APC 5521
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 without Contrast
Danbury, CT
Negotiated rates from the hospital’s own file: 6 payers, 14 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna all commercial plans other · outpatient | $83 | $83 | — | — | 674 | $83 – $83 |
| 2 | Blue Cross Blue Shield anthem tiered other commercial plan other · outpatient | $87 | $87 | — | — | 1–10 | $87 – $87 |
| 3 | Cigna all commercial plans other · outpatient | $92 | $92 | — | — | 435 | $92 – $92 |
| 4 | Blue Cross Blue Shield anthem medicare managed care plan other · outpatient | $98 | $98 | — | — | 107 | $98 – $98 |
| 5 | WellCare medicare managed care plan other · outpatient | $98 | $98 | — | — | 38 | $98 – $98 |
| 6 | Blue Cross Blue Shield anthem pathways exchange other · outpatient | $101 | $101 | — | — | 217 | $101 – $101 |
| 7 | UnitedHealthcare medicare managed care plan other · outpatient | $103 | $103 | — | — | 644 | $103 – $103 |
| 8 | Aetna medicare managed care plan other · outpatient | $104 | $104 | — | — | 484 | $104 – $104 |
| 9 | Cigna medicare managed care plan other · outpatient | $106 | $106 | — | — | 33 | $106 – $106 |
| 10 | Blue Cross Blue Shield anthem all commercial plans other · outpatient | $106 | $106 | — | — | 1,289 | $106 – $106 |
| 11 | UnitedHealthcare all commercial plans other · outpatient | $129 | $129 | — | — | 425 | $129 – $129 |
| 12 | Aetna whole health other commercial other · outpatient | $137 | $137 | — | — | 1–10 | $137 – $137 |
| 13 | MultiPlan all commercial plans other · outpatient | $251 | $251 | — | — | 1–10 | $251 – $251 |
| 14 | Blue Cross Blue Shield anthem prime other commercial plan other · outpatient | $672 | $672 | — | — | 1–10 | $672 – $672 |