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
Delaware, OH
See all hospitals reporting APC 5522 →Price type
Grady Memorial Hospital’s median price of $156 is 17% above the median hospital's median price ($133), higher than 59% of the 745 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: 9 payers, 25 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 | Caresource medicare managed care plan other · outpatient | $80 | $80 | — | — | 1–10 | $80 – $80 |
| 2 | Aetna medicare managed care plan other · outpatient | $99 | $99 | — | — | 796 | $99 – $99 |
| 3 | Blue Cross Blue Shield anthem medicare managed care plan other · outpatient | $99 | $99 | — | — | 380 | $99 – $99 |
| 4 | Humana medicare managed care plan other · outpatient | $99 | $99 | — | — | 529 | $99 – $99 |
| 5 | Medical Mutual medicare managed care plan other · outpatient | $99 | $99 | — | — | 246 | $99 – $99 |
| 6 | UnitedHealthcare medicare managed care plan other · outpatient | $99 | $99 | — | — | 412 | $99 – $99 |
| 7 | Devoted medicare managed care plan other · outpatient | $101 | $101 | — | — | 68 | $101 – $101 |
| 8 | Molina medicare managed care plan other · outpatient | $102 | $102 | — | — | 35 | $102 – $102 |
| 9 | Molina medicaid managed care plan other · outpatient | $126 | $126 | — | — | 127 | $126 – $126 |
| 10 | Caresource medicaid managed care plan other · outpatient | $133 | $133 | — | — | 238 | $133 – $133 |
| 11 | UnitedHealthcare medicaid managed care plan other · outpatient | $136 | $136 | — | — | 75 | $136 – $136 |
| 12 | Blue Cross Blue Shield anthem medicaid managed care plan other · outpatient | $138 | $138 | — | — | 30 | $138 – $138 |
| 13 | Humana medicaid managed care plan other · outpatient | $144 | $144 | — | — | 43 | $144 – $144 |
| 14 | Medical Mutual exchange other · outpatient | $168 | $168 | — | — | 67 | $168 – $168 |
| 15 | Blue Cross Blue Shield pathway exchange other · outpatient | $301 | $301 | — | — | 152 | $301 – $301 |
| 16 | Medical Mutual all commercial plans other · outpatient | $411 | $411 | — | — | 348 | $411 – $411 |
| 17 | Aetna all commercial plans other · outpatient | $420 | $420 | — | — | 479 | $420 – $420 |
| 18 | Cigna ppo other · outpatient | $429 | $429 | — | — | 1–10 | $429 – $429 |
| 19 | Caresource exchange other · outpatient | $451 | $451 | — | — | 1–10 | $451 – $451 |
| 20 | Blue Cross Blue Shield anthem blue access hmo/ppo other · outpatient | $471 | $471 | — | — | 1,146 | $471 – $471 |
| 21 | UnitedHealthcare all commercial plans other · outpatient | $556 | $556 | — | — | 869 | $556 – $556 |
| 22 | Cigna hmo other · outpatient | $572 | $572 | — | — | 185 | $572 – $572 |
| 23 | UnitedHealthcare options ppo other · outpatient | $627 | $627 | — | — | 30 | $627 – $627 |
| 24 | Cigna great west other commercial plan other · outpatient | $673 | $673 | — | — | 39 | $673 – $673 |
| 25 | Blue Cross Blue Shield anthem traditional other · outpatient | $849 | $849 | — | — | 1–10 | $849 – $849 |
Last updated: Apr 1, 2026
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