APC 9004

Inclisiran 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

Injection, inclisiran, 1 mg

Payers reporting APC 9004

Payer pricing summary

Low

Average

$108

Median

$15

High

$1.2k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Excellus case rate · outpatient	4	$17	$17	$6	37%	3–30	$12 – $28
2	Highmark case rate · outpatient · +2 other terms	5	$12	$17	$6	35%	1–10	$12 – $27
3	UnitedHealthcare fee schedule · outpatient · +4 other terms	174	$13	$13	$0	1%	—	$12 – $13
4	Humana fee schedule · outpatient · +5 other terms	161	$13	$13	$4	27%	—	$12 – $51
5	Aetna fee schedule · outpatient · +6 other terms	155	$13	$13	$1	11%	—	$12 – $21
6	WellCare fee schedule · outpatient · +2 other terms	131	$13	$13	$1	4%	—	$12 – $17
7	Blue Cross Blue Shield fee schedule · outpatient · +5 other terms	126	$13	$13	$1	4%	—	$12 – $18
8	Devoted fee schedule · outpatient · +2 other terms	122	$13	$13	$0	1%	—	$13 – $13
9	Cigna Healthspring fee schedule · outpatient · +1 other terms	110	$13	$13	$0	3%	—	$13 – $14
10	Molina fee schedule · outpatient · +3 other terms	69	$19	$18	$7	38%	—	$12 – $33
11	Superior Healthplan fee schedule · outpatient	40	$13	$13	$0	0%	—	$13 – $14
12	Anthem fee schedule · outpatient · +2 other terms	31	$13	$13	$0	2%	—	$12 – $13
13	Oscar fee schedule · outpatient · +2 other terms	27	$12	$14	$3	19%	—	$12 – $21
14	Amerihealth Caritas fee schedule · outpatient	17	$15	$15	$0	1%	—	$15 – $15
15	Medicare facility · fee schedule · outpatient · +1 other terms	16	$13	$216	$837	388%	—	$13 – $3.7k
16	Cigna fee schedule · outpatient · +2 other terms	15	$13	$13	$0	4%	—	$12 – $14
17	Clover fee schedule · outpatient · +2 other terms	15	$13	$13	$0	1%	—	$13 – $14
18	Kaiser fee schedule · outpatient · +2 other terms	15	$13	$13	$0	1%	—	$13 – $13
19	Ambetter case rate · outpatient · +3 other terms	12	$22	$25	$3	12%	—	$22 – $28
20	Optum fee schedule · outpatient · +2 other terms	8	$13	$19	$9	47%	—	$12 – $32
21	Medica facility · fee schedule · outpatient	5	$13	$13	$0	0%	—	$13 – $13
22	Tricare facility · fee schedule · outpatient	5	$12	$12	—	—	—	$12 – $12
23	Bcbs Nj facility · other · outpatient	3	$13	$13	—	—	—	$13 – $13
24	Sanford Health Plan case rate · outpatient	3	$18	$18	$2	10%	—	$15 – $21
25	Aetna Better Health facility · case rate · outpatient	1	$10	$10	$3	32%	—	$6 – $13

Page 1 of 2 · 28 payers