APC 09528
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
Plt, aph/pher, l/r, cmv-n
Low
$246
Average
$290
Median
$283
High
$402
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
14 payers; the 90th percentile is 1.4× 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 | 81 | $243 | $242 | $9 | 4% | — | $188 – $250 |
| 2 | Caresource fee schedule · outpatient | 15 | $250 | $250 | — | — | — | $250 – $250 |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +2 other terms | 6 | $250 | $250 | — | — | — | $250 – $250 |
| 4 | Aetna facility · fee schedule · outpatient · +1 other terms | 5 | $234 | $266 | $59 | 22% | — | $234 – $396 |
| 5 | Medicare facility · fee schedule · outpatient · +1 other terms | 4 | $246 | $246 | — | — | — | $246 – $246 |
| 6 | Medica facility · fee schedule · outpatient | 3 | $256 | $256 | — | — | — | $256 – $256 |
| 7 | Tricare fee schedule · both · +1 other terms | 2 | $252 | $252 | $56 | 22% | — | $165 – $306 |
| 8 | Ambetter facility · fee schedule · outpatient | 1 | $376 | $376 | — | — | — | $376 – $376 |
| 9 | Cigna fee schedule · both | 1 | $306 | $306 | — | — | — | $306 – $306 |
| 10 | Devoted facility · fee schedule · outpatient | 1 | $282 | $282 | — | — | — | $282 – $282 |
| 11 | Optum fee schedule · both | 1 | $306 | $306 | — | — | — | $306 – $306 |
| 12 | Oscar facility · fee schedule · outpatient | 1 | $402 | $402 | — | — | — | $402 – $402 |
| 13 | UnitedHealthcare fee schedule · both · +1 other terms | 1 | $306 | $306 | — | — | — | $306 – $306 |
| 14 | WellCare fee schedule · both · +1 other terms | 1 | $306 | $306 | — | — | — | $306 – $306 |
← Hospitals reporting APC 09528 · Snapshot 20261111T120946Z-9134e7f7