APC 7043

Infliximab infusion (non-biosimilar)

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

Infliximab not biosimil 10mg

Payers reporting APC 7043

Payer pricing summary

Low

$16

Average

$110

Median

$36

High

$1.2k

Payer rate distribution

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#
1	Excellus case rate · outpatient	4	$42	$43	$16	37%	752	$31 – $70
2	Highmark case rate · outpatient · +2 other terms	5	$31	$42	$15	35%	43–52	$31 – $68
3	UnitedHealthcare fee schedule · outpatient · +6 other terms	174	$33	$32	$1	2%	—	$31 – $34
4	Humana fee schedule · outpatient · +5 other terms	161	$32	$33	$9	28%	—	$30 – $130
5	Aetna fee schedule · outpatient · +5 other terms	155	$33	$33	$4	11%	—	$31 – $53
6	WellCare fee schedule · outpatient · +2 other terms	131	$33	$33	$1	4%	—	$31 – $43
7	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	126	$32	$32	$2	5%	—	$31 – $48
8	Devoted fee schedule · outpatient · +2 other terms	122	$32	$32	$1	2%	—	$31 – $34
9	Cigna Healthspring fee schedule · outpatient · +1 other terms	110	$33	$33	$1	4%	—	$31 – $35
10	Molina fee schedule · outpatient · +4 other terms	69	$48	$46	$18	39%	—	$31 – $85
11	Superior Healthplan fee schedule · outpatient	40	$34	$34	$1	2%	—	$33 – $34
12	Anthem fee schedule · outpatient · +2 other terms	31	$32	$32	$1	3%	—	$31 – $33
13	Oscar fee schedule · outpatient · +2 other terms	27	$32	$35	$7	19%	—	$30 – $53
14	Medicare facility · fee schedule · outpatient · +2 other terms	19	$32	$40	$48	118%	—	$30 – $315
15	Amerihealth Caritas fee schedule · outpatient · +1 other terms	17	$39	$38	$1	3%	—	$36 – $39
16	Cigna fee schedule · outpatient · +4 other terms	17	$33	$36	$11	30%	—	$31 – $77
17	Clover fee schedule · outpatient · +3 other terms	15	$33	$33	$1	2%	—	$33 – $34
18	Kaiser fee schedule · outpatient · +2 other terms	15	$33	$33	$1	2%	—	$31 – $33
19	Ambetter facility · fee schedule · outpatient · +3 other terms	13	$47	$79	$142	180%	—	$32 – $677
20	Optum fee schedule · outpatient · +3 other terms	8	$32	$47	$22	46%	—	$31 – $79
21	Medica facility · fee schedule · outpatient	5	$34	$34	$0	0%	—	$34 – $34
22	Tricare facility · fee schedule · outpatient	5	$31	$31	—	—	—	$31 – $31
23	Bcbs Nj facility · other · outpatient	3	$32	$32	—	—	—	$32 – $32
24	Magellan facility · fee schedule · outpatient · +1 other terms	3	$34	$34	—	—	—	$34 – $34
25	Sanford Health Plan case rate · outpatient	3	$45	$45	$5	10%	—	$38 – $52

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