APC 00874

Hyaluronic acid knee injection (Synvisc)

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

Synvisc or synvisc-one

Payers reporting APC 00874

Payer pricing summary

Low

Average

$38

Median

$19

High

$178

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +1 other terms	86	$7	$12	$12	98%	—	$6 – $47
2	Caresource fee schedule · outpatient · +1 other terms	20	$8	$17	$15	89%	—	$8 – $47
3	Blue Cross Blue Shield fee schedule · outpatient · +1 other terms	11	$8	$23	$16	70%	—	$8 – $45
4	Aetna facility · fee schedule · outpatient · +1 other terms	7	$7	$7	$0	4%	—	$7 – $8
5	Medicare facility · fee schedule · outpatient · +1 other terms	7	$8	$56	$44	79%	—	$8 – $96
6	UnitedHealthcare facility · fee schedule · outpatient · +2 other terms	7	$8	$52	$49	93%	—	$8 – $120
7	Clover fee schedule · outpatient	5	$30	$30	$15	50%	—	$15 – $45
8	Kaiser fee schedule · outpatient · +1 other terms	5	$31	$31	$16	50%	—	$16 – $47
9	WellCare fee schedule · outpatient · +1 other terms	5	$31	$31	$16	50%	—	$16 – $47
10	Anthem facility · fee schedule · outpatient	3	$8	$8	—	—	—	$8 – $8
11	Carefirst facility · fee schedule · outpatient	3	$8	$8	—	—	—	$8 – $8
12	Medica facility · fee schedule · outpatient	3	$8	$8	—	—	—	$8 – $8
13	Tricare facility · fee schedule · outpatient	3	$8	$8	—	—	—	$8 – $8
14	Aetna Better Health facility · other · outpatient · +1 other terms	2	$8	$8	—	—	—	$8 – $8
15	Ambetter facility · fee schedule · outpatient	2	$178	$178	—	—	—	$178 – $178
16	Amerihealth Caritas facility · fee schedule · outpatient	2	$152	$152	$55	37%	—	$96 – $207
17	Cigna facility · fee schedule · outpatient	2	$96	$96	—	—	—	$96 – $96
18	Medical Mutual facility · other · outpatient	2	$13	$13	$0	3%	—	$12 – $13
19	Bcbs Mi facility · fee schedule · outpatient	1	$8	$8	—	—	—	$8 – $8
20	Molina facility · fee schedule · outpatient	1	$8	$8	—	—	—	$8 – $8