Initial observation care cost at US hospitals
INITIAL OBSERVATION CARE · CPT 99218
$102.00
lowest cash price
$156.00
national median
$250.65
highest cash price
12
hospitals with a published cash price
Middle half of hospitals (25th–75th percentile) against the full range. The same procedure varies $102.00–$250.65 — the variation is the story.
Median cash price over time
Aug 1, 2025 ($250.65) → Sep 1, 2026 ($110.40)
By state
| State | Hospitals | Lowest cash | Median | Highest |
|---|---|---|---|---|
| Alaska | 1 | not published by hospital | not published by hospital | not published by hospital |
| Colorado | 1 | not published by hospital | not published by hospital | not published by hospital |
| Florida | 45 | not published by hospital | not published by hospital | not published by hospital |
| Illinois | 15 | $196.20 | $196.20 | $196.20 |
| Indiana | 16 | not published by hospital | not published by hospital | not published by hospital |
| Iowa | 14 | $186.60 | $196.20 | $196.20 |
| Kansas | 5 | $102.00 | $102.00 | $102.00 |
| Maine | 7 | $250.65 | $250.65 | $250.65 |
| Michigan | 12 | not published by hospital | not published by hospital | not published by hospital |
| New Hampshire | 1 | not published by hospital | not published by hospital | not published by hospital |
| New Jersey | 3 | not published by hospital | not published by hospital | not published by hospital |
| New York | 11 | not published by hospital | not published by hospital | not published by hospital |
| North Carolina | 12 | not published by hospital | not published by hospital | not published by hospital |
| Ohio | 13 | $156.00 | $156.00 | $156.00 |
| Oklahoma | 6 | not published by hospital | not published by hospital | not published by hospital |
| Pennsylvania | 3 | $110.40 | $110.40 | $115.20 |
| Tennessee | 6 | not published by hospital | not published by hospital | not published by hospital |
| Texas | 23 | not published by hospital | not published by hospital | not published by hospital |
| Washington | 1 | not published by hospital | not published by hospital | not published by hospital |
| Wisconsin | 5 | not published by hospital | not published by hospital | not published by hospital |
All hospitals
| Hospital | Location | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic childrens hospital for rehabilitation | Cleveland, OH | not published | $95.52 – $110.61 |
| avon hospital | Avon, OH | not published | $58.51 – $59.62 |
| cleveland clinic main campus | Cleveland, OH | not published | $68.73 – $79.59 |
| Covenant Hospital Plainview | Plainview, TX | not published | $213.68 – $219.79 |
| Atrium Health Pineville | Charlotte, NC | not published | $56.10 – $57.22 |
| Atrium Health Mercy | Charlotte, NC | not published | $56.10 – $57.22 |
| Covenant Children's Hospital | Lubbock, TX | not published | $345.33 – $345.33 |
| HCA HOUSTON NORTHWEST | SPRING, TX | not published | $964.55 – $964.55 |
| HCA FLORIDA KENDALL HOSPITAL | DORAL, FL | not published | $116.85 – $119.31 |
| HCA HOUSTON KINGWOOD | HUMBLE, TX | not published | $964.55 – $964.55 |
| Ascension Saint Thomas Midtown | Nashville, TN | not published | $83.58 – $90.46 |
| HCA HOUSTON CONROE | CONROE, TX | not published | $964.55 – $964.55 |
| HCA HOUSTON MEDICAL CENTER | Houston, TX | not published | $964.55 – $964.55 |
| HCA HOUSTON CLEAR LAKE | FRIENDSWOOD, TX | not published | $964.55 – $964.55 |
| Atrium Health Anson | Wadesboro, NC | not published | $56.10 – $57.22 |
| UnityPoint Health - St. Luke's Hospital | Cedar Rapids, IA | not published | $159.00 – $159.00 |
| UnityPoint Health - Trinity Regional Medical Center | Fort Dodge, IA | not published | $159.00 – $159.00 |
| UnityPoint Health - Trinity Muscatine | Muscatine, IA | not published | $159.00 – $159.00 |
| UnityPoint Health - Trinity Moline | Rock Island, IL | not published | $159.00 – $159.00 |
| UnityPoint Health - Trinity Bettendorf | Bettendorf, IA | not published | $159.00 – $159.00 |
| UnityPoint Health - St. Lukes Downtown | Sioux City, IA | not published | $159.00 – $159.00 |
| UnityPoint Health - Marshalltown | Marshalltown, IA | not published | $159.00 – $159.00 |
| UnityPoint Health - Jones Regional Medical Center | Anamosa, IA | not published | $159.00 – $159.00 |
| UnityPoint Health - Iowa Lutheran Hospital | Des Moines, IA | not published | $159.00 – $159.00 |
| Advocate Good Samaritan Hospital | Downers Grove, IL | not published | $342.81 – $390.18 |
| Providence St Luke's Rehabilitation Medical Center | Spokane, WA | not published | $321.62 – $321.62 |
| Ascension Columbia St. Mary's Hospital - Milwaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Milwaukee, WI | not published | $156.55 – $156.55 |
| UnityPoint Health - Grinnell Regional Medical Center | Grinnell, IA | not published | $159.00 – $159.00 |
| HCA FLORIDA PUTNAM HOSPITAL | Palatka, FL | not published | $107.35 – $113.00 |
| HCA FLORIDA PALMS WEST HOSPITAL | LOXAHATCHEE, FL | not published | $111.15 – $113.49 |
| HCA FLORIDA NORTHWEST HOSPITAL | MARGATE, FL | not published | $111.15 – $113.49 |
| UnityPoint Health - Finley Hospital | Dubuque, IA | not published | $159.00 – $159.00 |
| Advocate Condell Medical Center | Libertyville, IL | not published | $211.29 – $240.35 |
| Advocate Christ Medical Center | Oak Lawn, IL | not published | $334.92 – $381.16 |
| HCA HOUSTON PEARLAND | Pearland, TX | not published | $964.55 – $964.55 |
| Ascension Columbia St. Mary's Hospital - Ozaukee Campus (Columbia St. Mary's Hospital Milwaukee, Inc.) | Mequon, WI | not published | $156.55 – $156.55 |
| Lincoln Health | Damariscotta, ME | not published | $132.65 – $132.65 |
| Stephens Memorial Hospital | Norway, ME | not published | $132.65 – $132.65 |
| HCA FLORIDA NORTH FLORIDA HOSPITAL | NEWBERRY, FL | not published | $107.35 – $113.00 |
| Ascension Saint Alexius Women And Children's Hospital (Ascension St. Alexius Medical Center) | Hoffman Estates, IL | not published | $202.09 – $366.85 |
| Ascension St. Vincent's Clay County (St. Vincent's Medical Center, Inc.) | Middleburg, FL | not published | $247.75 – $247.75 |
| Ascension Saint Joseph - Chicago (Presence Chicago Hospital Network) | Chicago, IL | not published | $136.95 – $202.52 |
| Ascension Alexian Brothers Rehabilitation Hospital (Alexian Brothers Medical Center) | Elk Grove Village, IL | not published | $202.09 – $366.85 |
| Ascension Alexian Brothers Behavioral Health Hospital | Hoffman Estates, IL | not published | $214.14 – $366.85 |
| Ascension St. Vincent's Southside (St. Luke's-St. Vincent's HealthCare, Inc.) | Jacksonville, FL | not published | $247.75 – $247.75 |
| North Central Bronx | Bronx, NY | not published | $72.00 – $315.45 |
| Ascension St. Vincent's Riverside (St. Vincent's Medical Center, Inc.) | Jacksonville, FL | not published | $247.75 – $247.75 |
| Ascension St. Vincent's St. Johns County (St. Vincent's Health System, Inc.) | Saint Johns, FL | not published | $247.75 – $247.75 |
| Ascension Saint Thomas Hickman | Centerville, TN | not published | $90.46 – $90.46 |
| Ascension Saint Thomas Rutherford | Murfreesboro, TN | not published | $83.58 – $90.46 |