APC 1458

Phentolamine mesylate 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

Phentolaine mesylate inj

Payers reporting APC 1458

Payer pricing summary

Low

$226

Average

$547

Median

$427

High

$2.1k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +6 other terms	174	$423	$400	$53	13%	—	$257 – $442
2	Humana fee schedule · outpatient · +5 other terms	161	$421	$402	$138	34%	—	$257 – $1.7k
3	Aetna fee schedule · outpatient · +4 other terms	155	$424	$403	$76	19%	—	$260 – $691
4	WellCare fee schedule · outpatient · +2 other terms	131	$433	$361	$80	22%	—	$265 – $555
5	Blue Cross Blue Shield fee schedule · outpatient · +4 other terms	126	$429	$389	$70	18%	—	$257 – $599
6	Devoted fee schedule · outpatient · +2 other terms	122	$421	$376	$71	19%	—	$257 – $442
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	110	$429	$368	$77	21%	—	$257 – $450
8	Molina fee schedule · outpatient · +4 other terms	69	$474	$533	$247	46%	—	$281 – $1.1k
9	Superior Healthplan fee schedule · outpatient	40	$442	$404	$70	17%	—	$270 – $442
10	Anthem fee schedule · outpatient · +2 other terms	31	$421	$415	$26	6%	—	$289 – $433
11	Oscar fee schedule · outpatient · +2 other terms	27	$412	$419	$121	29%	—	$252 – $691
12	Medicare facility · fee schedule · outpatient · +2 other terms	20	$421	$388	$59	15%	—	$257 – $421
13	Ambetter facility · fee schedule · outpatient · +3 other terms	17	$778	$748	$391	52%	—	$303 – $2.0k
14	Amerihealth Caritas fee schedule · outpatient · +1 other terms	17	$505	$474	$67	14%	—	$329 – $505
15	Cigna fee schedule · outpatient · +2 other terms	17	$429	$464	$138	30%	—	$395 – $995
16	Clover fee schedule · outpatient · +3 other terms	15	$270	$341	$83	24%	—	$270 – $442
17	Kaiser fee schedule · outpatient · +2 other terms	15	$429	$425	$9	2%	—	$403 – $429
18	Optum fee schedule · outpatient · +3 other terms	8	$423	$490	$135	28%	—	$289 – $722
19	Highmark case rate · outpatient · +2 other terms	5	$432	$584	$207	35%	—	$432 – $947
20	Medica facility · fee schedule · outpatient	5	$437	$439	$2	0%	—	$437 – $442
21	Tricare facility · fee schedule · outpatient	5	$432	$432	—	—	—	$432 – $432
22	Excellus case rate · outpatient	4	$590	$603	$221	37%	—	$432 – $970
23	Bcbs Nj facility · other · outpatient	3	$421	$421	—	—	—	$421 – $421
24	Magellan facility · fee schedule · outpatient · +1 other terms	3	$442	$442	—	—	—	$442 – $442
25	Sanford Health Plan case rate · outpatient	3	$632	$637	$65	10%	—	$529 – $729

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