APC 5012

Clinic visit and related services at The Methodist 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

Clinic Visits and Related Services

Houston, TX

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Pricing by billing methodology

Price type

How this price compares nationally

The Methodist Hospital’s median price of $263 is 87% above the median hospital's median price ($140), higher than 94% of the 709 hospitals reporting APC 5012. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting APC 5012 at The Methodist Hospital

Negotiated rates from the hospital’s own file: 10 payers, 28 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	First Health first health/coventry ppo other · outpatient	$80	$80	—	—	1–10	$80 – $80
2	Molina medicare/medicaid managed care plan other · outpatient	$106	$106	—	—	1–10	$106 – $106
3	UnitedHealthcare medicare managed care - hmo other · outpatient	$125	$125	—	—	508	$125 – $125
4	Blue Cross Blue Shield medicare managed care - hmo other · outpatient	$127	$127	—	—	31	$127 – $127
5	Blue Cross Blue Shield medicare managed care - ppo other · outpatient	$127	$127	—	—	260	$127 – $127
6	UnitedHealthcare medicare managed care - ppo other · outpatient	$127	$127	—	—	609	$127 – $127
7	Humana medicare managed care - ppo other · outpatient	$127	$127	—	—	575	$127 – $127
8	Aetna medicare managed care - hmo/ppo other · outpatient	$128	$128	—	—	690	$128 – $128
9	Cigna texas healthspring medicare managed care - hmo/ppo other · outpatient	$130	$130	—	—	337	$130 – $130
10	Devoted medicare managed care - hmo other · outpatient	$131	$131	—	—	134	$131 – $131
11	Molina advantage medicare managed care plan other · outpatient	$178	$178	—	—	17	$178 – $178
12	Molina exchange other · outpatient	$199	$199	—	—	68	$199 – $199
13	Optum transplant medicare managed care plan other · outpatient	$221	$221	—	—	322	$221 – $221
14	Molina medicaid managed care plan other · outpatient	$263	$263	—	—	92	$263 – $263
15	Phcs ppo other · outpatient	$286	$286	—	—	1–10	$286 – $286
16	Blue Cross Blue Shield all commercial plans other · outpatient	$322	$322	—	—	3,019	$322 – $322
17	Cigna pcp optional/pcp required benefit plans hmo other · outpatient	$402	$402	—	—	258	$402 – $402
18	Aetna hmo/pos/ppo other · outpatient	$407	$407	—	—	448	$407 – $407
19	UnitedHealthcare all commercial plans other · outpatient	$528	$528	—	—	536	$528 – $528
20	Aetna new business discount other commercial plan other · outpatient	$533	$533	—	—	1–10	$533 – $533
21	Humana choicecare ppo other · outpatient	$626	$626	—	—	1–10	$626 – $626
22	Humana transplant medicare managed care plan other · outpatient	$662	$662	—	—	108	$662 – $662
23	Cigna all other benefit plans ppo other · outpatient	$939	$939	—	—	1–10	$939 – $939
24	Aetna transplant other · outpatient	$1.4k	$1.4k	—	—	112	$1.4k – $1.4k
25	Optum transplant other · outpatient	$1.7k	$1.7k	—	—	409	$1.7k – $1.7k

Page 1 of 2 · 28 rates

Last updated: Apr 1, 2026

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