APC 09104
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
Antithymocyte globuln rab
Low
$1.0k
Average
$2.8k
Median
$2.9k
High
$5.2k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
12 payers; the 90th percentile is 4.9× 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 · +1 other terms | 86 | $979 | $1.4k | $1.3k | 91% | — | $757 – $5.3k |
| 2 | Caresource fee schedule · outpatient | 20 | $1.0k | $2.1k | $1.8k | 88% | — | $1.0k – $5.2k |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +1 other terms | 11 | $1.0k | $3.2k | $2.0k | 63% | — | $1.0k – $5.0k |
| 4 | Aetna fee schedule · outpatient · +1 other terms | 5 | $5.1k | $5.1k | $25 | 0% | — | $5.1k – $5.1k |
| 5 | Clover fee schedule · outpatient | 5 | $5.0k | $5.0k | — | — | — | $5.0k – $5.0k |
| 6 | Kaiser fee schedule · outpatient · +1 other terms | 5 | $5.2k | $5.2k | — | — | — | $5.2k – $5.2k |
| 7 | Medicare fee schedule · outpatient · +1 other terms | 5 | $5.0k | $5.0k | — | — | — | $5.0k – $5.0k |
| 8 | UnitedHealthcare fee schedule · outpatient · +1 other terms | 5 | $5.0k | $5.0k | — | — | — | $5.0k – $5.0k |
| 9 | WellCare fee schedule · outpatient | 5 | $5.2k | $5.2k | — | — | — | $5.2k – $5.2k |
| 10 | Carefirst facility · fee schedule · outpatient | 3 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 11 | Tricare facility · fee schedule · outpatient | 3 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 12 | Medica facility · fee schedule · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
← Hospitals reporting APC 09104 · Snapshot 20261111T120946Z-9134e7f7