APC 05522
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
CT EXTREMITY UPPER UNENHANCED
Low
$79
Average
$171
Median
$124
High
$491
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
27 payers; the 90th percentile is 3.3× 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 | Medical Mutual facility · other · outpatient | 2 | $361 | $358 | $31 | 9% | 1,297–1,963 | $330 – $392 |
| 2 | Aetna Better Health facility · other · outpatient · +1 other terms | 4 | $62 | $62 | — | — | 14–140 | $62 – $62 |
| 3 | Humana fee schedule · outpatient · +2 other terms | 86 | $104 | $106 | $2 | 2% | — | $76 – $111 |
| 4 | Caresource fee schedule · outpatient · +1 other terms | 20 | $107 | $107 | $1 | 1% | — | $106 – $108 |
| 5 | UnitedHealthcare facility · fee schedule · outpatient · +4 other terms | 18 | $119 | $224 | $179 | 80% | — | $48 – $754 |
| 6 | Aetna facility · fee schedule · outpatient · +4 other terms | 15 | $102 | $118 | $43 | 37% | — | $48 – $324 |
| 7 | Medicare facility · fee schedule · outpatient · +2 other terms | 14 | $108 | $130 | $239 | 184% | — | $49 – $3.5k |
| 8 | Blue Cross Blue Shield fee schedule · outpatient · +4 other terms | 11 | $100 | $104 | $1 | 1% | — | $100 – $104 |
| 9 | Molina facility · fee schedule · outpatient · +1 other terms | 8 | $146 | $169 | $313 | 185% | — | $97 – $3.6k |
| 10 | Anthem facility · fee schedule · outpatient | 5 | $379 | $328 | $145 | 44% | — | $97 – $520 |
| 11 | Clover fee schedule · outpatient | 5 | $110 | $109 | $1 | 1% | — | $108 – $110 |
| 12 | Kaiser fee schedule · outpatient · +2 other terms | 5 | $108 | $107 | $1 | 1% | — | $106 – $108 |
| 13 | WellCare fee schedule · outpatient · +2 other terms | 5 | $108 | $107 | $1 | 1% | — | $106 – $108 |
| 14 | Ambetter facility · fee schedule · outpatient | 4 | $169 | $153 | $31 | 20% | — | $66 – $202 |
| 15 | Cigna facility · fee schedule · outpatient · +1 other terms | 4 | $227 | $248 | $74 | 30% | — | $112 – $337 |
| 16 | Devoted facility · fee schedule · outpatient | 4 | $106 | $105 | $4 | 4% | — | $52 – $109 |
| 17 | Tricare facility · fee schedule · outpatient · +1 other terms | 4 | $117 | $119 | $6 | 5% | — | $107 – $124 |
| 18 | Amerihealth Caritas facility · fee schedule · outpatient | 3 | $172 | $157 | $62 | 40% | — | $104 – $235 |
| 19 | Bcbs Mi facility · fee schedule · outpatient · +1 other terms | 3 | $103 | $103 | $2 | 2% | — | $100 – $106 |
| 20 | Carefirst facility · fee schedule · outpatient | 3 | $124 | $119 | $7 | 6% | — | $109 – $124 |
| 21 | Medica facility · fee schedule · outpatient | 3 | $112 | $112 | $0 | 0% | — | $112 – $112 |
| 22 | Bcbs Ca facility · fee schedule · outpatient | 2 | $416 | $384 | $177 | 46% | — | $134 – $510 |
| 23 | MultiPlan facility · other · outpatient · +1 other terms | 2 | $171 | $171 | $9 | 5% | — | $153 – $175 |
| 24 | Cigna Healthspring facility · fee schedule · outpatient | 1 | $101 | $101 | $3 | 3% | — | $50 – $101 |
| 25 | Highmark facility · fee schedule · outpatient · +1 other terms | 1 | $101 | $101 | $7 | 7% | — | $92 – $108 |
← Hospitals reporting APC 05522 · Snapshot 20261111T120946Z-9134e7f7