Preventive visit, new patient (age 40–64) (CPT 99386)
99386 is the billing code hospitals use for “Preventive visit, new patient (age 40–64)”. Prices below are each hospital's own posted facility charge.
441 of 2110 hospitals post a price for this code. Hospitals that don't post one are left out. We never guess a number.
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| Hospital | Location | Cash price | Gross charge | Medicare pays | × Medicare |
|---|---|---|---|---|---|
| University of Kansas Hospital | Kansas City, KS | $11.80 | $59 | — | — |
| University of Kansas Health System Olathe Hospital | Olathe, KS | $11.80 | $59 | — | — |
| The University of Kansas Health System Paola Hospital | Paola, KS | $11.80 | $59 | — | — |
| St. Thomas More Hospital | Canon City, CO | $17.72 | $44.29 | — | — |
| Chi St. Joseph Health Regional Hospital | Bryan, TX | $26.25 | $150 | — | — |
| Burleson St. Joseph Health Center | Caldwell, TX | $26.25 | $150 | — | — |
| Madison St. Joseph Health Center | Madisonville, TX | $26.25 | $150 | — | — |
| Grimes St. Joseph Health Center | Navasota, TX | $26.25 | $150 | — | — |
| Ochsner LSU Health - Monroe Medical Center | Monroe, LA | $30.13 | $131 | — | — |
| SSM Health St. Joseph Hospital - St. Charles | St. Charles, MO | $30.80 | $56 | — | — |
| SSM Health St. Clare Hospital - Fenton | Fenton, MO | $30.80 | $56 | — | — |
| SSM Health St. Mary's Hospital - St. Louis | Richmond Heights, MO | $30.80 | $56 | — | — |
| SSM Health DePaul Hospital - St. Louis | Bridgeton, MO | $30.80 | $56 | — | — |
| SSM Health St. Joseph Hospital - Lake Saint Louis | Lake Saint Louis, MO | $30.80 | $56 | — | — |
| Ochsner LSU Health - St. Mary Medical Center | Shreveport, LA | $36.68 | $131 | — | — |
| Elite Hospital Kingwood | Kingwood, TX | $37.50 | $75 | — | — |
| Star Valley Medical Center | Afton, WY | $38.50 | $55 | — | — |
| Arkansas Children's Hospital | Little Rock, AR | $38.70 | $43 | — | — |
| Arkansas Children's Northwest | Springdale, AR | $38.70 | $43 | — | — |
| Baptist Beaumont Hospital | Beaumont, TX | $38.87 | $299 | — | — |
| Touro | New Orleans, LA | $40.46 | $289 | — | — |
| Ochsner LSU Health - Academic Medical Center | Shreveport, LA | $40.61 | $131 | — | — |
| Monroe County Hospital | Monroeville, AL | $42.40 | $106 | — | — |
| University Medical Center of El Paso | El Paso, TX | $47.52 | $237.60 | — | — |
| Atoka County Medical Center | Atoka, OK | $48 | $120.50 | — | — |
| Benson Hospital | Benson, AZ | $48 | $100 | — | — |
| Hedrick Medical Center | Chillicothe, MO | $52.80 | $88 | — | — |
| Hardin Medical Center | Savannah, TN | $53.48 | $140 | — | — |
| OU Health University of Oklahoma Medical Center | Oklahoma City, OK | $54 | $540 | — | — |
| Washington County Hospital and Nursing Home | Chatom, AL | $54.17 | — | — | — |
| University Hospital – UMMC | Jackson, MS | $54.40 | $136 | — | — |
| UMMC Madison | Canton, MS | $54.40 | $136 | — | — |
| Prisma Health Blount Memorial Hospital | Maryville, TN | $56.73 | $183 | — | — |
| Unity Health - White County Medical Center | Searcy, AR | $60 | $240 | — | — |
| Unity Health - Jacksonville | Jacksonville, AR | $60 | $240 | — | — |
| Unity Health - Newport | Newport, AR | $60 | $240 | — | — |
| Northwest Mississippi Regional Medical Center | Clarksdale, MS | $60.60 | $242.40 | — | — |
| UCHealth University of Colorado Hospital | Aurora, CO | $61.95 | $177 | — | — |
| Russell Medical | Alexander City, AL | $62.28 | $173 | — | — |
| North Texas Medical Center | Gainesville, TX | $63 | $250 | — | — |
| Ellett Memorial Hospital | Appleton City, MO | $63.75 | $85 | — | — |
| Ochsner St. Martin Hospital | Breaux Bridge, LA | $64.35 | $214.50 | — | — |
| Anderson County Hospital | Garnett, KS | $66 | $110 | — | — |
| Allen County Regional Hospital | Iola, KS | $66 | $110 | — | — |
| Lawrence + Memorial Hospital | New London, CT | $67.47 | $187.41 | — | — |
| Mitchell County Hospital District | Colorado City, TX | $70 | $100 | — | — |
| CHI St. Vincent Morrilton | Morrilton, AR | $70.81 | $278 | — | — |
| Mississippi Baptist Medical Center | Jackson, MS | $71.19 | $339 | — | — |
| Trigg County Hospital | Cadiz, KY | $71.40 | $178.50 | — | — |
| Hancock County Hospital | Sneedville, TN | $71.99 | $313 | — | — |
| Bristol Regional Medical Center | Bristol, TN | $73.20 | $488 | — | — |
| Holston Valley Medical Center | Kingsport, TN | $73.20 | $488 | — | — |
| Hawkins County Memorial Hospital | Rogersville, TN | $73.20 | $488 | — | — |
| Greeneville Community Hospital | Greeneville, TN | $73.20 | $488 | — | — |
| Nacogdoches Medical Center | Nacogdoches, TX | $73.50 | $98 | — | — |
| Riverside Medical Center | Franklinton, LA | $74 | $185 | — | — |
| Jennie Stuart Health | Hopkinsville, KY | $74.09 | $239 | — | — |
| Saint Francis Hospital Muskogee | Muskogee, OK | $74.35 | $185.88 | — | — |
| Saint Francis Hospital, Inc | Tulsa, OK | $74.35 | $185.88 | — | — |
| Saint Francis Hospital South, LLC | Tulsa, OK | $74.35 | $185.88 | — | — |
| Saint Francis Hospital Vinita, Inc | Vinita, OK | $74.35 | $185.88 | — | — |
| Ochsner Abrom Kaplan Memorial Hospital | Kaplan, LA | $74.70 | $166 | — | — |
| Community Hospital, Onaga and St. Marys Campus | Onaga, KS | $75 | $189 | — | — |
| Tampa General Hospital | Tampa, FL | $77.70 | $222 | — | — |
| D.W. McMillan Memorial Hospital | Brewton, AL | $79.20 | $132 | — | — |
| Atmore Community Hospital | Atmore, AL | $79.20 | $132 | — | — |
| Methodist Hospital | Omaha, NE | $81.36 | $226 | — | — |
| ECU Health Bertie Hospital | Windsor, NC | $82.32 | $147 | — | — |
| Northwest Florida Community Hospital | Chipley, FL | $83.20 | $104 | — | — |
| Neshoba General | Philadelphia, MS | $83.30 | $119 | — | — |
| North Runnels Hospital | Winters, TX | $85 | $122 | — | — |
| UAB Medical West | Bessemer, AL | $86.25 | $115 | — | — |
| Ochsner Lafayette General Medical Center | Lafayette, LA | $86.79 | $263 | — | — |
| Parkland Memorial Hospital | Dallas, TX | $87.20 | $218 | — | — |
| St. Francis Medical Center | Monroe, LA | $87.25 | $174.50 | — | — |
| Scotland County Hospital | Memphis, MO | $87.50 | $125 | — | — |
| North Sunflower Medical Center | Ruleville, MS | $87.50 | $175 | — | — |
| Alamance Regional Medical Center | Burlington, NC | $88.06 | $231.74 | — | — |
| Cone Health Moses Cone Hospital | Greensboro, NC | $88.06 | $231.74 | — | — |
| Allendale County Hospital | Fairfax, SC | $89.25 | $105 | — | — |
| Methodist Fremont Health | Fremont, NE | $90.28 | $244 | — | — |
| University Health System | San Antonio, TX | $92.25 | $369 | — | — |
| Swisher Memorial Hospital | Tulia, TX | $93.50 | $187 | — | — |
| Bridgeport Hospital | Bridgeport, CT | $97.45 | $187.41 | — | — |
| Greenwich Hospital | Greenwich, CT | $97.45 | $187.41 | — | — |
| Winkler County Memorial Hospital | Kermit, TX | $97.78 | $122.22 | — | — |
| Hamilton Hospital | Olney, TX | $98 | $139.50 | — | — |
| Eastland Memorial Hospital | Eastland, TX | $99 | $198 | — | — |
| Lamb Healthcare Center | Littlefield, TX | $100 | $250 | — | — |
| Choctaw Memorial Hospital | Hugo, OK | $100 | $200 | — | — |
| Haskell Regional Hospital, Inc | Stigler, OK | $100 | $216 | — | — |
| Izard Regional Hospital | Calico Rock, AR | $100 | $302.50 | — | — |
| Ozarks Community Hospital | Gravette, AR | $100 | $582 | — | — |
| Highland Hills Medical Center | Senatobia, MS | $101 | $202 | — | — |
| Ochsner Rush Medical Center | Meridian, MS | $103.71 | $296.32 | — | — |
| Drumright Regional Hospital | Drumright, OK | $105 | $175 | — | — |
| Ochsner University Hospital & Clinics | Lafayette, LA | $105 | $210 | — | — |
| Crittenden Community Hospital | Marion, KY | $105.42 | $251 | — | — |
| Atrium Health Wake Forest Baptist Medical Center | Winston-Salem, NC | $105.50 | $211 | — | — |
| Wilkes Medical Center | North Wilkesboro, NC | $105.50 | $211 | — | — |
| Hugh Chatham Health – Medical Center | Elkin, NC | $105.50 | $211 | — | — |
| CHRISTUS St. Frances Cabrini Hospital | Alexandria, LA | $106.34 | $409 | — | — |
| LaSalle General Hospital | Jena, LA | $106.80 | $178 | — | — |
| Vanderbilt Bedford Hospital | Shelbyville, TN | $109.04 | $376 | — | — |
| Vanderbilt Tullahoma-Harton Hospital | Tullahoma, TN | $109.04 | $376 | — | — |
| Vanderbilt Wilson County Hospital | Lebanon, TN | $109.04 | $376 | — | — |
| Denver Health Medical Center | Denver, CO | $109.26 | $312.16 | — | — |
| Taylor Regional Hospital | Campbellsville, KY | $109.50 | $219 | — | — |
| Starr County Memorial Hospital | Rio Grande City, TX | $110 | $110 | — | — |
| Yale New Haven Hospital | New Haven, CT | $110.57 | $187.41 | — | — |
| Edwards County Medical Center | Kinsley, KS | $112 | $140 | — | — |
| Lexington Medical Center | Lexington, NC | $112.50 | $225 | — | — |
| Dosher Memorial Hospital | Southport, NC | $113.50 | $227 | — | — |
| McLeod Health Dillon | Dillon, SC | $114.31 | $161 | — | — |
| McLeod Regional Medical Center | Florence, SC | $114.31 | $161 | — | — |
| McLeod Health Loris | Loris, SC | $114.31 | $161 | — | — |
| McLeod Health Cheraw | Cheraw, SC | $114.31 | $161 | — | — |
| McLeod Health Clarendon | Manning, SC | $114.31 | $161 | — | — |
| Oklahoma Heart Hospital, LLC | Oklahoma City, OK | $114.97 | $328.50 | — | — |
| Oklahoma Heart Hospital South, LLC | Oklahoma City, OK | $114.97 | $328.50 | — | — |
| Iberia Medical Center | New Iberia, LA | $115.20 | $192 | — | — |
| T.J. Samson Community Hospital | Glasgow, KY | $116.35 | $179 | — | — |
| T.J. Health Columbia | Columbia, KY | $116.35 | $179 | — | — |
| Rolling Plains Memorial Hospital | Sweetwater, TX | $116.50 | $179.50 | — | — |
| Chambers Memorial Hospital | Danville, AR | $118.02 | $236.04 | — | — |
| Medina Regional Hospital | Hondo, TX | $118.40 | $131.55 | — | — |
| Prisma Health Oconee Memorial Hospital | Seneca, SC | $118.95 | $183 | — | — |
| Prisma Health Baptist Easley Hospital | Easley, SC | $118.95 | $183 | — | — |
| Prisma Health Richland Hospital | Columbia, SC | $118.95 | $183 | — | — |
| Prisma Health Greer Memorial Hospital | Greer, SC | $118.95 | $183 | — | — |
| Prisma Health Hillcrest Hospital | Simpsonville, SC | $118.95 | $183 | — | — |
| Prisma Health Laurens County Hospital | Clinton, SC | $118.95 | $183 | — | — |
| Prisma Health Tuomey Hospital | Sumter, SC | $118.95 | $183 | — | — |
| Prisma Health Greenville Memorial Hospital | Greenville, SC | $118.95 | $183 | — | — |
| Prisma Health Baptist Hospital | Columbia, SC | $118.95 | $183 | — | — |
| Prisma Health Patewood Hospital | Greenville, SC | $118.95 | $183 | — | — |
| Prisma Health Baptist Parkridge Hospital | Columbia, SC | $118.95 | $183 | — | — |
| Pike County Memorial Hospital | Louisiana, MO | $120 | $150 | — | — |
| Covenant Hospital Plainview | Plainview, TX | $121.38 | $289 | — | — |
| Covenant Hospital Levelland | Levelland, TX | $121.38 | $289 | — | — |
| Samaritan Hospital | Macon, MO | $123.50 | $154.50 | — | — |
| Cimarron Memorial Hospital | Boise City, OK | $124 | $248 | — | — |
| Cordell Memorial Hospital | Cordell, OK | $124 | $155 | — | — |
| Okeene Municipal Hospital | Okeene, OK | $124 | $155 | — | — |
| OCH Regional Medical Center | Starkville, MS | $124.16 | $194 | — | — |
| Harris Health | Houston, TX | $127 | $127 | — | — |
| Harlan County Health System | Alma, NE | $127.72 | $159.65 | — | — |
| Cochran Memorial Hospital | Morton, TX | $128.40 | $128.40 | — | — |
| White Mountain Regional Medical Center | Springerville, AZ | $128.74 | $225.86 | — | — |
| Wellstar Mountain Lakes Medical Center | Clayton, GA | $129.20 | $323 | — | — |
| Ozarks Healthcare | West Plains, MO | $129.38 | $258.75 | — | — |
| Lallie Kemp Regional Medical Center | Independence, LA | $130.55 | $217.58 | — | — |
| UK St. Claire Regional Medical Center | Morehead, KY | $132 | $176 | — | — |
| Tyler Holmes Memorial Hospital | Winona, MS | $132 | $176 | — | — |
| University Medical Center New Orleans | New Orleans, LA | $132.44 | $602 | — | — |
| Knox County Hospital | Knox City, TX | $135 | $135 | — | — |
| Valley View Medical Center | Fort Mohave, AZ | $135 | $225 | — | — |
| North Arkansas Regional Medical Center | Harrison, AR | $136.71 | $220.50 | — | — |
| Conway Medical Center | Conway, SC | $137 | $137 | — | — |
| Sweeny Community Hospital | Sweeny, TX | $137.16 | $228.60 | — | — |
| Gordon Memorial Hospital District | Gordon, NE | $138 | $138 | — | — |
| Tmc- Bonham Hospital | Bonham, TX | $139.70 | $466.40 | — | — |
| Whitesburg ARH Hospital | Whitesburg, KY | $139.80 | $233 | — | — |
| Hazard ARH Regional Medical Center | Hazard, KY | $139.80 | $233 | — | — |
| Paintsville ARH Hospital | Paintsville, KY | $139.80 | $233 | — | — |
| McDowell ARH Hospital | Mc Dowell, KY | $139.80 | $233 | — | — |
| Saint Luke's Hospital of Kansas City | Kansas City, MO | $139.80 | $233 | — | — |
| Ochsner American Legion Hospital | Jennings, LA | $139.86 | $333 | — | — |
| St. Bernards Medical Center | Jonesboro, AR | $140.40 | $216 | — | — |
| Franklin Medical Center | Winnsboro, LA | $140.40 | $234 | — | — |
| Hospital District #1 of Rice County | Lyons, KS | $142.50 | $190 | — | — |
| Bradley County Medical Center | Warren, AR | $142.50 | $285 | — | — |
| East Carroll Parish Hospital | Lake Providence, LA | $143.51 | $191.34 | — | — |
| Valley County Health System | Ord, NE | $144 | $160 | — | — |
| Texas Health Harris Methodist Hospital Fort Worth (Texas Health Resources) | Fort Worth, TX | $144.60 | $241 | — | — |
| Texas Health Presbyterian Hospital Dallas | Dallas, TX | $144.60 | $241 | — | — |
| Muenster Memorial Hospital | Muenster, TX | $146 | $195 | — | — |
| Jewell County Hospital | Mankato, KS | $150 | $200 | — | — |
| Medicine Lodge Memorial Hospital | Medicine Lodge, KS | $150 | $150 | — | — |
| Chicot Memorial Medical Center | Lake Village, AR | $150 | $150 | — | — |
| Southwest Arkansas Regional Medical Center | Hope, AR | $150 | $375 | — | — |
| Natchitoches Regional Medical Center | Natchitoches, LA | $150 | $375 | — | — |
| Kiowa County Memorial Hospital | Greensburg, KS | $150.45 | $177 | — | — |
| Methodist Healthcare Memphis Hospitals | Memphis, TN | $151.58 | $689 | — | — |
| Methodist Olive Branch Hospital | Olive Branch, MS | $151.58 | $689 | — | — |
| West Feliciana Hospital | St. Francisville, LA | $152.40 | $254 | — | — |
| Baxter Health | Mountain Home, AR | $152.65 | $254.41 | — | — |
| Parkview Hospital | Wheeler, TX | $153 | $180 | — | — |
| Ellinwood District Hospital | Ellinwood, KS | $153 | $180 | — | — |
| Calhoun-Liberty Hospital | Blountstown, FL | $154 | $220 | — | — |
| F W Huston Medical Center | Winchester, KS | $156 | $195 | — | — |
| ECU Health Chowan Hospital | Edenton, NC | $156.24 | $279 | — | — |
| Weisbrod Memorial County Hospital | Eads, CO | $157.20 | $262 | — | — |
| Monroe Regional Hospital | Aberdeen, MS | $158 | $216 | — | — |
| Boone Hospital Center | Columbia, MO | $158.40 | $264 | — | — |
| Atrium Health Cabarrus | Concord, NC | $161.46 | $322.92 | — | — |
| Atrium Health Cleveland | Shelby, NC | $161.46 | $322.92 | — | — |
| Atrium Health Anson | Wadesboro, NC | $161.46 | $322.92 | — | — |
| Atrium Health Pineville | Charlotte, NC | $161.46 | $322.92 | — | — |
| Atrium Health Carolinas Medical Center | Charlotte, NC | $161.46 | $322.92 | — | — |
| Atrium Health Stanly | Albemarle, NC | $161.46 | $322.92 | — | — |
| Atrium Health Union | Monroe, NC | $161.46 | $322.92 | — | — |
| Atrium Health Lincoln | Lincolnton, NC | $161.46 | $322.92 | — | — |
| Atrium Health University City | Charlotte, NC | $161.46 | $322.92 | — | — |
| Iron County Medical Center | Pilot Knob, MO | $161.78 | $179.76 | — | — |
| JPS Health Network | Fort Worth, TX | $163.20 | $272 | — | — |
| Fisher County Hospital District | Rotan, TX | $164 | $193 | — | — |
| North Central Kansas Medical Center | Concordia, KS | $164.36 | $234.80 | — | — |
| Rockcastle Regional Hospital and Respiratory Care Center | Mount Vernon, KY | $164.92 | $217 | — | — |
| Girard Medical Center | Girard, KS | $165 | $275 | — | — |
| Ste. Genevieve County Memorial Hospital | Ste. Genevieve, MO | $165 | $330 | — | — |
| Kiowa District Hospital | Kiowa, KS | $168 | $210 | — | — |
| Mercy Hospital Cassville | Cassville, MO | $168.35 | $259 | — | — |
| Owensboro Health Twin Lakes Medical Center | Leitchfield, KY | $168.81 | $259.71 | — | — |
| Hansford County Hospital | Spearman, TX | $169 | $225 | — | — |
| Ward Memorial Hospital | Monahans, TX | $169 | $241 | — | — |
| Memorial Hospital & Manor | Bainbridge, GA | $169.05 | $241.50 | — | — |
| Prowers Medical Center | Lamar, CO | $169.80 | $283 | — | — |
| Coryell Memorial Hospital | Gatesville, TX | $170 | $283.50 | — | — |
| Mosaic Life Care at St. Joseph - Medical Center | St. Joseph, MO | $170 | $200 | — | — |
| Lexington Regional Health Center | Lexington, NE | $170.40 | $177.50 | — | — |
| Phelps Health Hospital | Rolla, MO | $171.34 | $244.77 | — | — |
| Kingman Regional Medical Center | Kingman, AZ | $171.50 | $490 | — | — |
| Livingston Hospital | Salem, KY | $171.75 | $286.25 | — | — |
| Greeley County Health Services | Tribune, KS | $175 | $250 | — | — |
| Our Lady of Lourdes Regional Medical Center | Lafayette, LA | $175.50 | $351 | — | — |
| Atrium Health Floyd Medical Center | Rome, GA | $177 | $354 | — | — |
| Baxter Health Fulton County Hospital | Salem, AR | $177.45 | $253.50 | — | — |
| Tallahatchie General Hospital | Charleston, MS | $177.45 | $227 | — | — |
| Phillips County Health Systems | Phillipsburg, KS | $177.65 | $209 | — | — |
| Freeman Hospital West | Joplin, MO | $177.90 | $296.50 | — | — |
| Plains Memorial Hospital | Dimmitt, TX | $179 | $239 | — | — |
| Nashville General Hospital | Nashville, TN | $179.40 | $299 | — | — |
| Dimmit Regional Hospital | Carrizo Springs, TX | $180 | $300 | — | — |
| Rush County Memorial Hospital | La Crosse, KS | $180 | $200 | — | — |
| Satanta District Hospital, Clinics, & LTCU | Satanta, KS | $180 | $200 | — | — |
| Minneola District Hospital Nbr 2 | Minneola, KS | $180.60 | $258 | — | — |
| Ochsner Laird Hospital | Union, MS | $180.76 | $296.32 | — | — |
| Arbuckle Memorial Hospital Authority | Sulphur, OK | $181 | $226.50 | — | — |
| Jasper Memorial Hospital | Monticello, GA | $181.50 | $363 | — | — |
| Muleshoe Area Medical Center | Muleshoe, TX | $182 | $304 | — | — |
| Grove Hill Rural Emergency Hospital | Grove Hill, AL | $184.20 | $307 | — | — |
| Great Plains Health | North Platte, NE | $184.50 | $307.50 | — | — |
| Holton Community Hospital | Holton, KS | $184.50 | $246 | — | — |
| Nacogdoches Memorial Hospital | Nacogdoches, TX | $185 | $618 | — | — |
| Community Memorial Healthcare, Inc | Marysville, KS | $185 | $185 | — | — |
| Wayne General Hospital | Waynesboro, MS | $186 | $186 | — | — |
| Ochsner Scott Regional | Morton, MS | $186.68 | $296.32 | — | — |
| Howard University Hospital | Washington, DC | $187.41 | $234.26 | — | — |
| Wilson Medical Center | Neodesha, KS | $187.50 | $250 | — | — |
| Rio Grande Hospital | Del Norte, CO | $188.07 | $250.76 | — | — |
| CarolinaEast Medical Center | New Bern, NC | $189.60 | $316 | — | — |
| Ochiltree General Hospital | Perryton, TX | $190 | $272 | — | — |
| Lackey Memorial Hospital | Forest, MS | $190.10 | $190.10 | — | — |
| Golden Valley Memorial Healthcare | Clinton, MO | $191.32 | $318.86 | — | — |
| Memorial Medical Center | Port Lavaca, TX | $192.50 | $275 | — | — |
| Spartanburg Medical Center | Spartanburg, SC | $192.60 | $321 | — | — |
| Cherokee Medical Center | Gaffney, SC | $192.60 | $321 | — | — |
| Pelham Medical Center | Greer, SC | $192.60 | $321 | — | — |
| Union Medical Center | Union, SC | $192.60 | $321 | — | — |
| St. Bernards Five Rivers Medical Center | Pocahontas, AR | $194.40 | $216 | — | — |
| South Lincoln Medical Center | Kemmerer, WY | $194.52 | $259.35 | — | — |
| Faith Health | Norfolk, NE | $195 | $311.50 | — | — |
| Franklin County Memorial Hospital | Meadville, MS | $195 | $195 | — | — |
| Rangely District Hospital | Rangely, CO | $196.66 | $302.55 | — | — |
| Hot Springs County Memorial Hospital | Thermopolis, WY | $197 | $197 | — | — |
| Frio Regional Hospital | Pearsall, TX | $197 | $281 | — | — |
| Ochsner Watkins Hospital | Quitman, MS | $198.53 | $296.32 | — | — |
| Norton County Hospital | Norton, KS | $198.80 | $284 | — | — |
| Brown County Hospital | Ainsworth, NE | $200 | $266 | — | — |
| Mercy Hospital St. Louis | St. Louis, MO | $200.20 | $308 | — | — |
| Mercy Hospital Washington | Washington, MO | $200.20 | $308 | — | — |
| Tippah County Hospital | Ripley, MS | $202.50 | $202.50 | — | — |
| Vanderbilt University Hospital | Nashville, TN | $203.04 | $376 | — | — |
| Rhea Medical Center | Dayton, TN | $204 | $300 | — | — |
| Ochsner Stennis Hospital | De Kalb, MS | $204.46 | $296.32 | — | — |
| St. Luke's Hospital | Chesterfield, MO | $204.60 | $341 | — | — |
| Southwest Medical Center | Liberal, KS | $204.80 | $256 | — | — |
| Nevada Regional Medical Center | Nevada, MO | $206.55 | $459 | — | — |
| Cleveland Clinic Martin North Hospital | Stuart, FL | $206.70 | $318 | — | — |
| Cleveland Clinic Indian River Hospital | Vero Beach, FL | $206.70 | $318 | — | — |
| Cleveland Clinic Hospital | Weston, FL | $206.70 | $318 | — | — |
| Patterson Health Center | Anthony, KS | $208 | $260 | — | — |
| Pemiscot Memorial Hospital | Hayti, MO | $209.30 | $299 | — | — |
| Memorial Hospital of Carbon County | Rawlins, WY | $210 | $280 | — | — |
| Ottawa County Health Center | Minneapolis, KS | $210 | $210 | — | — |
| Golden Plains Community Hospital | Borger, TX | $212.35 | $303.35 | — | — |
| Rapides Regional Medical Center | Alexandria, LA | $212.89 | $212.89 | — | — |
| Delta Memorial Hospital | Dumas, AR | $213.74 | $267.18 | — | — |
| Dignity Health, Yavapai Regional Medical Center West | Prescott, AZ | $218.15 | $294 | — | — |
| Sharkey Issaquena Community Hospital | Rolling Fork, MS | $220 | $275 | — | — |
| Weatherford Regional Hospital, Inc of Weatherford | Weatherford, OK | $220.80 | $276 | — | — |
| Hermann Area District Hospital | Hermann, MO | $220.95 | $368.25 | — | — |
| Chadron Hospital | Chadron, NE | $223 | $318 | — | — |
| Neosho Memorial Regional Medical Center | Chanute, KS | $223.02 | $297.36 | — | — |
| Pratt Regional Medical Center | Pratt, KS | $224 | $320 | — | — |
| Ochsner Choctaw General | Butler, AL | $225.20 | $296.32 | — | — |
| Nebraska Medical Center | Omaha, NE | $227.50 | $350 | — | — |
| Bellevue Medical Center | Bellevue, NE | $227.50 | $350 | — | — |
| Jackson Healthcare Center | Edna, TX | $228 | $285 | — | — |
| Bayou Bend Health System | Franklin, LA | $228.20 | $326 | — | — |
| Cheyenne County Hospital | St. Francis, KS | $230.35 | $271 | — | — |
| Muscogee (creek) Nation Medical Center | Okmulgee, OK | $231.09 | $385.15 | — | — |
| Henderson Community Hospital | Henderson, NE | $232 | $290 | — | — |
| Garden County Health Services | Oshkosh, NE | $233 | $342 | — | — |
| Ashland Health Center | Ashland, KS | $236 | $295 | — | — |
| MedStar Washington Hospital Center | Washington, DC | $237.34 | $365.14 | — | — |
| Crane County Hospital District | Crane, TX | $242 | $346 | — | — |
| Pawnee County Memorial Hospital | Pawnee City, NE | $242 | $302 | — | — |
| Morrill County Community Hospital | Bridgeport, NE | $246 | $262 | — | — |
| Sheridan Memorial Hospital | Sheridan, WY | $246.40 | $308 | — | — |
| Saunders Medical Center | Wahoo, NE | $252.75 | $337 | — | — |
| Atrium Health Navicent The Medical Center | Macon, GA | $253 | $506 | — | — |
| Jackson Parish Hospital | Jonesboro, LA | $253 | $253 | — | — |
| Hardtner Medical Center | Olla, LA | $253.94 | $317.43 | — | — |
| Grisell Memorial Hospital | Ransom, KS | $254.90 | $268.32 | — | — |
| Rio Grande Regional Hospital | Mcallen, TX | $255.15 | $255.15 | — | — |
| Family Health West Hospital | Fruita, CO | $255.50 | $365 | — | — |
| Titus Regional Medical Center | Mount Pleasant, TX | $257.40 | $429 | — | — |
| Memorial Hospital | Seminole, TX | $258.30 | $369 | — | — |
| Fredonia Regional Hospital | Fredonia, KS | $258.63 | $258.63 | — | — |
| SCK Health | Arkansas City, KS | $260 | $260 | — | — |
| Cozad Community Hospital | Cozad, NE | $263 | $292 | — | — |
| Memorial Hospital | Aurora, NE | $264 | $275 | — | — |
| Self Regional Healthcare | Greenwood, SC | $264 | $440 | — | — |
| Edgefield County Healthcare | Edgefield, SC | $264 | $440 | — | — |
| Dundy County Hospital | Benkelman, NE | $266 | $295.50 | — | — |
| ECU Health Medical Center | Greenville, NC | $267.65 | $505 | — | — |
| West Holt Memorial Hospital | Atkinson, NE | $268 | $335 | — | — |
| Peterson Regional Medical Center | Kerrville, TX | $268.80 | $384 | — | — |
| North Oaks Medical Center | Hammond, LA | $268.82 | $855 | — | — |
| Falls Community Hospital and Clinic | Marlin, TX | $272 | $340 | — | — |
| Putnam County Memorial Hospital | Unionville, MO | $272.40 | $272.40 | — | — |
| Stanton County Hospital | Johnson, KS | $273 | $273 | — | — |
| Crook County Medical Services District | Sundance, WY | $277.72 | $370.30 | — | — |
| Mary Lanning Healthcare | Hastings, NE | $278.10 | $309 | — | — |
| Niobrara County Hospital District | Lusk, WY | $280 | $350 | — | — |
| Callaway District Hospital | Callaway, NE | $280 | $311 | — | — |
| Freeman Neosho Hospital | Neosho, MO | $280.50 | $467.50 | — | — |
| Nemaha Valley Community Hospital | Seneca, KS | $281.70 | $313 | — | — |
| Community Hospital | McCook, NE | $284.63 | $316.25 | — | — |
| Spanish Peaks Regional Health Center | Walsenburg, CO | $286.20 | $318 | — | — |
| Mcpherson Hospital Inc | Mcpherson, KS | $286.38 | $387 | — | — |
| Boone County Health Center | Albion, NE | $287 | $287 | — | — |
| Morton County Hospital | Elkhart, KS | $288 | $320 | — | — |
| Cleveland Area Hospital | Cleveland, OK | $288.80 | $361 | — | — |
| Decatur Health | Oberlin, KS | $288.90 | $321 | — | — |
| Osmond General Hospital | Osmond, NE | $290 | $290 | — | — |
| Franklin County Memorial Hospital | Franklin, NE | $292 | $324 | — | — |
| Estes Park Medical Center | Estes Park, CO | $294 | $392 | — | — |
| Sabetha Community Hospital | Sabetha, KS | $294 | $294 | — | — |
| Webster County Community Hospital | Red Cloud, NE | $295 | $310 | — | — |
| Phelps Memorial Health Center | Holdrege, NE | $295.20 | $328 | — | — |
| Friend Community Healthcare System | Friend, NE | $295.21 | $492.01 | — | — |
| Cody Regional Health | Cody, WY | $295.80 | $348 | — | — |
| Genoa Community Hospital | Genoa, NE | $296 | $329 | — | — |
| Community Hospital – Fairfax | Fairfax, MO | $296 | $296 | — | — |
| Niobrara Valley Hospital | Lynch, NE | $298 | $298 | — | — |
| Bellville Medical Center | Bellville, TX | $300 | $300 | — | — |
| Mccamey Hospital | Mccamey, TX | $300 | $300 | — | — |
| Kearney County Health Services | Minden, NE | $301 | $376 | — | — |
| Kimball Health Services | Kimball, NE | $304 | $304 | — | — |
| Lane County Hospital | Dighton, KS | $305 | $305 | — | — |
| Ellsworth County Medical Center | Ellsworth, KS | $306 | $306 | — | — |
| Brodstone Healthcare | Superior, NE | $307 | $323 | — | — |
| Cogdell Memorial Hospital | Snyder, TX | $308 | $308 | — | — |
| Abbeville Area Medical Center | Abbeville, SC | $308 | $440 | — | — |
| Woman's Hospital | Baton Rouge, LA | $308 | $308 | — | — |
| Keefe Memorial Hospital | Cheyenne Wells, CO | $312 | $312 | — | — |
| Rock County Hospital | Bassett, NE | $314 | $330 | — | — |
| Saint Francis Hospital | Hartford, CT | $314.60 | $572 | — | — |
| Clay County Medical Center | Clay Center, KS | $315 | $315 | — | — |
| Lake Butler Hospital | Lake Butler, FL | $320.96 | $320.96 | — | — |
| Tri Valley Health System | Cambridge, NE | $323.10 | $359 | — | — |
| Liberty Dayton Regional Medical Center | Liberty, TX | $328 | $469 | — | — |
| Pender Community Health | Pender, NE | $329 | $387 | — | — |
| Powell Valley Healthcare | Powell, WY | $332.69 | $391.40 | — | — |
| Wickenburg Community Hospital | Wickenburg, AZ | $335.40 | $516 | — | — |
| York General Health Care Services | York, NE | $337.50 | $337.50 | — | — |
| Amberwell Hiawatha | Hiawatha, KS | $339 | $339 | — | — |
| Amberwell Atchison Association | Atchison, KS | $339 | $339 | — | — |
| Lake Charles Memorial Hospital | Lake Charles, LA | $340.50 | $567.50 | — | — |
| Regional Medical Center | Memphis, TN | $349.05 | $542.85 | — | — |
| Beatrice Community Hospital & Health Center, Inc | Beatrice, NE | $353 | $353 | — | — |
| Seiling Municipal Hospital | Seiling, OK | $353.14 | $205.20 | — | — |
| Thayer County Health Services | Hebron, NE | $360 | $360 | — | — |
| Montrose Regional Health | Montrose, CO | $360.75 | $481 | — | — |
| Johnson County Hospital | Tecumseh, NE | $364 | $364 | — | — |
| Gunnison Valley Hospital | Gunnison, CO | $364.65 | $429 | — | — |
| Val Verde Regional Medical Center | Del Rio, TX | $369.20 | $568 | — | — |
| Cherry County Hospital | Valentine, NE | $377.65 | $377.65 | — | — |
| Perkins County Health Services | Grant, NE | $381 | $381 | — | — |
| Holy Cross Hospital | Fort Lauderdale, FL | $384.15 | $591 | — | — |
| Share Medical Center | Alva, OK | $387.99 | $596.91 | — | — |
| Danbury Hospital | Danbury, CT | $392 | $392 | — | — |
| Hamilton County Hospital | Syracuse, KS | $392.18 | $392.18 | — | — |
| Jefferson Regional | Pine Bluff, AR | $394 | $394 | — | — |
| DeSoto Regional Health System | Mansfield, LA | $395.50 | $565 | — | — |
| St. John's Medical Center | Jackson, WY | $400 | $400 | — | — |
| Refugio County Memorial Hospital | Refugio, TX | $410.80 | $513.50 | — | — |
| Saint Francis Medical Center | Cape Girardeau, MO | $420 | $420 | — | — |
| Pershing Health System | Brookfield, MO | $423 | $423 | — | — |
| Memorial Hospital of Sweetwater County | Rock Springs, WY | $427 | $427 | — | — |
| Norwalk Hospital | Norwalk, CT | $427 | $427 | — | — |
| HCA Florida North Florida Hospital | Gainesville, FL | $432.29 | $432.29 | — | — |
| St. Helena Parish Hospital & Nursing Home | Greensburg, LA | $450 | $450 | — | — |
| Larkin Community Hospital | South Miami, FL | $460.60 | $658 | — | — |
| HCA Houston Healthcare Southeast | Pasadena, TX | $498.11 | $498.11 | — | — |
| Colquitt Regional Medical Center | Moultrie, GA | $520 | $520 | — | — |
| Chase County Community Hospital | Imperial, NE | $565 | $565 | — | — |
| Thibodaux Regional Health System | Thibodaux, LA | $596 | $596 | — | — |
| East Valley ER & Hospital | Gilbert, AZ | $597.15 | $1,327 | — | — |
| Alexandria Emergency Hospital | Alexandria, LA | $597.15 | $1,327 | — | — |
| Emory University Hospital | Atlanta, GA | $642 | $642 | — | — |
| Emory Decatur Hospital | Decatur, GA | $642 | $642 | — | — |
| Emory University Hospital Midtown | Atlanta, GA | $642 | $642 | — | — |
| Emory Saint Joseph's Hospital | Atlanta, GA | $642 | $642 | — | — |
| Emory Hillandale Hospital | Lithonia, GA | $642 | $642 | — | — |
| Emory Johns Creek Hospital | Johns Creek, GA | $642 | $642 | — | — |
| Brushy Creek Family Hospital LLC | Round Rock, TX | $655.20 | $728 | — | — |
| Bandera Family Hospital | San Antonio, TX | $655.20 | $728 | — | — |
| Sedgwick County Memorial Hospital | Julesburg, CO | $676 | $676 | — | — |
| Doctors Hosptal at Renaissance | Edinburg, TX | $1,076.67 | $1,076.67 | — | — |
| Crescent Medical Center Lancaster | Lancaster, TX | $1,081 | $1,663 | — | — |
| Jackson Memorial Hospital | Miami, FL | — | $73 | — | — |
| Holdenville General Hospital | Holdenville, OK | — | $178.50 | — | — |
| Western Missouri Medical Center | Warrensburg, MO | — | $188.20 | — | — |
| Cuero Regional Hospital | Cuero, TX | — | $191 | — | — |
| University of Texas M D Anderson Cancer Center | Houston, TX | — | $206 | — | — |
| Cameron Regional Medical Center | Cameron, MO | — | $216 | — | — |
| Cobre Valley Regional Medical Center | Globe, AZ | — | $277.50 | — | — |
| Kearny County Hospital | Lakin, KS | — | $279 | — | — |
| Coffey County Hospital | Burlington, KS | — | $284.28 | — | — |
| Pioneers Medical Center | Meeker, CO | — | $293 | — | — |
| Mount Graham Regional Medical Center | Safford, AZ | — | $306 | — | — |
| Antelope Memorial Hospital | Neligh, NE | — | $319 | — | — |
| La Paz Regional Hospital | Parker, AZ | — | $330 | — | — |
| Candler County Hospital | Metter, GA | — | $338 | — | — |
| Mount San Rafael Hospital | Trinidad, CO | — | $362.25 | — | — |
| Valleywise Health Medical Center | Phoenix, AZ | — | $460 | — | — |
| Mangum Regional Medical Center | Mangum, OK | — | $460.80 | — | — |
“Medicare pays” is the facility (technical) rate, matching the posted facility charge; the doctor's separate professional fee is excluded throughout. “—” means Medicare has no comparable facility rate for this code.