APC 5161

Level 1 ENT Procedures

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.

Generation details were not recorded for this description.

Original text from hospital filings

Payers reporting APC 5161

Payer pricing summary

Low

$166

Average

$2.2k

Median

$784

High

$32.1k

Payer rate distribution

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#
1	Caresource other · outpatient · +3 other terms	17	$1.9k	$1.8k	$1.7k	92%	875–1,046	$36 – $7.8k
2	Excellus case rate · outpatient · +1 other terms	5	$672	$676	$173	26%	270–288	$417 – $984
3	Cigna other · outpatient · +6 other terms	39	$8.6k	$10.3k	$8.3k	80%	91–469	$0 – $25k
4	First Health other · outpatient · +2 other terms	3	$26.1k	$20.0k	$8.5k	42%	29–47	$8.0k – $26.1k
5	Medical Mutual other · outpatient · +4 other terms	8	$2.0k	$2.3k	$2.9k	125%	8–80	$242 – $10.2k
6	Highmark case rate · outpatient · +2 other terms	5	$296	$420	$158	38%	4–40	$296 – $694
7	Ucare facility · other · outpatient	2	$392	$392	$153	39%	2–20	$238 – $545
8	Healthcare Highways other · outpatient	1	$7.3k	$7.3k	—	—	1–10	$7.3k – $7.3k
9	Medicaid other · outpatient · +1 other terms	1	$211	$211	—	—	1–10	$211 – $211
10	MultiPlan percent of total billed charges · outpatientfrom % of charges	1	$263	$263	—	—	1–10	$263 – $263
11	Phcs percent of total billed charges · outpatientfrom % of charges	1	$32.1k	$32.1k	—	—	1–10	$32.1k – $32.1k
12	UnitedHealthcare fee schedule · outpatient · +9 other terms	176	$243	$377	$381	101%	—	$211 – $1.5k
13	Humana fee schedule · outpatient · +8 other terms	162	$238	$250	$71	29%	—	$208 – $989
14	Aetna fee schedule · outpatient · +9 other terms	156	$242	$246	$30	12%	—	$210 – $406
15	WellCare fee schedule · outpatient · +4 other terms	132	$245	$246	$12	5%	—	$212 – $300
16	Blue Cross Blue Shield fee schedule · outpatient · +8 other terms	127	$238	$253	$90	35%	—	$208 – $1.4k
17	Devoted fee schedule · outpatient · +3 other terms	122	$238	$238	$7	3%	—	$208 – $250
18	Cigna Healthspring fee schedule · outpatient · +1 other terms	110	$250	$245	$10	4%	—	$238 – $265
19	Molina fee schedule · outpatient · +7 other terms	69	$350	$340	$131	39%	—	$225 – $624
20	Superior Healthplan fee schedule · outpatient	40	$250	$250	$0	0%	—	$250 – $250
21	Anthem fee schedule · outpatient · +7 other terms	31	$250	$245	$15	6%	—	$225 – $305
22	Oscar fee schedule · outpatient · +3 other terms	27	$233	$262	$52	20%	—	$233 – $406
23	Medicare facility · fee schedule · outpatient · +2 other terms	24	$260	$1.7k	$2.5k	150%	—	$94 – $12.8k
24	Optum facility · per diem · outpatient · +4 other terms	23	$251	$500	$2.2k	444%	—	$214 – $25.5k
25	Ambetter facility · fee schedule · outpatient · +5 other terms	19	$426	$1.7k	$3.2k	184%	—	$108 – $14.6k

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