APC 734

Levothyroxine 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

Inj, levothyroxine, freskabi

Payers reporting APC 734

Payer pricing summary

Low

Average

$12

Median

High

$47

Payer rate distribution

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#
1	Excellus case rate · outpatient	2	$14	$14	$2	13%	1–10	$12 – $15
2	UnitedHealthcare fee schedule · outpatient · +3 other terms	173	$7	$7	$1	12%	—	$4 – $7
3	Humana fee schedule · outpatient · +3 other terms	160	$7	$7	$2	30%	—	$4 – $28
4	Aetna fee schedule · outpatient · +3 other terms	155	$7	$7	$1	14%	—	$4 – $8
5	WellCare fee schedule · outpatient · +2 other terms	130	$7	$7	$0	6%	—	$4 – $9
6	Blue Cross Blue Shield fee schedule · outpatient · +3 other terms	125	$7	$7	$0	6%	—	$4 – $7
7	Devoted fee schedule · outpatient · +1 other terms	122	$7	$7	$0	1%	—	$7 – $7
8	Cigna Healthspring fee schedule · outpatient · +1 other terms	110	$7	$7	$0	3%	—	$7 – $7
9	Molina fee schedule · outpatient · +3 other terms	68	$10	$10	$4	43%	—	$4 – $18
10	Superior Healthplan fee schedule · outpatient	40	$7	$7	$0	0%	—	$7 – $7
11	Anthem fee schedule · outpatient · +1 other terms	31	$7	$6	$1	21%	—	$4 – $7
12	Oscar fee schedule · outpatient · +1 other terms	27	$7	$7	$0	3%	—	$7 – $7
13	Amerihealth Caritas fee schedule · outpatient · +1 other terms	17	$8	$8	$0	2%	—	$8 – $8
14	Cigna fee schedule · outpatient · +2 other terms	15	$7	$6	$2	28%	—	$4 – $7
15	Clover fee schedule · outpatient · +3 other terms	15	$7	$7	$0	0%	—	$7 – $7
16	Kaiser fee schedule · outpatient · +2 other terms	15	$7	$7	$1	16%	—	$4 – $7
17	Medicare facility · fee schedule · outpatient · +1 other terms	13	$7	$10	$13	133%	—	$7 – $68
18	Ambetter case rate · outpatient · +2 other terms	12	$12	$11	$2	17%	—	$9 – $12
19	Optum fee schedule · outpatient · +3 other terms	8	$7	$10	$5	47%	—	$7 – $17
20	Medica facility · fee schedule · outpatient	5	$7	$7	$0	1%	—	$7 – $7
21	Highmark facility · other · outpatient · +2 other terms	4	$11	$17	$21	123%	—	$7 – $80
22	Bcbs Nj facility · other · outpatient	3	$7	$7	—	—	—	$7 – $7
23	Magellan fee schedule · outpatient	1	$7	$7	—	—	—	$7 – $7
24	Sanford Health Plan case rate · outpatient	1	$11	$11	$1	8%	—	$10 – $12