APC 09130
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
Inj, imm glob bivigam, 50
Low
$80
Average
$294
Median
$382
High
$419
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
8 payers; the 90th percentile is 5.0× 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 | Humana fee schedule · outpatient · +1 other terms | 81 | $77 | $77 | $3 | 4% | — | $60 – $80 |
| 2 | Caresource fee schedule · outpatient | 15 | $80 | $80 | — | — | — | $80 – $80 |
| 3 | Blue Cross Blue Shield fee schedule · outpatient · +1 other terms | 6 | $80 | $80 | — | — | — | $80 – $80 |
| 4 | Aetna facility · percent of total billed charges · outpatientfrom % of charges | 1 | $397 | $397 | — | — | — | $397 – $397 |
| 5 | Kaiser facility · other · outpatient | 1 | $397 | $397 | — | — | — | $397 – $397 |
| 6 | Molina facility · fee schedule · outpatient | 1 | $419 | $419 | $22 | 5% | — | $397 – $441 |
| 7 | MultiPlan facility · percent of total billed charges · outpatientfrom % of charges | 1 | $211 | $211 | — | — | — | $211 – $211 |
| 8 | UnitedHealthcare facility · fee schedule · outpatient | 1 | $397 | $397 | — | — | — | $397 – $397 |
← Hospitals reporting APC 09130 · Snapshot 20261111T120946Z-9134e7f7