APC 9155

Lenacapavir injection for HIV treatment

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 lenacapavir (hiv tx) 1mg

Payers reporting APC 9155

Payer pricing summary

Low

$12

Average

$488

Median

$23

High

$8.7k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +3 other terms	174	$23	$23	$0	1%	—	$22 – $23
2	Humana fee schedule · outpatient · +4 other terms	161	$22	$23	$6	27%	—	$22 – $89
3	Aetna fee schedule · outpatient · +4 other terms	155	$23	$23	$3	12%	—	$22 – $38
4	WellCare fee schedule · outpatient · +2 other terms	131	$23	$23	$1	4%	—	$22 – $29
5	Blue Cross Blue Shield fee schedule · outpatient · +4 other terms	126	$23	$23	$1	4%	—	$22 – $33
6	Devoted fee schedule · outpatient · +1 other terms	122	$22	$22	$0	1%	—	$22 – $23
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	110	$23	$23	$1	3%	—	$22 – $25
8	Molina fee schedule · outpatient · +3 other terms	69	$33	$32	$12	38%	—	$22 – $58
9	Superior Healthplan fee schedule · outpatient	40	$23	$23	$0	1%	—	$23 – $24
10	Anthem fee schedule · outpatient · +1 other terms	31	$22	$22	$0	2%	—	$22 – $23
11	Oscar fee schedule · outpatient · +2 other terms	27	$22	$24	$5	21%	—	$22 – $38
12	Amerihealth Caritas fee schedule · outpatient	17	$27	$27	$0	1%	—	$26 – $27
13	Cigna fee schedule · outpatient · +2 other terms	15	$23	$23	$1	3%	—	$22 – $24
14	Clover fee schedule · outpatient · +2 other terms	15	$23	$23	$0	1%	—	$23 – $24
15	Kaiser fee schedule · outpatient · +2 other terms	15	$23	$23	$0	1%	—	$22 – $23
16	Ambetter case rate · outpatient · +2 other terms	12	$40	$44	$5	12%	—	$40 – $50
17	Medicare case rate · outpatient · +1 other terms	8	$22	$22	—	—	—	$22 – $22
18	Optum fee schedule · outpatient · +1 other terms	8	$23	$34	$16	47%	—	$22 – $57
19	Highmark case rate · outpatient · +1 other terms	5	$22	$22	—	—	—	$22 – $22
20	Tricare facility · fee schedule · outpatient	5	$22	$22	—	—	—	$22 – $22
21	Excellus case rate · outpatient	4	$30	$31	$11	37%	—	$22 – $50
22	Bcbs Nj facility · other · outpatient	3	$22	$22	—	—	—	$22 – $22
23	Sanford Health Plan case rate · outpatient	3	$32	$32	$3	10%	—	$27 – $37
24	Aetna Better Health facility · case rate · outpatient	1	$17	$17	$6	32%	—	$12 – $23
25	Magellan fee schedule · outpatient	1	$22	$22	—	—	—	$22 – $22

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