APC 1015

Glatiramer acetate injection

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

Injection glatiramer acetate

Payers reporting APC 1015

Payer pricing summary

Low

$88

Average

$187

Median

$177

High

$317

Payer rate distribution

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#
1	Blue Cross Blue Shield fee schedule · outpatient · +4 other terms	22	$167	$172	$17	10%	—	$167 – $251
2	UnitedHealthcare fee schedule · outpatient · +3 other terms	21	$177	$176	$3	2%	—	$172 – $180
3	Aetna fee schedule · outpatient · +4 other terms	20	$177	$203	$53	26%	—	$172 – $300
4	Humana case rate · outpatient · +3 other terms	14	$174	$181	$9	5%	—	$167 – $195
5	Molina fee schedule · outpatient · +2 other terms	14	$175	$192	$28	14%	—	$172 – $257
6	Ambetter case rate · outpatient · +2 other terms	12	$301	$341	$47	14%	—	$301 – $397
7	Clover case rate · outpatient	12	$174	$183	$10	6%	—	$174 – $195
8	WellCare case rate · outpatient · +2 other terms	12	$179	$189	$12	7%	—	$179 – $204
9	Medicare case rate · outpatient · +1 other terms	8	$167	$167	—	—	—	$167 – $167
10	Anthem fee schedule · outpatient · +1 other terms	7	$172	$172	$1	1%	—	$172 – $175
11	Cigna fee schedule · outpatient · +1 other terms	7	$172	$176	$5	3%	—	$172 – $186
12	Tricare facility · fee schedule · outpatient	5	$167	$167	—	—	—	$167 – $167
13	Oscar fee schedule · outpatient · +1 other terms	3	$300	$300	$0	0%	—	$300 – $300
14	Sanford Health Plan case rate · outpatient	3	$232	$234	$24	10%	—	$194 – $268
15	Kaiser fee schedule · outpatient · +1 other terms	2	$175	$175	—	—	—	$175 – $175
16	Aetna Better Health facility · case rate · outpatient	1	$129	$129	$42	32%	—	$88 – $171
17	Devoted facility · other · outpatient	1	$130	$130	$54	41%	—	$76 – $184
18	Medicaid facility · case rate · outpatient	1	$88	$88	—	—	—	$88 – $88
19	Optum fee schedule · outpatient	1	$167	$167	—	—	—	$167 – $167