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
HC St Re-Eval (Medicaid)
Low
$30
Average
$185
Median
$75
High
$827
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
46 hospitals; the 90th percentile is 7.4× 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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51 hospital rates
iThe hospitals that file a Anthem 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 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $62 | $62 | — | — | — | $62 – $62 |
| 2 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 2 | $75 | $75 | — | — | — | $75 – $75 |
| 3 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 2 | $139 | $157 | $23 | 15% | — | $139 – $188 |
| 4 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $60 | $60 | — | — | — | $60 – $60 |
| 5 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $109 | $109 | — | — | — | $109 – $109 |
| 6 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $67 | $67 | — | — | — | $67 – $67 |
| 7 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 8 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $71 | $71 | — | — | — | $71 – $71 |
| 9 | COMMUNITY MEMORIAL HOSPITAL Hill, VA case rate · outpatient | 1 | $418 | $418 | — | — | — | $418 – $418 |
| 10 | Charles A. Dean Memorial Hospital Greenville, ME professional · fee schedule · outpatient | 2 | $75 | $75 | — | — | — | $75 – $75 |
| 11 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $61 | $61 | — | — | — | $61 – $61 |
| 12 | Covenant Medical Center Inc Saginaw, MI facility · fee schedule · outpatient | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 13 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 14 | Covenant Medical Center Inc Saginaw, MI facility · fee schedule · outpatient | 1 | $37 | $37 | — | — | — | $37 – $37 |
| 15 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $31 | $31 | — | — | — | $31 – $31 |
| 16 | Deaconess Hospital, Inc Newburgh, IN facility · fee schedule · outpatient | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 17 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 1 | $378 | $378 | — | — | — | $378 – $378 |
| 18 | Eastern Maine Medical Center Bangor, ME professional · fee schedule · outpatient | 2 | $75 | $75 | — | — | — | $75 – $75 |
| 19 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $64 | $64 | — | — | — | $64 – $64 |
| 20 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 21 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 3 | $57 | $55 | $4 | 8% | — | $48 – $58 |
| 22 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 3 | $57 | $49 | $12 | 25% | — | $31 – $58 |
| 23 | Gundersen Luthern Medical Center Inc La Crosse, WI facility · fee schedule · outpatient | 1 | $132 | $132 | — | — | — | $132 – $132 |
| 24 | LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient | 1 | $104 | $104 | — | — | — | $104 – $104 |
| 25 | LUTHERAN HOSPITAL Cleveland, OH facility · case rate · outpatient | 1 | $61 | $61 | — | — | — | $61 – $61 |
← Payers reporting HCPCS S9152 · Snapshot 20261111T120946Z-9134e7f7