APC 5034

Emergency department visit, level 4 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 4 Type B ED Visits

Payers reporting APC 5034

Payer pricing summary

Low

$149

Average

$340

Median

$294

High

$755

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +3 other terms	155	$276	$279	$42	15%	—	$234 – $500
2	Devoted fee schedule · outpatient	122	$266	$295	$73	25%	—	$246 – $483
3	Humana fee schedule · outpatient · +3 other terms	114	$266	$266	$12	5%	—	$232 – $340
4	UnitedHealthcare fee schedule · outpatient · +3 other terms	106	$276	$272	$14	5%	—	$235 – $300
5	Blue Cross Blue Shield fee schedule · outpatient · +3 other terms	80	$266	$279	$74	26%	—	$232 – $859
6	Molina fee schedule · outpatient · +3 other terms	52	$571	$517	$173	34%	—	$251 – $697
7	Superior Healthplan fee schedule · outpatient	43	$345	$310	$33	11%	—	$279 – $345
8	Cigna Healthspring fee schedule · outpatient	39	$271	$269	$8	3%	—	$266 – $295
9	Anthem fee schedule · outpatient · +1 other terms	31	$279	$279	$15	5%	—	$251 – $340
10	Oscar fee schedule · outpatient	17	$260	$303	$91	30%	—	$260 – $500
11	WellCare case rate · outpatient · +2 other terms	16	$330	$313	$30	10%	—	$278 – $353
12	Kaiser fee schedule · outpatient · +1 other terms	15	$284	$285	$3	1%	—	$279 – $291
13	Ambetter case rate · outpatient · +2 other terms	12	$474	$547	$92	17%	—	$468 – $655
14	Clover case rate · outpatient	12	$274	$292	$25	8%	—	$270 – $321
15	Cigna case rate · outpatient · +1 other terms	11	$771	$651	$336	52%	—	$318 – $1.3k
16	Medicare case rate · outpatient · +2 other terms	8	$260	$263	$6	2%	—	$260 – $278
17	Optum fee schedule · outpatient	8	$266	$398	$188	47%	—	$265 – $664
18	Tricare case rate · outpatient · +1 other terms	7	$250	$250	—	—	—	$250 – $250
19	Excellus case rate · outpatient	5	$750	$755	$193	26%	—	$465 – $1.1k
20	Highmark case rate · outpatient	5	$330	$469	$176	38%	—	$330 – $775
21	Sanford Health Plan case rate · outpatient	3	$414	$417	$42	10%	—	$346 – $477
22	Aetna Better Health facility · case rate · outpatient	1	$220	$220	$71	32%	—	$149 – $291
23	Magellan fee schedule · outpatient	1	$258	$258	—	—	—	$258 – $258
24	Medicaid facility · case rate · outpatient	1	$149	$149	—	—	—	$149 – $149