APC 05671
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
GROSS & MICROSCOPIC LEVEL IV
Low
$46
Average
$57
Median
$59
High
$65
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
6 hospitals; the 90th percentile is 1.3× 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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6 hospital rates
iThe hospitals that file a Tricare 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 | ACADIAN MEDICAL CENTER EUNICE, LA fee schedule · both | 9 | $49 | $46 | $4 | 9% | — | $39 – $49 |
| 2 | BERTRAND CHAFFEE HOSPITAL SPRINGVILLE, NY fee schedule · both | 3 | $65 | $65 | — | — | — | $65 – $65 |
| 3 | MedStar Georgetown Hospital Washington, DC facility · fee schedule · outpatient | 1 | $62 | $62 | — | — | — | $62 – $62 |
| 4 | MedStar Washington Hospital Center NW, WA facility · fee schedule · outpatient | 1 | $62 | $62 | — | — | — | $62 – $62 |
| 5 | National Rehabilitation Hospital Washington, WA facility · fee schedule · outpatient | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 6 | University of Texas MD Anderson Cancer Center The University of Texas M D Anderson Cancer Center Houston, TX facility · fee schedule · outpatient | 1 | $53 | $53 | — | — | — | $53 – $53 |
← Payers reporting APC 05671 · Snapshot 20261111T120946Z-9134e7f7