APC 05021
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
LEVEL I ED MINOR
Low
$50
Average
$294
Median
$107
High
$1.9k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
9 hospitals; the 90th percentile is 6.4× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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9 hospital rates
iThe hospitals that file a Molina rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Mercy Memorial Hospital Corporation Monroe, MI facility · other · outpatient | 1 | $50 | $50 | — | — | 1–10 | $50 – $50 |
| 2 | Bon Secours Community Hospital Jervis, NY facility · fee schedule · outpatient | 1 | $110 | $110 | — | — | — | $110 – $110 |
| 3 | Good Samaritan Hospital Suffern, NY facility · fee schedule · outpatient | 1 | $1.9k | $1.9k | $1.8k | 94% | — | $110 – $3.6k |
| 4 | HSA CGH LLC Coral Gables, FL facility · fee schedule · outpatient | 2 | $106 | $106 | $16 | 15% | — | $90 – $122 |
| 5 | HSA PGH LLC Hialeah, FL facility · fee schedule · outpatient | 2 | $106 | $106 | $16 | 15% | — | $90 – $122 |
| 6 | Hemet Global Medical Center Hemet, CA facility · fee schedule · outpatient | 2 | $107 | $107 | $1 | 1% | — | $106 – $108 |
| 7 | Memorial Hospital Fremont, OH facility · fee schedule · outpatient | 1 | $79 | $79 | — | — | — | $79 – $79 |
| 8 | St Anthony Community Hospital Warwick, NY facility · fee schedule · outpatient | 1 | $110 | $110 | — | — | — | $110 – $110 |
| 9 | Victor Valley Global Medical Center Victorville, CA facility · fee schedule · outpatient | 2 | $107 | $107 | $1 | 1% | — | $106 – $108 |
← Payers reporting APC 05021 · Snapshot 20261111T120946Z-9134e7f7