APC 9104
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
Antithymocyte globuln rabbit
Low
$523
Average
$1.2k
Median
$1.1k
High
$2.1k
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
27 payers; the 90th percentile is 1.4× 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 | UnitedHealthcare fee schedule · outpatient · +4 other terms | 174 | $1.0k | $1.0k | $24 | 2% | — | $929 – $1.1k |
| 2 | Humana fee schedule · outpatient · +4 other terms | 161 | $1.0k | $1.1k | $288 | 27% | — | $929 – $4.0k |
| 3 | Aetna fee schedule · outpatient · +4 other terms | 155 | $1.0k | $1.0k | $112 | 11% | — | $929 – $1.7k |
| 4 | WellCare fee schedule · outpatient · +2 other terms | 131 | $1.0k | $1.1k | $45 | 4% | — | $950 – $1.3k |
| 5 | Blue Cross Blue Shield fee schedule · outpatient · +4 other terms | 126 | $1.0k | $1.0k | $38 | 4% | — | $956 – $1.4k |
| 6 | Devoted fee schedule · outpatient · +1 other terms | 122 | $1.0k | $1.0k | $13 | 1% | — | $1.0k – $1.1k |
| 7 | Cigna Healthspring fee schedule · outpatient · +1 other terms | 110 | $1.1k | $1.0k | $29 | 3% | — | $1.0k – $1.1k |
| 8 | Molina fee schedule · outpatient · +3 other terms | 69 | $1.5k | $1.5k | $557 | 38% | — | $950 – $2.6k |
| 9 | Superior Healthplan fee schedule · outpatient | 40 | $1.1k | $1.1k | $11 | 1% | — | $1.1k – $1.1k |
| 10 | Anthem fee schedule · outpatient · +2 other terms | 31 | $1.0k | $1.0k | $31 | 3% | — | $950 – $1.1k |
| 11 | Oscar fee schedule · outpatient · +2 other terms | 27 | $1.0k | $1.1k | $204 | 19% | — | $990 – $1.7k |
| 12 | Amerihealth Caritas fee schedule · outpatient | 17 | $1.2k | $1.2k | $2 | 0% | — | $1.2k – $1.2k |
| 13 | Cigna fee schedule · outpatient · +2 other terms | 16 | $1.0k | $1.0k | $68 | 7% | — | $950 – $1.2k |
| 14 | Clover fee schedule · outpatient · +2 other terms | 15 | $1.1k | $1.1k | $13 | 1% | — | $1.1k – $1.1k |
| 15 | Kaiser fee schedule · outpatient · +2 other terms | 15 | $1.0k | $1.0k | $20 | 2% | — | $969 – $1.0k |
| 16 | Ambetter case rate · outpatient · +2 other terms | 12 | $1.8k | $2.0k | $196 | 10% | — | $1.8k – $2.2k |
| 17 | Medicare facility · fee schedule · outpatient · +2 other terms | 9 | $1.0k | $1.0k | $23 | 2% | — | $1.0k – $1.1k |
| 18 | Optum fee schedule · outpatient · +1 other terms | 8 | $1.0k | $1.5k | $741 | 48% | — | $999 – $2.6k |
| 19 | Highmark case rate · outpatient · +1 other terms | 5 | $999 | $1.4k | $479 | 35% | — | $999 – $2.2k |
| 20 | Tricare facility · fee schedule · outpatient | 5 | $999 | $999 | — | — | — | $999 – $999 |
| 21 | Excellus case rate · outpatient | 4 | $1.4k | $1.4k | $510 | 37% | — | $999 – $2.2k |
| 22 | Bcbs Nj facility · other · outpatient | 3 | $1.0k | $1.0k | — | — | — | $1.0k – $1.0k |
| 23 | Sanford Health Plan case rate · outpatient | 3 | $1.4k | $1.5k | $147 | 10% | — | $1.2k – $1.7k |
| 24 | Medica facility · fee schedule · outpatient | 2 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 25 | Aetna Better Health facility · case rate · outpatient | 1 | $771 | $771 | $248 | 32% | — | $523 – $1.0k |
← Hospitals reporting APC 9104 · Snapshot 20261111T120946Z-9134e7f7