent of total billed charges · bothfrom % of charges | 3 | $164 | $181 | $50 | 28% | — | $118 – $264 |
| 23 | MultiPlan professional · fee schedule · both | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 24 | Phcs professional · fee schedule · both · +2 other terms | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 25 | Amerihealth Caritas facility · percent of total billed charges · bothfrom % of charges | 1 | $133 | $133 | — | — | — | $133 – $133 |
← Hospitals reporting HCPCS S9117 · Snapshot 20261112T181611Z-3fa9fb76