APC 05504
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 4 Extraocular, Repa
Low
$3.9k
Average
$5.1k
Median
$4.1k
High
$12.0k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
16 payers; the 90th percentile is 1.8× 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 | $3.9k | $4.0k | $123 | 3% | — | $2.9k – $4.2k |
| 2 | Caresource fee schedule · outpatient | 20 | $4.0k | $4.0k | $24 | 1% | — | $4.0k – $4.0k |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +1 other terms | 11 | $3.8k | $3.9k | $30 | 1% | — | $3.8k – $3.9k |
| 4 | Medicare facility · fee schedule · outpatient · +2 other terms | 7 | $4.0k | $4.2k | $536 | 13% | — | $3.5k – $4.9k |
| 5 | Aetna fee schedule · outpatient · +2 other terms | 5 | $4.0k | $4.0k | $44 | 1% | — | $3.9k – $4.0k |
| 6 | Clover fee schedule · outpatient | 5 | $4.1k | $4.1k | $25 | 1% | — | $4.1k – $4.1k |
| 7 | Kaiser fee schedule · outpatient | 5 | $4.0k | $4.0k | $25 | 1% | — | $4.0k – $4.0k |
| 8 | Molina facility · fee schedule · outpatient | 5 | $5.1k | $4.9k | $579 | 12% | — | $4.2k – $5.5k |
| 9 | UnitedHealthcare fee schedule · outpatient · +3 other terms | 5 | $3.9k | $3.9k | $24 | 1% | — | $3.9k – $3.9k |
| 10 | WellCare fee schedule · outpatient · +2 other terms | 5 | $4.0k | $4.0k | $25 | 1% | — | $4.0k – $4.0k |
| 11 | Ambetter facility · fee schedule · outpatient | 2 | $7.6k | $7.6k | — | — | — | $7.6k – $7.6k |
| 12 | Amerihealth Caritas facility · fee schedule · outpatient | 2 | $6.5k | $6.5k | $2.4k | 37% | — | $4.1k – $8.8k |
| 13 | Cigna facility · fee schedule · outpatient · +1 other terms | 2 | $12.1k | $12.1k | $4.4k | 36% | — | $4.2k – $16.0k |
| 14 | Devoted facility · fee schedule · outpatient | 2 | $4.1k | $4.1k | — | — | — | $4.1k – $4.1k |
| 15 | Tricare fee schedule · both · +1 other terms | 2 | $4.1k | $4.1k | $841 | 21% | — | $2.7k – $4.9k |
| 16 | Optum fee schedule · both | 1 | $4.9k | $4.9k | — | — | — | $4.9k – $4.9k |
← Hospitals reporting APC 05504 · Snapshot 20261111T120946Z-9134e7f7