APC 0874
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.
Original text from hospital filings
Synvisc or synvisc-one
Low
$4
Average
$47
Median
$8
High
$215
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
14 payers; the 90th percentile is 35.7× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Excellus case rate · outpatient | 2 | $8 | $8 | — | — | 111–120 | $8 – $8 |
| 2 | Highmark case rate · outpatient | 2 | $8 | $8 | — | — | 1–10 | $8 – $8 |
| 3 | Aetna facility · fee schedule · outpatient · +4 other terms | 5 | $8 | $8 | $0 | 1% | — | $8 – $8 |
| 4 | Blue Cross Blue Shield facility · fee schedule · outpatient · +6 other terms | 5 | $17 | $18 | $8 | 47% | — | $7 – $30 |
| 5 | Humana facility · fee schedule · outpatient · +2 other terms | 5 | $8 | $8 | $0 | 0% | — | $8 – $8 |
| 6 | Tricare facility · fee schedule · outpatient | 5 | $8 | $8 | — | — | — | $8 – $8 |
| 7 | UnitedHealthcare facility · fee schedule · outpatient · +4 other terms | 5 | $8 | $8 | — | — | — | $8 – $8 |
| 8 | WellCare facility · fee schedule · outpatient | 5 | $8 | $8 | $0 | 2% | — | $8 – $8 |
| 9 | Cigna case rate · outpatient · +1 other terms | 2 | $8 | $8 | — | — | — | $8 – $8 |
| 10 | Sanford Health Plan case rate · outpatient | 2 | $13 | $13 | $1 | 11% | — | $11 – $15 |
| 11 | Aetna Better Health facility · case rate · outpatient | 1 | $6 | $6 | $2 | 32% | — | $4 – $8 |
| 12 | Ambetter facility · case rate · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 13 | Medicaid facility · case rate · outpatient | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 14 | Molina facility · case rate · outpatient | 1 | $6 | $6 | $2 | 32% | — | $4 – $8 |
← Hospitals reporting APC 0874 · Snapshot 20261111T120946Z-9134e7f7