APC 859

Ustekinumab-aekn injection, per billing unit

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

Inj ustekinumab-aekn, 1 m

Payers reporting APC 859

Payer pricing summary

Low

$29

Average

$73

Median

$42

High

$701

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +2 other terms	153	$44	$38	$12	31%	—	$11 – $45
2	Humana fee schedule · outpatient · +2 other terms	148	$43	$37	$20	54%	—	$10 – $173
3	Aetna fee schedule · outpatient · +1 other terms	135	$44	$37	$14	37%	—	$10 – $48
4	WellCare fee schedule · outpatient · +1 other terms	127	$45	$29	$17	58%	—	$11 – $57
5	Devoted fee schedule · outpatient · +1 other terms	122	$43	$34	$14	42%	—	$11 – $45
6	Blue Cross Blue Shield fee schedule · outpatient · +1 other terms	121	$43	$35	$14	40%	—	$11 – $45
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	110	$44	$30	$17	54%	—	$11 – $46
8	Molina fee schedule · outpatient · +1 other terms	55	$64	$48	$33	69%	—	$11 – $113
9	Superior Healthplan fee schedule · outpatient	40	$45	$38	$14	37%	—	$11 – $45
10	Anthem fee schedule · outpatient	24	$43	$42	$6	15%	—	$11 – $45
11	Oscar fee schedule · outpatient · +1 other terms	24	$42	$36	$14	39%	—	$12 – $45
12	Amerihealth Caritas fee schedule · outpatient	17	$52	$45	$15	34%	—	$12 – $52
13	Clover fee schedule · outpatient · +2 other terms	15	$12	$25	$16	64%	—	$11 – $45
14	Kaiser fee schedule · outpatient · +1 other terms	13	$44	$44	$0	1%	—	$43 – $44
15	Cigna fee schedule · outpatient · +1 other terms	9	$44	$45	$1	3%	—	$44 – $47
16	Medicare case rate · outpatient · +1 other terms	8	$40	$40	—	—	—	$40 – $40
17	Optum fee schedule · outpatient · +1 other terms	8	$36	$34	$11	31%	—	$11 – $43
18	Ambetter case rate · outpatient · +1 other terms	7	$73	$73	—	—	—	$73 – $73
19	Highmark case rate · outpatient · +1 other terms	3	$40	$40	—	—	—	$40 – $40
20	Excellus case rate · outpatient	2	$80	$80	$10	13%	—	$70 – $91
21	Bcbs Nj facility · other · outpatient	1	$43	$43	—	—	—	$43 – $43
22	Magellan fee schedule · outpatient	1	$43	$43	—	—	—	$43 – $43
23	Sanford Health Plan case rate · outpatient	1	$73	$73	$6	8%	—	$67 – $78