APC 5165
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 5 ENT Procedures
Saint Louis, MO
See all hospitals reporting APC 5165 →Price type
SSM-SLUH, Inc.’s median price of $5.4k is 15% below the median hospital's median price ($6.3k), higher than 7% of the 584 hospitals reporting APC 5165. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
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 | Phcs all commercial plans other · outpatient | $646 | $646 | — | — | 1–10 | $646 – $646 |
| 2 | Blue Cross Blue Shield anthem pathway exchange other · outpatient | $2.8k | $2.8k | — | — | 1–10 | $2.8k – $2.8k |
| 3 | Blue Cross Blue Shield anthem blue preferred hmo/pos other · outpatient | $4.0k | $4.0k | — | — | 1–10 | $4.0k – $4.0k |
| 4 | Molina medicaid managed care plan other · outpatient | $4.1k | $4.1k | — | — | 1–10 | $4.1k – $4.1k |
| 5 | UnitedHealthcare options ppo other · outpatient | $4.3k | $4.3k | — | — | 1–10 | $4.3k – $4.3k |
| 6 | Blue Cross Blue Shield anthem blue access choice all commercial plans other · outpatient | $4.4k | $4.4k | — | — | 23 | $4.4k – $4.4k |
| 7 | Molina dual eligible medicare/medicaid managed care plan other · outpatient | $4.4k | $4.4k | — | — | 1–10 | $4.4k – $4.4k |
| 8 | Cigna all commercial plans other · outpatient | $4.7k | $4.7k | — | — | 14 | $4.7k – $4.7k |
| 9 | Blue Cross Blue Shield community il medicaid managed care plan other · outpatient | $4.7k | $4.7k | — | — | 1–10 | $4.7k – $4.7k |
| 10 | Aetna better health medicaid managed care plan other · outpatient | $4.8k | $4.8k | — | — | 1–10 | $4.8k – $4.8k |
| 11 | Blue Cross Blue Shield anthem medicare managed care plan other · outpatient | $5.3k | $5.3k | — | — | 1–10 | $5.3k – $5.3k |
| 12 | UnitedHealthcare medicare managed care plan other · outpatient | $5.6k | $5.6k | — | — | 18 | $5.6k – $5.6k |
| 13 | Aetna gold advantage medicare managed care plan other · outpatient | $5.6k | $5.6k | — | — | 1–10 | $5.6k – $5.6k |
| 14 | Blue Cross Blue Shield anthem blue access ppo other · outpatient | $5.6k | $5.6k | — | — | 24 | $5.6k – $5.6k |
| 15 | Humana medicare managed care plan other · outpatient | $5.7k | $5.7k | — | — | 1–10 | $5.7k – $5.7k |
| 16 | UnitedHealthcare optum vaccn government other · outpatient | $5.7k | $5.7k | — | — | 1–10 | $5.7k – $5.7k |
| 17 | Aetna nap other commercial plan percent of total billed charges · outpatientfrom % of charges | $5.7k | $5.7k | — | — | 1–10 | $5.7k – $5.7k |
| 18 | UnitedHealthcare non-ppo other commercial plan other · outpatient | $6.4k | $6.4k | — | — | 32 | $6.4k – $6.4k |
| 19 | Aetna all commercial plans other · outpatient | $7.3k | $7.3k | — | — | 12 | $7.3k – $7.3k |
| 20 | UnitedHealthcare community care medicaid managed care plan other · outpatient | $9.2k | $9.2k | — | — | 11 | $9.2k – $9.2k |
| 21 | Medica exchange other · outpatient | $10.1k | $10.1k | — | — | 1–10 | $10.1k – $10.1k |
| 22 | Blue Cross Blue Shield anthem healthy blue medicaid managed care plan other · outpatient | $12.0k | $12.0k | — | — | 1–10 | $12.0k – $12.0k |
Last updated: Apr 1, 2026
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