APC 5031

Level 1 emergency department visit, type B

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

Level 1 Type B ED Visits

Payers reporting APC 5031

Payer pricing summary

Low

$44

Average

$97

Median

$84

High

$212

Payer rate distribution

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Filter by billing class

#
1	Aetna fee schedule · outpatient · +3 other terms	155	$78	$79	$13	16%	—	$66 – $147
2	Devoted fee schedule · outpatient	122	$75	$83	$21	25%	—	$69 – $136
3	Humana fee schedule · outpatient · +3 other terms	114	$75	$75	$4	5%	—	$65 – $96
4	UnitedHealthcare fee schedule · outpatient · +3 other terms	106	$78	$77	$5	7%	—	$66 – $88
5	Blue Cross Blue Shield fee schedule · outpatient · +3 other terms	80	$75	$79	$18	23%	—	$65 – $219
6	Molina fee schedule · outpatient · +3 other terms	52	$161	$147	$47	32%	—	$71 – $196
7	Superior Healthplan fee schedule · outpatient	43	$97	$87	$9	11%	—	$78 – $97
8	Cigna Healthspring fee schedule · outpatient	39	$76	$76	$2	3%	—	$75 – $83
9	Anthem fee schedule · outpatient · +1 other terms	31	$78	$79	$5	6%	—	$71 – $96
10	Oscar fee schedule · outpatient	17	$73	$86	$28	33%	—	$73 – $147
11	WellCare case rate · outpatient · +2 other terms	16	$93	$91	$8	9%	—	$82 – $99
12	Kaiser fee schedule · outpatient · +1 other terms	15	$80	$81	$2	2%	—	$78 – $86
13	Ambetter case rate · outpatient · +2 other terms	12	$140	$161	$27	17%	—	$138 – $193
14	Clover case rate · outpatient	12	$81	$86	$7	8%	—	$80 – $95
15	Cigna case rate · outpatient · +1 other terms	11	$217	$185	$93	50%	—	$94 – $371
16	Medicare case rate · outpatient · +2 other terms	8	$77	$77	$2	2%	—	$77 – $82
17	Optum fee schedule · outpatient	8	$76	$112	$53	47%	—	$74 – $187
18	Tricare case rate · outpatient · +1 other terms	7	$73	$73	—	—	—	$73 – $73
19	Excellus case rate · outpatient	5	$211	$212	$54	26%	—	$131 – $309
20	Highmark case rate · outpatient	5	$93	$132	$49	38%	—	$93 – $218
21	Sanford Health Plan case rate · outpatient	3	$122	$123	$12	10%	—	$102 – $140
22	Aetna Better Health facility · case rate · outpatient	1	$65	$65	$21	32%	—	$44 – $86
23	Magellan fee schedule · outpatient	1	$73	$73	—	—	—	$73 – $73
24	Medicaid facility · case rate · outpatient	1	$44	$44	—	—	—	$44 – $44