Initial Medicare preventive physical exam visit at Monument Health Network Inc

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

INITIAL PREVENTIVE PHYSICAL EXAMINATION; FACE-TO-FACE VISIT, SERVICES LIMITED TO NEW BENEFICIARY DURING THE FIRST 12 MONTHS OF MEDICARE ENROLLMENT

Custer, SD

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How this price compares nationally

Monument Health Network Inc’s median price of $304 is 100% above the median hospital's median price ($152), higher than 89% of the 1,491 hospitals reporting HCPCS G0402. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS G0402 at Monument Health Network Inc

Negotiated rates from the hospital’s own file: 6 payers, 12 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	UnitedHealthcare uhc mcr adv percent of total billed charges · outpatientfrom % of charges	$85	$85	—	—	—	$85 – $85
2	Medica medica mcr adv percent of total billed charges · outpatientfrom % of charges	$87	$87	—	—	—	$87 – $87
3	Wellmark bcbs wellmark mcr adv percent of total billed charges · outpatientfrom % of charges	$87	$87	—	—	1–10	$87 – $87
4	Medica medica mcaid percent of total billed charges · outpatientfrom % of charges	$113	$113	—	—	1–10	$113 – $113
5	Medica medica mcr adv fee schedule · outpatient	$113	$113	—	—	—	$113 – $113
6	Wellmark bcbs wellmark mcr adv fee schedule · outpatient	$113	$113	—	—	—	$113 – $113
7	Wellmark bcbs wellmark - all other plans percent of total billed charges · outpatientfrom % of charges	$304	$304	—	—	1–10	$304 – $304
8	Aetna aetna - all plans percent of total billed charges · outpatientfrom % of charges	$321	$321	—	—	1–10	$321 – $321
9	MultiPlan multiplan/phcs - all plans percent of total billed charges · outpatientfrom % of charges	$321	$321	—	—	—	$321 – $321
10	Medica medica commercial - all other plans percent of total billed charges · outpatientfrom % of charges	$328	$328	—	—	1–10	$328 – $328
11	UnitedHealthcare uhc - all other plans percent of total billed charges · outpatientfrom % of charges	$328	$328	—	—	—	$328 – $328
12	Humana humana commercial - all plans percent of total billed charges · outpatientfrom % of charges	$338	$338	—	—	—	$338 – $338

Last updated: Sep 1, 2026

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