APC 1295
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
Sm 153 lexidronam
Low
$2.3k
Average
$4.6k
Median
$3.8k
High
$15.8k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
29 payers; the 90th percentile is 2.1× 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 | UnitedHealthcare fee schedule · outpatient · +3 other terms | 174 | $3.2k | $3.3k | $337 | 10% | — | $3.1k – $4.5k |
| 2 | Humana fee schedule · outpatient · +4 other terms | 161 | $3.2k | $3.3k | $927 | 28% | — | $3.0k – $12.6k |
| 3 | Aetna fee schedule · outpatient · +4 other terms | 155 | $3.2k | $3.4k | $802 | 23% | — | $3.1k – $7.6k |
| 4 | WellCare fee schedule · outpatient · +2 other terms | 131 | $3.3k | $3.3k | $174 | 5% | — | $3.2k – $4.5k |
| 5 | Blue Cross Blue Shield fee schedule · outpatient · +4 other terms | 126 | $3.2k | $3.6k | $2.2k | 61% | — | $3.1k – $25.9k |
| 6 | Devoted fee schedule · outpatient · +1 other terms | 122 | $3.2k | $3.2k | $10 | 0% | — | $3.2k – $3.3k |
| 7 | Cigna Healthspring fee schedule · outpatient · +1 other terms | 110 | $3.3k | $3.2k | $89 | 3% | — | $3.2k – $3.4k |
| 8 | Molina fee schedule · outpatient · +4 other terms | 69 | $4.7k | $4.7k | $1.7k | 37% | — | $3.2k – $8.3k |
| 9 | Superior Healthplan fee schedule · outpatient | 40 | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 10 | Anthem fee schedule · outpatient · +2 other terms | 31 | $3.2k | $3.4k | $466 | 14% | — | $3.2k – $4.4k |
| 11 | Oscar fee schedule · outpatient · +2 other terms | 27 | $3.1k | $3.7k | $1.4k | 37% | — | $3.1k – $7.6k |
| 12 | Amerihealth Caritas fee schedule · outpatient | 17 | $3.8k | $3.8k | $72 | 2% | — | $3.6k – $3.8k |
| 13 | Cigna fee schedule · outpatient · +2 other terms | 16 | $3.4k | $4.9k | $4.7k | 96% | — | $3.2k – $23.2k |
| 14 | Clover fee schedule · outpatient · +2 other terms | 15 | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 15 | Kaiser fee schedule · outpatient · +2 other terms | 15 | $3.2k | $3.4k | $391 | 12% | — | $3.2k – $4.4k |
| 16 | Ambetter case rate · outpatient · +3 other terms | 12 | $7.8k | $21.0k | $15.7k | 75% | — | $7.8k – $39.6k |
| 17 | Medicare case rate · outpatient · +2 other terms | 8 | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
| 18 | Optum fee schedule · outpatient · +1 other terms | 8 | $3.4k | $4.9k | $2.2k | 45% | — | $3.2k – $7.9k |
| 19 | Highmark case rate · outpatient · +2 other terms | 5 | $3.2k | $4.3k | $1.5k | 35% | — | $3.2k – $6.9k |
| 20 | Medica facility · fee schedule · outpatient | 5 | $3.3k | $3.3k | $15 | 0% | — | $3.3k – $3.3k |
| 21 | Tricare facility · fee schedule · outpatient | 5 | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
| 22 | Excellus case rate · outpatient | 4 | $4.3k | $4.4k | $1.6k | 37% | — | $3.2k – $7.1k |
| 23 | Sanford Health Plan case rate · outpatient | 3 | $6.3k | $6.3k | $638 | 10% | — | $5.2k – $7.2k |
| 24 | Aetna Better Health facility · case rate · outpatient | 1 | $3.3k | $3.3k | $1.1k | 32% | — | $2.3k – $4.4k |
| 25 | Bcbs Nj facility · other · outpatient | 1 | $3.2k | $3.2k | — | — | — | $3.2k – $3.2k |
← Hospitals reporting APC 1295 · Snapshot 20261111T120946Z-9134e7f7