APC 1542

New technology procedure, level 5

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

New Technology - Level 5

Payers reporting APC 1542

Payer pricing summary

Low

$183

Average

$412

Median

$361

High

$979

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +2 other terms	174	$352	$352	$15	4%	—	$306 – $443
2	Humana fee schedule · outpatient · +2 other terms	161	$345	$363	$104	29%	—	$301 – $1.4k
3	Aetna fee schedule · outpatient · +2 other terms	155	$354	$359	$47	13%	—	$304 – $613
4	WellCare fee schedule · outpatient · +1 other terms	131	$355	$356	$17	5%	—	$307 – $434
5	Blue Cross Blue Shield fee schedule · outpatient · +2 other terms	125	$345	$352	$20	6%	—	$301 – $450
6	Devoted fee schedule · outpatient	122	$345	$345	$10	3%	—	$301 – $362
7	Cigna Healthspring fee schedule · outpatient	110	$362	$355	$15	4%	—	$345 – $383
8	Molina fee schedule · outpatient · +2 other terms	69	$507	$494	$189	38%	—	$325 – $904
9	Superior Healthplan fee schedule · outpatient	40	$362	$362	$0	0%	—	$362 – $362
10	Anthem fee schedule · outpatient · +1 other terms	31	$362	$357	$19	5%	—	$326 – $441
11	Oscar fee schedule · outpatient	27	$338	$383	$83	22%	—	$338 – $613
12	Amerihealth Caritas fee schedule · outpatient	17	$430	$420	$21	5%	—	$374 – $430
13	Cigna fee schedule · outpatient · +1 other terms	15	$351	$349	$9	3%	—	$331 – $365
14	Clover fee schedule · outpatient · +1 other terms	15	$362	$347	$17	5%	—	$316 – $362
15	Kaiser fee schedule · outpatient · +1 other terms	15	$369	$367	$4	1%	—	$358 – $369
16	Medicare case rate · outpatient	8	$319	$323	$8	2%	—	$319 – $342
17	Optum fee schedule · outpatient	8	$344	$515	$245	48%	—	$330 – $862
18	Ambetter case rate · outpatient · +2 other terms	7	$574	$576	$5	1%	—	$574 – $589
19	Tricare case rate · outpatient	7	$306	$306	—	—	—	$306 – $306
20	Excellus case rate · outpatient	5	$974	$979	$251	26%	—	$604 – $1.4k
21	Highmark case rate · outpatient	5	$428	$609	$228	38%	—	$428 – $1.0k
22	Sanford Health Plan case rate · outpatient	3	$508	$511	$52	10%	—	$425 – $585
23	Aetna Better Health facility · case rate · outpatient	1	$270	$270	$87	32%	—	$183 – $358
24	Magellan fee schedule · outpatient	1	$335	$335	—	—	—	$335 – $335
25	Medicaid facility · case rate · outpatient	1	$183	$183	—	—	—	$183 – $183