APC 5571
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 Imaging with Contrast
Low
$156
Average
$380
Median
$178
High
$2.7k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
35 hospitals; the 90th percentile is 5.8× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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35 hospital rates
iThe hospitals that file a Tricare rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Aspirus Eagle River Hospital Eagle River, WI other · outpatient | 1 | $1.2k | $1.2k | — | — | 1–10 | $1.2k – $1.2k |
| 2 | Aspirus Langlade Hospital Antigo, WI other · outpatient | 1 | $2.7k | $2.7k | — | — | 1–10 | $2.7k – $2.7k |
| 3 | Aspirus Plover Hospital Stevens Point, WI other · outpatient | 1 | $413 | $413 | — | — | 1–10 | $413 – $413 |
| 4 | Aspirus Rhinelander Hospital Rhinelander, WI other · outpatient | 1 | $181 | $181 | — | — | 1–10 | $181 – $181 |
| 5 | Aspirus St. Luke’s Hospital Duluth, MN other · outpatient | 1 | $305 | $305 | — | — | 1–10 | $305 – $305 |
| 6 | Aspirus Stevens Point Hospital Stevens Point, WI other · outpatient | 1 | $169 | $169 | — | — | 1–10 | $169 – $169 |
| 7 | Aspirus Wausau Hospital Wausau, WI other · outpatient | 1 | $169 | $169 | — | — | 13 | $169 – $169 |
| 8 | Aspirus Wisconsin Rapids Hospital Wisconsin Rapids, WI other · outpatient | 1 | $413 | $413 | — | — | 1–10 | $413 – $413 |
| 9 | CORNING HOSPITAL Corning, NY facility · fee schedule · outpatient | 1 | $178 | $178 | — | — | — | $178 – $178 |
| 10 | Canton-Potsdam Hospital Potsdam, NY facility · other · outpatient | 1 | $226 | $226 | — | — | 1–10 | $226 – $226 |
| 11 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · other · outpatient | 1 | $246 | $246 | — | — | 1–10 | $246 – $246 |
| 12 | El Camino Hospital Los Gatos, CA other · outpatient | 1 | $261 | $261 | — | — | 1–10 | $261 – $261 |
| 13 | GUTHRIE CORTLAND MEDICAL CENTER Cortland, NY facility · fee schedule · outpatient | 1 | $178 | $178 | — | — | — | $178 – $178 |
| 14 | Gouverneur Hospital Gouverneur, NY facility · other · outpatient | 1 | $1.2k | $1.2k | — | — | 1–10 | $1.2k – $1.2k |
| 15 | Logan Health - Whitefish Whitefish, MT other · outpatient | 1 | $1.3k | $1.3k | — | — | 1–10 | $1.3k – $1.3k |
| 16 | Logan Health Medical Center Kalispell, MT other · outpatient | 1 | $350 | $350 | — | — | 1–10 | $350 – $350 |
| 17 | Massena Hospital Inc Massena, NY facility · other · outpatient | 1 | $395 | $395 | — | — | 1–10 | $395 – $395 |
| 18 | McLeod Health Dillon, SC case rate · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 19 | McLeod Health Cheraw, SC case rate · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 20 | McLeod Health Manning, SC case rate · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 21 | McLeod Health Florence, SC case rate · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 22 | McLeod Health Beach, SC case rate · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 23 | McLeod Health Loris, SC case rate · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 24 | McLeod Health River, SC case rate · outpatient | 1 | $156 | $156 | — | — | — | $156 – $156 |
| 25 | Metrohealth System Parma, OH facility · other · outpatient | 1 | $165 | $165 | — | — | 1–10 | $165 – $165 |
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