APC 5572

Level 2 imaging with contrast dye at Elmhurst Memorial 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

Level 2 Imaging with Contrast

Elmhurst, IL

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Pricing by billing methodology

Price type

How this price compares nationally

Elmhurst Memorial Hospital’s median price of $471 is 2% above the median hospital's median price ($461), higher than 51% of the 740 hospitals reporting APC 5572. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting APC 5572 at Elmhurst Memorial Hospital

Negotiated rates from the hospital’s own file: 7 payers, 21 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	$75	$75	—	—	203	$75 – $75
2	WellCare medicare managed care plan other · outpatient	$160	$160	—	—	1–10	$160 – $160
3	Blue Cross Blue Shield mmai medicare managed care plan other · outpatient	$346	$346	—	—	24	$346 – $346
4	Humana mmai medicare managed care plan other · outpatient	$355	$355	—	—	51	$355 – $355
5	Aetna medicare managed care plan other · outpatient	$366	$366	—	—	396	$366 – $366
6	UnitedHealthcare medicare managed care plan other · outpatient	$366	$366	—	—	322	$366 – $366
7	Humana medicare managed care plan other · outpatient	$368	$368	—	—	842	$368 – $368
8	Blue Cross Blue Shield medicare managed care plan other · outpatient	$368	$368	—	—	145	$368 – $368
9	Cigna medicare managed care plan other · outpatient	$368	$368	—	—	51	$368 – $368
10	Molina medicaid managed care plan other · outpatient	$451	$451	—	—	15	$451 – $451
11	Blue Cross Blue Shield medicaid managed care plan other · outpatient	$491	$491	—	—	692	$491 – $491
12	Aetna medicaid managed care plan other · outpatient	$492	$492	—	—	46	$492 – $492
13	Aetna mmai medicare managed care plan other · outpatient	$503	$503	—	—	1–10	$503 – $503
14	Molina medicare managed care plan other · outpatient	$720	$720	—	—	1–10	$720 – $720
15	Aetna all commercial plans other · outpatient	$1.4k	$1.4k	—	—	387	$1.4k – $1.4k
16	UnitedHealthcare core/navigate other commercial plan other · outpatient	$1.8k	$1.8k	—	—	80	$1.8k – $1.8k
17	UnitedHealthcare all commercial plans other · outpatient	$1.8k	$1.8k	—	—	461	$1.8k – $1.8k
18	Cigna all commercial plans percent of total billed charges · outpatientfrom % of charges	$2.7k	$2.7k	—	—	227	$2.7k – $2.7k
19	Blue Cross Blue Shield hpn other commercial plan percent of total billed charges · outpatientfrom % of charges	$9.5k	$9.5k	—	—	1–10	$9.5k – $9.5k
20	Blue Cross Blue Shield choice other commercial plan other · outpatient	$10.0k	$10.0k	—	—	404	$10.0k – $10.0k
21	Blue Cross Blue Shield ppo other · outpatient	$10.3k	$10.3k	—	—	2,417	$10.3k – $10.3k

Last updated: Apr 1, 2026

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