APC 9261

Ustekinumab injection under the skin

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

Ustekinumab sub cu inj, 1 mg

Payers reporting APC 9261

Payer pricing summary

Low

$78

Average

$9.0k

Median

$196

High

$52.6k

Payer rate distribution

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#
1	Blue Cross Blue Shield fee schedule · outpatient · +4 other terms	22	$149	$155	$18	12%	—	$149 – $237
2	UnitedHealthcare fee schedule · outpatient · +3 other terms	21	$161	$159	$3	2%	—	$154 – $164
3	Aetna fee schedule · outpatient · +3 other terms	20	$161	$185	$48	26%	—	$154 – $273
4	Humana case rate · outpatient · +4 other terms	14	$155	$165	$10	6%	—	$149 – $180
5	Molina fee schedule · outpatient · +2 other terms	14	$159	$175	$25	14%	—	$156 – $234
6	Ambetter case rate · outpatient · +2 other terms	12	$269	$310	$48	16%	—	$269 – $367
7	Clover case rate · outpatient · +1 other terms	12	$155	$166	$12	7%	—	$155 – $180
8	WellCare case rate · outpatient · +2 other terms	12	$160	$172	$14	8%	—	$160 – $189
9	Medicare case rate · outpatient · +1 other terms	8	$149	$149	—	—	—	$149 – $149
10	Anthem fee schedule · outpatient · +1 other terms	7	$156	$156	$1	1%	—	$156 – $159
11	Cigna fee schedule · outpatient · +1 other terms	7	$156	$167	$22	13%	—	$156 – $219
12	Tricare facility · fee schedule · outpatient	5	$149	$149	—	—	—	$149 – $149
13	Oscar fee schedule · outpatient · +1 other terms	3	$273	$273	$0	0%	—	$273 – $273
14	Sanford Health Plan case rate · outpatient	3	$228	$230	$23	10%	—	$191 – $263
15	Kaiser fee schedule · outpatient · +1 other terms	2	$159	$159	—	—	—	$159 – $159
16	Aetna Better Health facility · case rate · outpatient	1	$115	$115	$37	32%	—	$78 – $152
17	Bcbs Nj facility · other · outpatient	1	$52.6k	$52.6k	$36.9k	70%	—	$490 – $104.9k
18	Devoted facility · fee schedule · outpatient · +1 other terms	1	$39.8k	$39.8k	—	—	—	$39.8k – $39.8k
19	Highmark facility · other · outpatient	1	$32.9k	$32.9k	$33.4k	102%	—	$123 – $104.9k
20	Medicaid facility · case rate · outpatient	1	$78	$78	—	—	—	$78 – $78
21	Optum fee schedule · outpatient · +1 other terms	1	$149	$149	—	—	—	$149 – $149