APC 05692
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
TX/PROPH/DG ADDL SEQ IV INF
Low
$51
Average
$113
Median
$90
High
$265
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
27 payers; the 90th percentile is 3.1× 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 | $249 | $247 | $21 | 9% | 529–592 | $228 – $270 |
| 2 | Aetna Better Health facility · other · outpatient · +1 other terms | 4 | $39 | $39 | $9 | 24% | 4–40 | $17 – $43 |
| 3 | Humana fee schedule · outpatient · +2 other terms | 86 | $72 | $73 | $2 | 3% | — | $53 – $76 |
| 4 | Caresource fee schedule · outpatient · +1 other terms | 20 | $74 | $74 | $0 | 1% | — | $73 – $74 |
| 5 | UnitedHealthcare facility · fee schedule · outpatient · +4 other terms | 17 | $81 | $158 | $127 | 80% | — | $16 – $403 |
| 6 | Aetna facility · fee schedule · outpatient · +4 other terms | 15 | $70 | $85 | $37 | 44% | — | $64 – $223 |
| 7 | Medicare facility · fee schedule · outpatient · +2 other terms | 13 | $74 | $116 | $343 | 297% | — | $64 – $3.5k |
| 8 | Blue Cross Blue Shield fee schedule · outpatient · +4 other terms | 11 | $69 | $72 | $1 | 1% | — | $69 – $72 |
| 9 | Molina facility · fee schedule · outpatient · +1 other terms | 8 | $91 | $147 | $441 | 301% | — | $67 – $3.6k |
| 10 | Anthem facility · fee schedule · outpatient | 5 | $254 | $222 | $97 | 44% | — | $67 – $348 |
| 11 | Clover fee schedule · outpatient | 5 | $76 | $75 | $0 | 1% | — | $75 – $76 |
| 12 | Kaiser fee schedule · outpatient · +2 other terms | 5 | $74 | $74 | $0 | 1% | — | $73 – $74 |
| 13 | WellCare fee schedule · outpatient · +2 other terms | 5 | $74 | $74 | $0 | 1% | — | $73 – $74 |
| 14 | Ambetter facility · fee schedule · outpatient | 4 | $117 | $101 | $19 | 18% | — | $91 – $139 |
| 15 | Cigna facility · fee schedule · outpatient · +1 other terms | 4 | $224 | $221 | $65 | 29% | — | $78 – $293 |
| 16 | Devoted facility · fee schedule · outpatient | 4 | $73 | $72 | $3 | 4% | — | $69 – $75 |
| 17 | Tricare facility · fee schedule · outpatient · +1 other terms | 4 | $81 | $82 | $4 | 5% | — | $74 – $85 |
| 18 | Amerihealth Caritas facility · fee schedule · outpatient | 3 | $118 | $102 | $41 | 41% | — | $72 – $162 |
| 19 | Bcbs Mi facility · fee schedule · outpatient · +1 other terms | 3 | $71 | $71 | $1 | 2% | — | $69 – $73 |
| 20 | Carefirst facility · fee schedule · outpatient | 3 | $85 | $82 | $5 | 6% | — | $75 – $85 |
| 21 | Medica facility · fee schedule · outpatient | 3 | $77 | $77 | — | — | — | $77 – $77 |
| 22 | Bcbs Ca facility · fee schedule · outpatient | 2 | $286 | $265 | $122 | 46% | — | $92 – $351 |
| 23 | MultiPlan facility · other · outpatient · +1 other terms | 2 | $117 | $117 | $6 | 5% | — | $106 – $121 |
| 24 | Cigna Healthspring facility · fee schedule · outpatient | 1 | $69 | $69 | — | — | — | $69 – $69 |
| 25 | Highmark facility · fee schedule · outpatient · +1 other terms | 1 | $68 | $68 | $5 | 8% | — | $62 – $74 |
← Hospitals reporting APC 05692 · Snapshot 20261111T120946Z-9134e7f7