APC 01565
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 28
Low
$4.9k
Average
$5.8k
Median
$5.9k
High
$6.4k
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 | $5.1k | $5.0k | $240 | 5% | — | $3.8k – $5.4k |
| 2 | Caresource fee schedule · outpatient | 15 | $5.3k | $5.3k | — | — | — | $5.3k – $5.3k |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +1 other terms | 6 | $4.9k | $4.9k | — | — | — | $4.9k – $4.9k |
| 4 | Medicare fee schedule · both | 2 | $5.6k | $5.5k | $813 | 15% | — | $4.8k – $6.4k |
| 5 | Tricare fee schedule · both · +1 other terms | 2 | $5.5k | $5.5k | $969 | 18% | — | $3.8k – $6.4k |
| 6 | Aetna fee schedule · both | 1 | $6.4k | $6.4k | — | — | — | $6.4k – $6.4k |
| 7 | Cigna fee schedule · both | 1 | $6.4k | $6.4k | — | — | — | $6.4k – $6.4k |
| 8 | Optum fee schedule · both | 1 | $6.4k | $6.4k | — | — | — | $6.4k – $6.4k |
| 9 | UnitedHealthcare fee schedule · both | 1 | $6.4k | $6.4k | — | — | — | $6.4k – $6.4k |
| 10 | WellCare fee schedule · both | 1 | $6.4k | $6.4k | — | — | — | $6.4k – $6.4k |
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