APC 869

Ustekinumab-kfce 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 ustekinumab-kfce, 1 m

Payers reporting APC 869

Payer pricing summary

Low

$12

Average

$23

Median

$21

High

$50

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +1 other terms	153	$25	$21	$8	37%	—	$3 – $26
2	Humana fee schedule · outpatient · +1 other terms	148	$25	$20	$12	61%	—	$3 – $99
3	Aetna fee schedule · outpatient · +2 other terms	135	$25	$20	$9	45%	—	$3 – $27
4	WellCare fee schedule · outpatient · +1 other terms	127	$25	$15	$11	75%	—	$3 – $33
5	Devoted fee schedule · outpatient	122	$25	$19	$10	52%	—	$3 – $26
6	Cigna Healthspring fee schedule · outpatient	110	$25	$16	$11	67%	—	$3 – $26
7	Blue Cross Blue Shield fee schedule · outpatient · +1 other terms	105	$25	$18	$10	54%	—	$3 – $26
8	Molina fee schedule · outpatient	55	$36	$26	$20	79%	—	$4 – $65
9	Superior Healthplan fee schedule · outpatient	40	$26	$21	$9	45%	—	$3 – $26
10	Anthem fee schedule · outpatient	24	$25	$24	$4	17%	—	$3 – $25
11	Oscar fee schedule · outpatient	24	$24	$20	$10	48%	—	$3 – $26
12	Amerihealth Caritas fee schedule · outpatient	17	$30	$25	$10	39%	—	$4 – $30
13	Clover fee schedule · outpatient	15	$4	$12	$11	88%	—	$3 – $26
14	Kaiser fee schedule · outpatient	13	$25	$25	$0	1%	—	$25 – $25
15	Cigna fee schedule · outpatient · +1 other terms	9	$25	$26	$1	3%	—	$25 – $27
16	Optum fee schedule · outpatient	8	$17	$16	$9	56%	—	$3 – $25
17	Highmark case rate · outpatient	3	$25	$25	—	—	—	$25 – $25
18	Medicare facility · fee schedule · outpatient	3	$25	$22	$7	30%	—	$3 – $25
19	Excellus case rate · outpatient	2	$50	$50	$6	13%	—	$43 – $56
20	Medica facility · fee schedule · outpatient	2	$26	$26	—	—	—	$26 – $26
21	Ambetter fee schedule · outpatient · +1 other terms	1	$18	$18	$2	10%	—	$16 – $20
22	Magellan fee schedule · outpatient	1	$25	$25	—	—	—	$25 – $25