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Payers and negotiated rates for APC 0726 | medprice.ai

APC 0726

Dexrazoxane HCl injection

Payers reporting APC 0726

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Payer pricing summary

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Low

$33

Average

$63

Median

$63

High

$162

Payer rate distribution

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#
1	Excellus case rate · outpatient	2	$63	$63	—	—	140	$63 – $63
2	Aetna facility · fee schedule · outpatient · +2 other terms	5	$65	$65	$1	1%	—	$63 – $65
3	Blue Cross Blue Shield facility · fee schedule · outpatient · +3 other terms	5	$134	$140	$65	47%	—	$59 – $239
4	Humana facility · fee schedule · outpatient · +2 other terms	5	$65	$65	$0	0%	—	$65 – $65
5	Tricare facility · fee schedule · outpatient	5	$63	$63	—	—	—	$63 – $63
6	UnitedHealthcare facility · fee schedule · outpatient · +2 other terms	5	$63	$63	—	—	—	$63 – $63
7	WellCare facility · fee schedule · outpatient	5	$65	$65	$1	2%	—	$63 – $66
8	Cigna case rate · outpatient	2	$63	$63	—	—	—	$63 – $63
9	Highmark case rate · outpatient	2	$63	$63	—	—	—	$63 – $63
10	Sanford Health Plan case rate · outpatient	2	$46	$46	$5	11%	—	$39 – $54
11	Aetna Better Health facility · case rate · outpatient	1	$49	$49	$16	32%	—	$33 – $64
12	Ambetter facility · case rate · outpatient	1	$33	$33	—	—	—	$33 – $33
13	Medicaid facility · case rate · outpatient	1	$33	$33	—	—	—	$33 – $33
14	Molina facility · case rate · outpatient	1	$49	$49	$16	32%	—	$33 – $64

← Hospitals reporting APC 0726 · Snapshot 20261111T120946Z-9134e7f7