APC 755

Oral methotrexate liquid (Jylamvo brand)

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-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Oral methotrexate (jylamv

Payers reporting APC 755

Payer pricing summary

Low

$18

Average

$22

Median

$20

High

$37

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +1 other terms	173	$19	$19	$1	3%	—	$16 – $20
2	Humana fee schedule · outpatient · +1 other terms	160	$19	$19	$5	29%	—	$16 – $75
3	Aetna fee schedule · outpatient · +1 other terms	155	$19	$19	$3	14%	—	$16 – $33
4	WellCare fee schedule · outpatient · +1 other terms	130	$19	$19	$1	5%	—	$17 – $25
5	Blue Cross Blue Shield fee schedule · outpatient · +2 other terms	125	$19	$19	$1	4%	—	$16 – $19
6	Devoted fee schedule · outpatient	122	$19	$19	$1	3%	—	$16 – $20
7	Cigna Healthspring fee schedule · outpatient	110	$19	$18	$1	7%	—	$16 – $20
8	Molina fee schedule · outpatient · +2 other terms	68	$27	$26	$10	40%	—	$18 – $49
9	Superior Healthplan fee schedule · outpatient	40	$20	$19	$0	2%	—	$17 – $20
10	Anthem fee schedule · outpatient · +1 other terms	31	$19	$19	$0	3%	—	$16 – $19
11	Oscar fee schedule · outpatient	27	$18	$20	$5	22%	—	$18 – $33
12	Amerihealth Caritas fee schedule · outpatient	17	$22	$22	$1	6%	—	$19 – $22
13	Cigna fee schedule · outpatient · +1 other terms	15	$19	$19	$0	3%	—	$19 – $20
14	Clover fee schedule · outpatient · +1 other terms	15	$20	$19	$1	3%	—	$17 – $20
15	Kaiser fee schedule · outpatient · +1 other terms	15	$19	$19	$0	1%	—	$19 – $19
16	Ambetter case rate · outpatient · +1 other terms	12	$33	$38	$6	15%	—	$33 – $44
17	Medicare case rate · outpatient	8	$18	$18	—	—	—	$18 – $18
18	Optum fee schedule · outpatient	8	$19	$27	$13	47%	—	$16 – $47
19	Highmark case rate · outpatient	3	$28	$27	$9	34%	—	$18 – $41
20	Excellus case rate · outpatient	2	$37	$37	$5	13%	—	$32 – $41
21	Magellan fee schedule · outpatient	1	$19	$19	—	—	—	$19 – $19
22	Sanford Health Plan case rate · outpatient	1	$28	$28	$2	8%	—	$26 – $30