APC 874

Synvisc or Synvisc-One knee 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

Synvisc or synvisc-one

Payers reporting APC 874

Payer pricing summary

Low

Average

$31

Median

High

$287

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +3 other terms	174	$8	$8	$1	9%	—	$6 – $10
2	Humana fee schedule · outpatient · +4 other terms	161	$8	$8	$2	30%	—	$6 – $30
3	Aetna fee schedule · outpatient · +3 other terms	155	$8	$8	$2	21%	—	$6 – $16
4	WellCare fee schedule · outpatient · +2 other terms	131	$8	$7	$1	9%	—	$6 – $10
5	Blue Cross Blue Shield fee schedule · outpatient · +3 other terms	125	$8	$7	$1	8%	—	$6 – $9
6	Devoted fee schedule · outpatient · +1 other terms	122	$8	$7	$0	6%	—	$6 – $8
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	110	$8	$7	$1	11%	—	$6 – $8
8	Molina fee schedule · outpatient · +2 other terms	69	$11	$11	$4	40%	—	$7 – $20
9	Superior Healthplan fee schedule · outpatient	40	$8	$8	$0	5%	—	$6 – $8
10	Anthem fee schedule · outpatient · +2 other terms	31	$8	$8	$1	9%	—	$6 – $9
11	Oscar fee schedule · outpatient · +3 other terms	27	$7	$8	$3	32%	—	$7 – $16
12	Medicare facility · fee schedule · outpatient · +2 other terms	18	$8	$7	$1	10%	—	$6 – $8
13	Amerihealth Caritas fee schedule · outpatient · +1 other terms	17	$9	$9	$1	10%	—	$7 – $9
14	Cigna fee schedule · outpatient · +2 other terms	17	$8	$10	$4	38%	—	$8 – $23
15	Clover fee schedule · outpatient · +3 other terms	15	$7	$8	$0	6%	—	$6 – $8
16	Kaiser fee schedule · outpatient · +2 other terms	15	$8	$8	$1	7%	—	$8 – $9
17	Ambetter case rate · outpatient · +2 other terms	12	$14	$17	$3	19%	—	$14 – $21
18	Optum fee schedule · outpatient · +3 other terms	8	$8	$10	$4	42%	—	$6 – $17
19	Medica facility · fee schedule · outpatient	5	$8	$8	$0	1%	—	$8 – $8
20	Highmark facility · other · outpatient · +2 other terms	4	$12	$85	$264	312%	—	$8 – $1.2k
21	Bcbs Nj facility · other · outpatient	3	$8	$8	—	—	—	$8 – $8
22	Excellus case rate · outpatient	2	$16	$16	$2	13%	—	$14 – $18
23	Magellan facility · fee schedule · outpatient · +1 other terms	2	$8	$8	—	—	—	$8 – $8
24	Caresource facility · fee schedule · outpatient	1	$8	$8	—	—	—	$8 – $8
25	Sanford Health Plan case rate · outpatient	1	$14	$14	$1	8%	—	$13 – $15