APC 5721
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
Level 1 Diagnostic Tests and Related Services
Low
$103
Average
$273
Median
$138
High
$2.1k
Each hospital's average Optum rate, under the methodology and billing class chosen below.
74 hospitals; the 90th percentile is 4.5× 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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74 hospital rates
iThe hospitals that file a Optum 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 | Affinity Hospital LLC Birmingham, AL facility · fee schedule · outpatient | 1 | $118 | $118 | — | — | — | $118 – $118 |
| 2 | Altru Hospital Grand Forks, ND facility · other · outpatient | 1 | $168 | $168 | — | — | 137 | $168 – $168 |
| 3 | Altru Hospital Devils Lake Devils Lake, ND facility · other · outpatient | 1 | $168 | $168 | — | — | 137 | $168 – $168 |
| 4 | Bluffton Health System LLC Bluffton, IN facility · per diem · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 5 | Brandon HMA LLC Brandon, MS facility · fee schedule · outpatient | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 6 | CRAWFORD LONG HOSPITAL Atlanta, GA facility · other · outpatient | 1 | $155 | $155 | — | — | 36 | $155 – $155 |
| 7 | Campbell County HMA, LLC LaFollette, TN facility · fee schedule · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 8 | Childrens Hospital of Los Angeles Angeles, CA facility · fee schedule · outpatient | 1 | $217 | $217 | — | — | — | $217 – $217 |
| 9 | Clinton Memorial Hospital Wilmington, OH other · outpatient | 1 | $103 | $103 | — | — | 1–10 | $103 – $103 |
| 10 | Cocke County HMA, LLC Newport, TN facility · per diem · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 11 | DEKALB MEDICAL CENTER, INC Lithonia, GA facility · other · outpatient | 1 | $156 | $156 | — | — | 1–10 | $156 – $156 |
| 12 | DEKALB MEDICAL CENTER, INC Decatur, GA facility · other · outpatient | 1 | $156 | $156 | — | — | 13 | $156 – $156 |
| 13 | Dana-Farber Cancer Institute Boston, MA other · outpatient | 2 | $1.3k | $1.3k | $846 | 64% | 2–20 | $471 – $2.2k |
| 14 | Dupont Hospital LLC Wayne, IN facility · per diem · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
| 15 | Durant HMA LLC Durant, OK facility · per diem · outpatient | 1 | $124 | $124 | — | — | — | $124 – $124 |
| 16 | EHCA JOHN'S CREEK, LLC Johns Creek, GA facility · other · outpatient | 1 | $156 | $156 | — | — | 1–10 | $156 – $156 |
| 17 | EMORY UNIVERSITY Atlanta, GA facility · other · outpatient | 1 | $156 | $156 | — | — | 35 | $156 – $156 |
| 18 | East Georgia Regional Medical Center LLC Statesboro, GA facility · per diem · outpatient | 1 | $123 | $123 | — | — | — | $123 – $123 |
| 19 | Foley Hospital Company LLC Foley, AL facility · fee schedule · outpatient | 1 | $122 | $122 | — | — | — | $122 – $122 |
| 20 | Gadsden Regional Medical Center LLC Gadsden, AL facility · fee schedule · outpatient | 1 | $115 | $115 | — | — | — | $115 – $115 |
| 21 | HENRICO DOCTORS HOSPITAL - FOREST MECHANICSVILLE, VA fee schedule · outpatient | 1 | $129 | $129 | — | — | — | $129 – $129 |
| 22 | HMA Santa Rosa Medical Center LLC Milton, FL facility · per diem · outpatient | 1 | $134 | $134 | — | — | — | $134 – $134 |
| 23 | Houston Methodist Baytown Hospital Baytown, TX other · outpatient | 1 | $117 | $117 | — | — | 1–10 | $117 – $117 |
| 24 | Houston Methodist The Woodlands Hospital The Woodlands, TX other · outpatient | 1 | $1.1k | $1.1k | — | — | 1–10 | $1.1k – $1.1k |
| 25 | IOM Health System LP Fort Wayne, IN facility · per diem · outpatient | 1 | $136 | $136 | — | — | — | $136 – $136 |
← Payers reporting APC 5721 · Snapshot 20261111T120946Z-9134e7f7