APC 05303
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
GSTRRPHY SUTR DUOL/GSTR ULCR
Low
$3.7k
Average
$5.6k
Median
$4.5k
High
$13.3k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
22 payers; the 90th percentile is 2.5× 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 · +2 other terms | 86 | $3.8k | $3.9k | $154 | 4% | — | $2.8k – $4.1k |
| 2 | Caresource fee schedule · outpatient | 20 | $4.0k | $4.0k | $22 | 1% | — | $3.9k – $4.0k |
| 3 | UnitedHealthcare facility · fee schedule · outpatient · +3 other terms | 15 | $4.5k | $6.9k | $5.6k | 81% | — | $3.4k – $21.6k |
| 4 | Blue Cross Blue Shield fee schedule · outpatient · +3 other terms | 11 | $3.7k | $3.8k | $40 | 1% | — | $3.7k – $3.9k |
| 5 | Medicare facility · fee schedule · outpatient · +2 other terms | 9 | $4.0k | $4.1k | $599 | 14% | — | $3.4k – $6.5k |
| 6 | Molina facility · fee schedule · outpatient · +1 other terms | 7 | $4.7k | $4.7k | $433 | 9% | — | $4.1k – $5.1k |
| 7 | Aetna facility · fee schedule · outpatient · +3 other terms | 6 | $4.6k | $4.5k | $918 | 20% | — | $3.4k – $6.1k |
| 8 | Clover fee schedule · outpatient | 5 | $4.0k | $4.0k | $25 | 1% | — | $4.0k – $4.0k |
| 9 | Kaiser fee schedule · outpatient · +2 other terms | 5 | $4.0k | $3.9k | $24 | 1% | — | $3.9k – $4.0k |
| 10 | WellCare fee schedule · outpatient · +2 other terms | 5 | $4.0k | $3.9k | $24 | 1% | — | $3.9k – $4.0k |
| 11 | Ambetter facility · fee schedule · outpatient | 4 | $6.3k | $7.0k | $931 | 13% | — | $4.9k – $7.4k |
| 12 | Cigna facility · fee schedule · outpatient · +1 other terms | 4 | $12.0k | $11.9k | $4.2k | 36% | — | $4.2k – $15.7k |
| 13 | Tricare facility · fee schedule · outpatient · +1 other terms | 4 | $4.3k | $4.4k | $238 | 5% | — | $3.9k – $4.6k |
| 14 | Carefirst facility · fee schedule · outpatient | 3 | $4.6k | $4.4k | $243 | 6% | — | $4.0k – $4.6k |
| 15 | Devoted facility · fee schedule · outpatient | 3 | $4.0k | $4.0k | $43 | 1% | — | $3.8k – $4.0k |
| 16 | MultiPlan facility · other · outpatient · +1 other terms | 3 | $6.5k | $11.4k | $10.6k | 93% | — | $6.5k – $35k |
| 17 | Amerihealth Caritas facility · fee schedule · outpatient | 2 | $6.3k | $6.3k | $2.3k | 37% | — | $4.0k – $8.7k |
| 18 | Bcbs Ca facility · fee schedule · outpatient | 2 | $14.2k | $13.3k | $6.8k | 51% | — | $4.9k – $18.8k |
| 19 | Aetna Better Health facility · fee schedule · outpatient | 1 | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
| 20 | Cigna Healthspring facility · fee schedule · outpatient | 1 | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 21 | Optum fee schedule · both | 1 | $4.8k | $4.8k | — | — | — | $4.8k – $4.8k |
| 22 | Oscar facility · fee schedule · outpatient | 1 | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
← Hospitals reporting APC 05303 · Snapshot 20261111T120946Z-9134e7f7