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
Etoh/ Subst Abuse Scrn/Int 15-30min
Ozark, MO
See all hospitals reporting HCPCS G0396 →Price type
Mercy Hospital Springfield’s median price of $88 is 120% above the median hospital's median price ($40), higher than 87% of the 1,054 hospitals reporting HCPCS G0396. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 13 payers, 23 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Medicaid hb sprg mo medicaid facility · fee schedule · outpatient | $25 | $25 | — | — | — | $25 – $25 |
| 2 | WellCare hb sprg & lebn wellcare mcr 103% facility · other · outpatient | $38 | $38 | — | — | — | $38 – $38 |
| 3 | Blue Cross Blue Shield hb sprg missouri care plan/healthy blue facility · fee schedule · outpatient | $42 | $42 | — | — | — | $42 – $42 |
| 4 | UnitedHealthcare hb sprg uhc mo medicaid facility · fee schedule · outpatient | $43 | $43 | — | — | — | $43 – $43 |
| 5 | Medica hb sprg lebn medica exchange facility · percent of total billed charges · outpatientfrom % of charges | $61 | $61 | — | — | — | $61 – $61 |
| 6 | Ambetter hb sprg ambetter exchange mo facility · percent of total billed charges · outpatientfrom % of charges | $63 | $63 | — | — | — | $63 – $63 |
| 7 | Aetna hb sprg aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $78 | $78 | — | — | — | $78 – $78 |
| 8 | Anthem hb sprg anthem alliance facility · percent of total billed charges · outpatientfrom % of charges | $78 | $78 | — | — | — | $78 – $78 |
| 9 | Anthem hb sprg anthem blue access facility · percent of total billed charges · outpatientfrom % of charges | $78 | $78 | — | — | — | $78 – $78 |
| 10 | Blue Cross Blue Shield hb sprg anthem alliance facility · percent of total billed charges · outpatientfrom % of charges | $78 | $78 | — | — | — | $78 – $78 |
| 11 | Blue Cross Blue Shield hb sprg anthem blue access facility · percent of total billed charges · outpatientfrom % of charges | $78 | $78 | — | — | — | $78 – $78 |
| 12 | Blue Cross Blue Shield hb sprg anthem pathways exchange facility · percent of total billed charges · outpatientfrom % of charges | $78 | $78 | — | — | — | $78 – $78 |
| 13 | First Health hb sprg aetna first health-network access facility · percent of total billed charges · outpatientfrom % of charges | $87 | $87 | — | — | — | $87 – $87 |
| 14 | Humana hb sprg humana facility · percent of total billed charges · outpatientfrom % of charges | $105 | $105 | — | — | — | $105 – $105 |
| 15 | Cigna hb sprg cigna hmo facility · percent of total billed charges · outpatientfrom % of charges | $107 | $107 | — | — | — | $107 – $107 |
| 16 | Blue Cross Blue Shield hb sprg anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges | $113 | $113 | — | — | — | $113 – $113 |
| 17 | Blue Cross Blue Shield hb sprg anthem traditional facility · percent of total billed charges · outpatientfrom % of charges | $118 | $118 | — | — | — | $118 – $118 |
| 18 | Cigna hb sprg cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $119 | $119 | — | — | — | $119 – $119 |
| 19 | MultiPlan hb sprg phcs (mpi) facility · percent of total billed charges · outpatientfrom % of charges | $119 | $119 | — | — | — | $119 – $119 |
| 20 | UnitedHealthcare hb sprg uhc individual exchange facility · per diem · outpatient | $384 | $384 | — | — | — | $384 – $384 |
| 21 | Optum hb sprg uhc all payer facility · per diem · outpatient | $411 | $411 | — | — | — | $411 – $411 |
| 22 | UnitedHealthcare hb sprg uhc all payer facility · per diem · outpatient | $411 | $411 | — | — | — | $411 – $411 |
| 23 | UnitedHealthcare hb sprg uhc options ppo facility · per diem · outpatient | $636 | $636 | — | — | — | $636 – $636 |
Last updated: Jun 4, 2026
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