APC 5231
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.
Original text from hospital filings
Level 1 ICD and Similar Procedures
Low
$11.7k
Average
$31.3k
Median
$25.9k
High
$68.7k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
33 payers; the 90th percentile is 2.5× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Cigna other · outpatient · +5 other terms | 28 | $40.0k | $50.1k | $35.4k | 71% | 34–340 | $285 – $128.5k |
| 2 | Excellus case rate · outpatient · +1 other terms | 5 | $63.1k | $63.5k | $16.3k | 26% | 24 | $39.2k – $92.4k |
| 3 | Medical Mutual other · outpatient · +2 other terms | 4 | $30.6k | $32.4k | $12.7k | 39% | 5–50 | $21.0k – $55.1k |
| 4 | Caresource other · outpatient · +2 other terms | 4 | $25.7k | $26.9k | $3.0k | 11% | 4–40 | $24.4k – $32.0k |
| 5 | Highmark case rate · outpatient · +2 other terms | 5 | $27.8k | $39.5k | $14.8k | 38% | 1–10 | $27.8k – $65.2k |
| 6 | UnitedHealthcare fee schedule · outpatient · +6 other terms | 176 | $22.8k | $22.5k | $1.8k | 8% | — | $14.0k – $28.8k |
| 7 | Humana fee schedule · outpatient · +6 other terms | 162 | $22.4k | $23.5k | $6.7k | 29% | — | $19.5k – $92.9k |
| 8 | Aetna fee schedule · outpatient · +6 other terms | 156 | $22.9k | $23.2k | $3.0k | 13% | — | $19.7k – $39.3k |
| 9 | WellCare fee schedule · outpatient · +4 other terms | 132 | $23.0k | $23.1k | $1.1k | 5% | — | $19.9k – $28.2k |
| 10 | Blue Cross Blue Shield fee schedule · outpatient · +7 other terms | 127 | $22.3k | $24.4k | $9.6k | 40% | — | $19.5k – $130.4k |
| 11 | Devoted fee schedule · outpatient · +3 other terms | 122 | $22.3k | $22.4k | $632 | 3% | — | $19.5k – $23.5k |
| 12 | Cigna Healthspring fee schedule · outpatient · +1 other terms | 110 | $23.5k | $23.0k | $968 | 4% | — | $22.3k – $24.9k |
| 13 | Molina fee schedule · outpatient · +5 other terms | 69 | $32.9k | $32.0k | $12.3k | 38% | — | $21.1k – $58.6k |
| 14 | Superior Healthplan fee schedule · outpatient | 40 | $23.5k | $23.5k | $14 | 0% | — | $23.5k – $23.5k |
| 15 | Anthem fee schedule · outpatient · +4 other terms | 31 | $23.5k | $23.1k | $1.3k | 6% | — | $21.1k – $28.6k |
| 16 | Oscar fee schedule · outpatient · +3 other terms | 27 | $21.9k | $24.8k | $5.3k | 21% | — | $21.9k – $39.3k |
| 17 | Medicare facility · fee schedule · outpatient · +2 other terms | 20 | $23.1k | $23.9k | $2.4k | 10% | — | $19.8k – $28.5k |
| 18 | Amerihealth Caritas fee schedule · outpatient · +2 other terms | 17 | $30.2k | $29.1k | $2.3k | 8% | — | $24.2k – $30.2k |
| 19 | Optum facility · per diem · outpatient · +4 other terms | 16 | $23.4k | $23.0k | $1.4k | 6% | — | $20.1k – $25.2k |
| 20 | Clover fee schedule · outpatient · +4 other terms | 15 | $23.5k | $22.5k | $1.1k | 5% | — | $20.5k – $23.5k |
| 21 | Kaiser fee schedule · outpatient · +4 other terms | 15 | $23.9k | $23.8k | $351 | 1% | — | $22.9k – $23.9k |
| 22 | Ambetter case rate · outpatient · +5 other terms | 12 | $37.2k | $43.0k | $7.2k | 17% | — | $36.8k – $51.5k |
| 23 | Tricare case rate · outpatient · +1 other terms | 7 | $19.6k | $19.6k | — | — | — | $19.6k – $19.6k |
| 24 | Medica facility · fee schedule · outpatient · +1 other terms | 5 | $23.8k | $23.9k | $173 | 1% | — | $23.5k – $24.0k |
| 25 | Bcbs Nj facility · other · outpatient | 3 | $23.3k | $23.3k | $57 | 0% | — | $23.3k – $23.4k |
← Hospitals reporting APC 5231 · Snapshot 20261111T120946Z-9134e7f7