APC 863

Iodine-125 iothalamate diagnostic test

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

I125 iothalamate, dx

Payers reporting APC 863

Payer pricing summary

Low

$471

Average

$746

Median

$662

High

$1.3k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +2 other terms	153	$656	$656	$7	1%	—	$646 – $682
2	Humana fee schedule · outpatient · +1 other terms	148	$650	$677	$190	28%	—	$624 – $2.6k
3	Aetna fee schedule · outpatient · +1 other terms	135	$656	$657	$10	1%	—	$643 – $715
4	WellCare fee schedule · outpatient · +2 other terms	127	$669	$675	$23	3%	—	$650 – $858
5	Devoted fee schedule · outpatient	122	$650	$650	$2	0%	—	$650 – $682
6	Cigna Healthspring fee schedule · outpatient	110	$676	$661	$18	3%	—	$650 – $702
7	Blue Cross Blue Shield fee schedule · outpatient · +1 other terms	105	$663	$657	$8	1%	—	$637 – $676
8	Molina fee schedule · outpatient · +1 other terms	55	$957	$956	$369	39%	—	$663 – $1.7k
9	Superior Healthplan fee schedule · outpatient	40	$682	$682	—	—	—	$682 – $682
10	Anthem fee schedule · outpatient	24	$650	$656	$9	1%	—	$650 – $669
11	Oscar fee schedule · outpatient · +1 other terms	24	$637	$656	$22	3%	—	$637 – $682
12	Amerihealth Caritas fee schedule · outpatient	17	$780	$773	$15	2%	—	$741 – $780
13	Clover fee schedule · outpatient	15	$682	$682	—	—	—	$682 – $682
14	Kaiser fee schedule · outpatient	13	$663	$662	$3	1%	—	$650 – $663
15	Cigna fee schedule · outpatient · +1 other terms	9	$663	$676	$18	3%	—	$663 – $702
16	Optum fee schedule · outpatient	8	$650	$1.0k	$472	46%	—	$650 – $1.6k
17	Highmark case rate · outpatient	3	$1.0k	$955	$325	34%	—	$650 – $1.4k
18	Excellus case rate · outpatient	2	$1.3k	$1.3k	$167	13%	—	$1.1k – $1.5k
19	Medicare facility · fee schedule · outpatient	2	$650	$650	—	—	—	$650 – $650
20	Ambetter fee schedule · outpatient	1	$471	$471	$49	10%	—	$422 – $520
21	Magellan fee schedule · outpatient	1	$650	$650	—	—	—	$650 – $650