APC 5301
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 1 Upper GI Procedures
Houston, TX
See all hospitals reporting APC 5301 →Price type
Methodist West Houston Hospital’s median price of $1.4k is 24% above the median hospital's median price ($1.2k), higher than 63% of the 737 hospitals reporting APC 5301. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 11 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 | Blue Cross Blue Shield medicare managed care - hmo other · outpatient | $843 | $843 | — | — | 1–10 | $843 – $843 |
| 2 | Blue Cross Blue Shield medicare managed care - ppo other · outpatient | $920 | $920 | — | — | 15 | $920 – $920 |
| 3 | UnitedHealthcare medicare managed care - hmo other · outpatient | $939 | $939 | — | — | 97 | $939 – $939 |
| 4 | Aetna medicare managed care - hmo/ppo other · outpatient | $939 | $939 | — | — | 133 | $939 – $939 |
| 5 | Optum transplant medicare managed care plan other · outpatient | $945 | $945 | — | — | 20 | $945 – $945 |
| 6 | UnitedHealthcare medicare managed care - ppo other · outpatient | $946 | $946 | — | — | 98 | $946 – $946 |
| 7 | Cigna texas healthspring medicare managed care - hmo/ppo other · outpatient | $955 | $955 | — | — | 29 | $955 – $955 |
| 8 | Humana medicare managed care - ppo other · outpatient | $1.0k | $1.0k | — | — | 108 | $1.0k – $1.0k |
| 9 | MultiPlan ppo other · outpatient | $1.3k | $1.3k | — | — | 1–10 | $1.3k – $1.3k |
| 10 | Devoted medicare managed care - hmo other · outpatient | $1.4k | $1.4k | — | — | 20 | $1.4k – $1.4k |
| 11 | First Health first health/coventry ppo other · outpatient | $1.4k | $1.4k | — | — | 1–10 | $1.4k – $1.4k |
| 12 | Blue Cross Blue Shield all commercial plans other · outpatient | $1.7k | $1.7k | — | — | 442 | $1.7k – $1.7k |
| 13 | Molina medicare/medicaid managed care plan other · outpatient | $1.7k | $1.7k | — | — | 1–10 | $1.7k – $1.7k |
| 14 | Molina advantage medicare managed care plan other · outpatient | $1.9k | $1.9k | — | — | 1–10 | $1.9k – $1.9k |
| 15 | Molina exchange other · outpatient | $1.9k | $1.9k | — | — | 11 | $1.9k – $1.9k |
| 16 | Aetna hmo/pos/ppo other · outpatient | $3.1k | $3.1k | — | — | 95 | $3.1k – $3.1k |
| 17 | Cigna local plus/surefit hmo/ppo other · outpatient | $3.8k | $3.8k | — | — | 1–10 | $3.8k – $3.8k |
| 18 | Cigna network c-24 hmo/ppo other · outpatient | $4.0k | $4.0k | — | — | 11 | $4.0k – $4.0k |
| 19 | UnitedHealthcare all commercial plans other · outpatient | $4.0k | $4.0k | — | — | 126 | $4.0k – $4.0k |
| 20 | Cigna pcp optional/pcp required benefit plans hmo other · outpatient | $4.2k | $4.2k | — | — | 159 | $4.2k – $4.2k |
| 21 | Phcs ppo other · outpatient | $5.5k | $5.5k | — | — | 1–10 | $5.5k – $5.5k |
| 22 | Cigna all other benefit plans ppo other · outpatient | $5.8k | $5.8k | — | — | 1–10 | $5.8k – $5.8k |
| 23 | Optum transplant other · outpatient | $7.7k | $7.7k | — | — | 1–10 | $7.7k – $7.7k |
| 24 | Aetna new business discount other commercial plan other · outpatient | $7.8k | $7.8k | — | — | 1–10 | $7.8k – $7.8k |
| 25 | Cigna lifesource transplant other · outpatient | $11.5k | $11.5k | — | — | 25 | $11.5k – $11.5k |
Last updated: Apr 1, 2026
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