APC 9122

Triptorelin pamoate 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

Triptorelin pamoate

Payers reporting APC 9122

Payer pricing summary

Low

$248

Average

$669

Median

$487

High

$3.6k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +4 other terms	174	$468	$470	$9	2%	—	$414 – $505
2	Humana fee schedule · outpatient · +4 other terms	161	$463	$483	$132	27%	—	$414 – $1.9k
3	Aetna fee schedule · outpatient · +4 other terms	155	$468	$482	$64	13%	—	$414 – $842
4	WellCare fee schedule · outpatient · +2 other terms	131	$477	$484	$17	3%	—	$463 – $611
5	Blue Cross Blue Shield fee schedule · outpatient · +4 other terms	126	$472	$472	$18	4%	—	$454 – $688
6	Devoted fee schedule · outpatient · +1 other terms	122	$463	$465	$3	1%	—	$463 – $486
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	110	$482	$473	$12	3%	—	$463 – $504
8	Molina fee schedule · outpatient · +3 other terms	69	$682	$668	$254	38%	—	$472 – $1.2k
9	Superior Healthplan fee schedule · outpatient	40	$486	$488	$3	1%	—	$486 – $493
10	Anthem fee schedule · outpatient · +1 other terms	31	$472	$471	$8	2%	—	$463 – $491
11	Oscar fee schedule · outpatient · +1 other terms	27	$460	$510	$118	23%	—	$454 – $842
12	Amerihealth Caritas fee schedule · outpatient · +1 other terms	17	$556	$552	$9	2%	—	$532 – $556
13	Cigna fee schedule · outpatient · +2 other terms	16	$481	$485	$12	3%	—	$472 – $502
14	Clover fee schedule · outpatient · +2 other terms	15	$493	$490	$3	1%	—	$486 – $493
15	Kaiser fee schedule · outpatient · +2 other terms	15	$472	$474	$7	1%	—	$463 – $491
16	Ambetter case rate · outpatient · +2 other terms	12	$855	$945	$107	11%	—	$855 – $1.1k
17	Medicare case rate · outpatient · +2 other terms	8	$475	$475	—	—	—	$475 – $475
18	Optum fee schedule · outpatient · +2 other terms	8	$468	$701	$332	47%	—	$463 – $1.2k
19	Highmark case rate · outpatient · +2 other terms	5	$475	$642	$227	35%	—	$475 – $1.0k
20	Tricare facility · fee schedule · outpatient	5	$475	$475	—	—	—	$475 – $475
21	Excellus case rate · outpatient	4	$648	$662	$242	37%	—	$475 – $1.1k
22	Bcbs Nj facility · other · outpatient	3	$463	$463	—	—	—	$463 – $463
23	Sanford Health Plan case rate · outpatient	3	$713	$718	$73	10%	—	$596 – $821
24	Aetna Better Health facility · case rate · outpatient	1	$366	$366	$118	32%	—	$248 – $484
25	Magellan fee schedule · outpatient	1	$463	$463	—	—	—	$463 – $463

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