APC 5035

Level 5 emergency department visit

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 5 Type B ED Visits

Payers reporting APC 5035

Payer pricing summary

Low

$211

Average

$506

Median

$436

High

$1.2k

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +3 other terms	155	$420	$428	$54	13%	—	$363 – $707
2	Devoted fee schedule · outpatient	122	$413	$416	$32	8%	—	$382 – $751
3	Humana fee schedule · outpatient · +3 other terms	114	$413	$410	$17	4%	—	$360 – $528
4	UnitedHealthcare fee schedule · outpatient · +3 other terms	106	$420	$414	$17	4%	—	$363 – $435
5	Blue Cross Blue Shield fee schedule · outpatient · +4 other terms	80	$412	$421	$89	21%	—	$360 – $1.1k
6	Molina fee schedule · outpatient · +3 other terms	52	$887	$788	$286	36%	—	$390 – $1.1k
7	Superior Healthplan fee schedule · outpatient	40	$536	$483	$51	11%	—	$433 – $536
8	Cigna Healthspring fee schedule · outpatient	39	$421	$418	$12	3%	—	$413 – $459
9	Anthem fee schedule · outpatient · +1 other terms	31	$433	$425	$25	6%	—	$390 – $528
10	Oscar fee schedule · outpatient	17	$404	$458	$115	25%	—	$404 – $707
11	WellCare case rate · outpatient · +2 other terms	16	$477	$454	$57	13%	—	$393 – $549
12	Kaiser fee schedule · outpatient · +1 other terms	15	$442	$438	$10	2%	—	$412 – $442
13	Ambetter case rate · outpatient · +2 other terms	12	$670	$774	$130	17%	—	$662 – $927
14	Clover case rate · outpatient	12	$387	$413	$35	8%	—	$382 – $455
15	Cigna case rate · outpatient · +1 other terms	11	$1.2k	$991	$543	55%	—	$450 – $2.0k
16	Medicare case rate · outpatient · +2 other terms	8	$368	$372	$9	2%	—	$368 – $394
17	Optum fee schedule · outpatient	8	$412	$615	$295	48%	—	$380 – $1.0k
18	Tricare case rate · outpatient · +1 other terms	7	$353	$353	—	—	—	$353 – $353
19	Excellus case rate · outpatient	5	$1.2k	$1.2k	$300	26%	—	$723 – $1.7k
20	Highmark case rate · outpatient	5	$513	$729	$273	38%	—	$513 – $1.2k
21	Sanford Health Plan case rate · outpatient	3	$585	$589	$60	10%	—	$489 – $674
22	Aetna Better Health facility · case rate · outpatient	1	$312	$312	$100	32%	—	$211 – $412
23	Magellan fee schedule · outpatient	1	$401	$401	—	—	—	$401 – $401
24	Medicaid facility · case rate · outpatient	1	$211	$211	—	—	—	$211 – $211