APC 01505
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
New Technology - Level 5
Low
$326
Average
$389
Median
$397
High
$428
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
10 payers; the 90th percentile is 1.3× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Humana fee schedule · outpatient · +1 other terms | 81 | $341 | $333 | $16 | 5% | — | $251 – $363 |
| 2 | Caresource fee schedule · outpatient | 15 | $352 | $352 | — | — | — | $352 – $352 |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +1 other terms | 6 | $330 | $330 | — | — | — | $330 – $330 |
| 4 | Medicare fee schedule · both | 2 | $373 | $366 | $54 | 15% | — | $319 – $428 |
| 5 | Tricare fee schedule · both · +1 other terms | 2 | $366 | $366 | $65 | 18% | — | $255 – $428 |
| 6 | Aetna fee schedule · both | 1 | $428 | $428 | — | — | — | $428 – $428 |
| 7 | Cigna fee schedule · both | 1 | $428 | $428 | — | — | — | $428 – $428 |
| 8 | Optum fee schedule · both | 1 | $428 | $428 | — | — | — | $428 – $428 |
| 9 | UnitedHealthcare fee schedule · both | 1 | $428 | $428 | — | — | — | $428 – $428 |
| 10 | WellCare fee schedule · both | 1 | $428 | $428 | — | — | — | $428 – $428 |
← Hospitals reporting APC 01505 · Snapshot 20261111T120946Z-9134e7f7