APC 5522
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 2 Imaging without Contrast
Dublin, OH
See all hospitals reporting APC 5522 →Price type
Dublin Methodist Hospital’s median price of $227 is 71% above the median hospital's median price ($133), higher than 72% of the 741 hospitals reporting APC 5522. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 29 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 medicare managed care plan other · outpatient | $99 | $99 | — | — | 1,316 | $99 – $99 |
| 2 | Blue Cross Blue Shield anthem medicare managed care plan other · outpatient | $99 | $99 | — | — | 468 | $99 – $99 |
| 3 | Humana medicare managed care plan other · outpatient | $99 | $99 | — | — | 615 | $99 – $99 |
| 4 | Medical Mutual medicare managed care plan other · outpatient | $99 | $99 | — | — | 182 | $99 – $99 |
| 5 | Aetna medicaid managed care plan other · outpatient | $100 | $100 | — | — | 1–10 | $100 – $100 |
| 6 | UnitedHealthcare medicare managed care plan other · outpatient | $100 | $100 | — | — | 587 | $100 – $100 |
| 7 | Caresource medicare managed care plan other · outpatient | $101 | $101 | — | — | 13 | $101 – $101 |
| 8 | Devoted medicare managed care plan other · outpatient | $101 | $101 | — | — | 46 | $101 – $101 |
| 9 | Molina medicare managed care plan other · outpatient | $103 | $103 | — | — | 38 | $103 – $103 |
| 10 | UnitedHealthcare medicaid managed care plan other · outpatient | $183 | $183 | — | — | 115 | $183 – $183 |
| 11 | Blue Cross Blue Shield pathway exchange other · outpatient | $189 | $189 | — | — | 268 | $189 – $189 |
| 12 | Caresource exchange other · outpatient | $194 | $194 | — | — | 17 | $194 – $194 |
| 13 | Blue Cross Blue Shield anthem medicaid managed care plan other · outpatient | $220 | $220 | — | — | 146 | $220 – $220 |
| 14 | Caresource medicaid managed care plan other · outpatient | $221 | $221 | — | — | 710 | $221 – $221 |
| 15 | Molina medicaid managed care plan other · outpatient | $227 | $227 | — | — | 222 | $227 – $227 |
| 16 | Medical Mutual exchange other · outpatient | $229 | $229 | — | — | 127 | $229 – $229 |
| 17 | Humana medicaid managed care plan other · outpatient | $230 | $230 | — | — | 133 | $230 – $230 |
| 18 | First Health all commercial plans other · outpatient | $347 | $347 | — | — | 1–10 | $347 – $347 |
| 19 | Blue Cross Blue Shield anthem blue access hmo/ppo other · outpatient | $357 | $357 | — | — | 2,613 | $357 – $357 |
| 20 | Aetna all commercial plans other · outpatient | $389 | $389 | — | — | 998 | $389 – $389 |
| 21 | Cigna hmo other · outpatient | $398 | $398 | — | — | 436 | $398 – $398 |
| 22 | UnitedHealthcare all commercial plans other · outpatient | $401 | $401 | — | — | 870 | $401 – $401 |
| 23 | Medical Mutual all commercial plans other · outpatient | $402 | $402 | — | — | 845 | $402 – $402 |
| 24 | UnitedHealthcare options other commercial plan other · outpatient | $418 | $418 | — | — | 1,558 | $418 – $418 |
| 25 | Aetna asa other commercial plan other · outpatient | $444 | $444 | — | — | 226 | $444 – $444 |
Last updated: Apr 1, 2026
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