RC 479
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
Evaluation and testing for balance with recording
Low
$7
Average
$188
Median
$80
High
$511
Each hospital's average Molina rate, under the methodology and billing class chosen below.
16 hospitals; the 90th percentile is 74.7× 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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25 hospital rates
iThe hospitals that file a Molina 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 | $588 | $494 | $438 | 89% | — | $28 – $1.1k |
| 2 | Amisub of South Carolina, Inc. Fort Mill, SC fee schedule · outpatient | 1 | $435 | $435 | — | — | — | $435 – $435 |
| 3 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 1 | $45 | $45 | — | — | — | $45 – $45 |
| 4 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE other · outpatient | 1 | $535 | $960 | $843 | 88% | — | $321 – $3.0k |
| 5 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges | 1 | $338 | $338 | — | — | — | $338 – $338 |
| 6 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $443 | $443 | — | — | — | $443 – $443 |
| 7 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · inpatientfrom % of charges | 1 | $100 | $99 | $60 | 61% | — | $10 – $193 |
| 8 | Childrens Hospital Colorado Aurora, CO percent of total billed charges · outpatientfrom % of charges | 1 | $100 | $99 | $60 | 61% | — | $10 – $193 |
| 9 | GRITMAN MEDICAL CENTER INC Moscow, ID facility · case rate · both | 1 | $74 | $72 | $3 | 4% | — | $68 – $74 |
| 10 | GRITMAN MEDICAL CENTER INC Moscow, ID facility · fee schedule · both | 2 | $25 | $31 | $22 | 72% | — | $6 – $73 |
| 11 | Gottlieb Memorial Hospital Melrose Park, IL facility · case rate · outpatient | 1 | $182 | $182 | — | — | — | $182 – $182 |
| 12 | Gottlieb Memorial Hospital Melrose Park, IL facility · fee schedule · outpatient | 2 | $29 | $29 | $3 | 9% | — | $27 – $32 |
| 13 | Loyola University Medical Center Maywood, IL facility · case rate · outpatient | 1 | $264 | $264 | — | — | — | $264 – $264 |
| 14 | Loyola University Medical Center Maywood, IL facility · fee schedule · outpatient | 2 | $32 | $32 | $5 | 17% | — | $27 – $38 |
| 15 | MacNeal Hospital Berwyn, IL facility · case rate · outpatient | 1 | $182 | $182 | — | — | — | $182 – $182 |
| 16 | MacNeal Hospital Berwyn, IL facility · fee schedule · outpatient | 2 | $29 | $29 | $3 | 9% | — | $27 – $32 |
| 17 | Margaretville Memorial Hospital Margaretville, NY facility · fee schedule · outpatient | 1 | $73 | $73 | — | — | — | $73 – $73 |
| 18 | Mercy Hospital Jefferson Imperial, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6 | $7 | $2 | 31% | — | $5 – $11 |
| 19 | Mercy Hospital South Louis, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6 | $7 | $2 | 31% | — | $5 – $11 |
| 20 | Mercy Hospitals East Communities dba Mercy Hospital Washington Washington, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $6 | $7 | $2 | 31% | — | $5 – $11 |
| 21 | Nebraska Medical Center Omaha, NE fee schedule · outpatient | 1 | $45 | $45 | — | — | — | $45 – $45 |
| 22 | Nebraska Medical Center Omaha, NE other · outpatient | 1 | $535 | $960 | $843 | 88% | — | $321 – $3.0k |
| 23 | Nebraska Medical Center Omaha, NE percent of total billed charges · outpatientfrom % of charges | 1 | $338 | $338 | — | — | — | $338 – $338 |
| 24 | Southeast Hospital dba Mercy Hospital Southeast Girardeau, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $57 | $57 | — | — | — | $57 – $57 |
| 25 | Vanderbilt University Medical Center Nashville, TN percent of total billed charges · bothfrom % of charges | 1 | $40 | $51 | $39 | 76% | — | $3 – $136 |
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