APC 5721
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 Diagnostic Tests and Related Services
Saint Louis, MO
Negotiated rates from the hospital’s own file: 9 payers, 29 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 anthem blue access choice all commercial plans other · outpatient | $42 | $42 | — | — | 205 | $42 – $42 |
| 2 | Blue Cross Blue Shield anthem traditional percent of total billed charges · outpatientfrom % of charges | $43 | $43 | — | — | 1–10 | $43 – $43 |
| 3 | Blue Cross Blue Shield anthem blue access ppo other · outpatient | $47 | $47 | — | — | 244 | $47 – $47 |
| 4 | Blue Cross Blue Shield anthem blue preferred hmo/pos other · outpatient | $47 | $47 | — | — | 31 | $47 – $47 |
| 5 | Molina medicaid managed care plan other · outpatient | $89 | $89 | — | — | 29 | $89 – $89 |
| 6 | Aetna better health medicaid managed care plan other · outpatient | $90 | $90 | — | — | 1–10 | $90 – $90 |
| 7 | UnitedHealthcare employee other · outpatient | $93 | $93 | — | — | 14 | $93 – $93 |
| 8 | Blue Cross Blue Shield anthem pathway exchange other · outpatient | $103 | $103 | — | — | 41 | $103 – $103 |
| 9 | Blue Cross Blue Shield community il medicaid managed care plan other · outpatient | $114 | $114 | — | — | 1–10 | $114 – $114 |
| 10 | Blue Cross Blue Shield anthem medicare managed care plan other · outpatient | $121 | $121 | — | — | 75 | $121 – $121 |
| 11 | Molina dual eligible medicare/medicaid managed care plan other · outpatient | $121 | $121 | — | — | 1–10 | $121 – $121 |
| 12 | UnitedHealthcare medicare managed care plan other · outpatient | $122 | $122 | — | — | 343 | $122 – $122 |
| 13 | Aetna gold advantage medicare managed care plan other · outpatient | $123 | $123 | — | — | 179 | $123 – $123 |
| 14 | Aetna medicare managed care plan other · outpatient | $123 | $123 | — | — | 1–10 | $123 – $123 |
| 15 | UnitedHealthcare optum vaccn government other · outpatient | $123 | $123 | — | — | 1–10 | $123 – $123 |
| 16 | Phcs all commercial plans other · outpatient | $125 | $125 | — | — | 1–10 | $125 – $125 |
| 17 | Humana medicare managed care plan other · outpatient | $127 | $127 | — | — | 48 | $127 – $127 |
| 18 | Optum transplant medicare managed care plan other · outpatient | $147 | $147 | — | — | 1–10 | $147 – $147 |
| 19 | Humana all commercial plans percent of total billed charges · outpatientfrom % of charges | $149 | $149 | — | — | 1–10 | $149 – $149 |
| 20 | Aetna carelink all commercial plans other · outpatient | $150 | $150 | — | — | 1–10 | $150 – $150 |
| 21 | UnitedHealthcare non-ppo other commercial plan other · outpatient | $177 | $177 | — | — | 294 | $177 – $177 |
| 22 | UnitedHealthcare options ppo other · outpatient | $177 | $177 | — | — | 61 | $177 – $177 |
| 23 | Cigna all commercial plans other · outpatient | $247 | $247 | — | — | 80 | $247 – $247 |
| 24 | UnitedHealthcare community care medicaid managed care plan other · outpatient | $282 | $282 | — | — | 59 | $282 – $282 |
| 25 | Medica medicare managed care plan other · outpatient | $338 | $338 | — | — | 1–10 | $338 – $338 |