APC 5012

Clinic visit and related services at Edward Hospital

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

Original text from hospital filings

Clinic Visits and Related Services

Naperville, IL

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Pricing by billing methodology

Price type

How this price compares nationally

Edward Hospital’s median price of $208 is 48% above the median hospital's median price ($140), higher than 89% of the 710 hospitals reporting APC 5012. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting APC 5012 at Edward Hospital

Negotiated rates from the hospital’s own file: 8 payers, 22 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	Blue Cross Blue Shield hmo other · outpatient	$40	$40	—	—	1,552	$40 – $40
2	Devoted medicare managed care plan other · outpatient	$105	$105	—	—	1–10	$105 – $105
3	Blue Cross Blue Shield mmai medicare managed care plan other · outpatient	$122	$122	—	—	41	$122 – $122
4	Humana mmai medicare managed care plan other · outpatient	$128	$128	—	—	67	$128 – $128
5	Blue Cross Blue Shield medicare managed care plan other · outpatient	$132	$132	—	—	355	$132 – $132
6	Humana medicare managed care plan other · outpatient	$132	$132	—	—	1,573	$132 – $132
7	Aetna medicare managed care plan other · outpatient	$132	$132	—	—	1,359	$132 – $132
8	UnitedHealthcare medicare managed care plan other · outpatient	$133	$133	—	—	875	$133 – $133
9	WellCare medicare managed care plan other · outpatient	$161	$161	—	—	1–10	$161 – $161
10	Aetna mmai medicare managed care plan other · outpatient	$193	$193	—	—	1–10	$193 – $193
11	Molina medicare managed care plan other · outpatient	$202	$202	—	—	1–10	$202 – $202
12	Cigna medicare managed care plan other · outpatient	$213	$213	—	—	44	$213 – $213
13	Aetna medicaid managed care plan other · outpatient	$224	$224	—	—	129	$224 – $224
14	Molina medicaid managed care plan other · outpatient	$229	$229	—	—	66	$229 – $229
15	Blue Cross Blue Shield medicaid managed care plan other · outpatient	$238	$238	—	—	2,908	$238 – $238
16	Cigna all commercial plans percent of total billed charges · outpatientfrom % of charges	$363	$363	—	—	1,128	$363 – $363
17	UnitedHealthcare all commercial plans other · outpatient	$413	$413	—	—	2,072	$413 – $413
18	UnitedHealthcare core/navigate other commercial plan other · outpatient	$413	$413	—	—	391	$413 – $413
19	Aetna all commercial plans other · outpatient	$452	$452	—	—	1,971	$452 – $452
20	Blue Cross Blue Shield choice other commercial plan other · outpatient	$842	$842	—	—	1,522	$842 – $842
21	Blue Cross Blue Shield ppo other · outpatient	$879	$879	—	—	10,225	$879 – $879
22	Blue Cross Blue Shield hpn other commercial plan percent of total billed charges · outpatientfrom % of charges	$991	$991	—	—	1–10	$991 – $991

Last updated: Apr 1, 2026

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