APC 5851

Intensive outpatient program, 3 services per day

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-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Intensive Outpatient (3 s

Payers reporting APC 5851

Payer pricing summary

Low

$58

Average

$145

Median

$130

High

$357

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +2 other terms	174	$128	$127	$7	5%	—	$88 – $162
2	Humana fee schedule · outpatient · +2 other terms	161	$126	$131	$38	29%	—	$88 – $522
3	Aetna fee schedule · outpatient · +2 other terms	155	$128	$128	$14	11%	—	$88 – $195
4	WellCare fee schedule · outpatient · +1 other terms	131	$129	$130	$6	5%	—	$111 – $158
5	Blue Cross Blue Shield fee schedule · outpatient · +2 other terms	125	$126	$126	$10	8%	—	$106 – $164
6	Devoted fee schedule · outpatient	122	$126	$126	$4	3%	—	$110 – $132
7	Cigna Healthspring fee schedule · outpatient	110	$132	$129	$5	4%	—	$126 – $140
8	Molina fee schedule · outpatient · +2 other terms	69	$185	$178	$70	39%	—	$111 – $330
9	Superior Healthplan fee schedule · outpatient	40	$132	$132	$0	0%	—	$132 – $132
10	Anthem fee schedule · outpatient · +1 other terms	31	$132	$127	$11	8%	—	$111 – $161
11	Oscar fee schedule · outpatient	27	$123	$136	$22	16%	—	$123 – $195
12	Amerihealth Caritas fee schedule · outpatient	17	$157	$153	$8	5%	—	$136 – $157
13	Cigna fee schedule · outpatient · +1 other terms	15	$121	$120	$7	6%	—	$111 – $128
14	Clover fee schedule · outpatient · +1 other terms	15	$132	$126	$6	5%	—	$115 – $132
15	Kaiser fee schedule · outpatient · +1 other terms	15	$135	$132	$7	5%	—	$113 – $135
16	Medicare case rate · outpatient	8	$101	$102	$2	2%	—	$101 – $108
17	Optum fee schedule · outpatient	8	$126	$186	$91	49%	—	$105 – $314
18	Ambetter case rate · outpatient · +2 other terms	7	$182	$183	$2	1%	—	$182 – $187
19	Tricare case rate · outpatient	7	$97	$97	—	—	—	$97 – $97
20	Excellus case rate · outpatient	5	$355	$357	$91	26%	—	$220 – $520
21	Highmark case rate · outpatient	5	$156	$222	$83	38%	—	$156 – $367
22	Sanford Health Plan case rate · outpatient	3	$161	$162	$16	10%	—	$135 – $186
23	Aetna Better Health facility · case rate · outpatient	1	$86	$86	$28	32%	—	$58 – $113
24	Magellan fee schedule · outpatient	1	$122	$122	—	—	—	$122 – $122
25	Medicaid facility · case rate · outpatient	1	$58	$58	—	—	—	$58 – $58