APC 9262

Intrathecal tofersen 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

Inj tofersen intrathec 1 mg

Payers reporting APC 9262

Payer pricing summary

Low

$83

Average

$535

Median

$168

High

$6.9k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +3 other terms	174	$162	$162	$3	2%	—	$151 – $168
2	Humana fee schedule · outpatient · +4 other terms	161	$160	$167	$46	27%	—	$151 – $640
3	Aetna fee schedule · outpatient · +5 other terms	155	$162	$165	$19	11%	—	$151 – $272
4	WellCare fee schedule · outpatient · +2 other terms	131	$165	$167	$7	4%	—	$155 – $211
5	Blue Cross Blue Shield fee schedule · outpatient · +4 other terms	126	$163	$162	$6	4%	—	$151 – $226
6	Devoted fee schedule · outpatient · +1 other terms	122	$160	$160	$1	1%	—	$160 – $168
7	Cigna Healthspring fee schedule · outpatient · +1 other terms	110	$166	$164	$4	3%	—	$160 – $178
8	Molina fee schedule · outpatient · +2 other terms	69	$236	$229	$88	38%	—	$155 – $419
9	Superior Healthplan fee schedule · outpatient	40	$168	$168	$1	1%	—	$168 – $173
10	Anthem fee schedule · outpatient · +1 other terms	31	$160	$161	$3	2%	—	$155 – $165
11	Oscar fee schedule · outpatient · +1 other terms	27	$157	$174	$35	20%	—	$157 – $272
12	Amerihealth Caritas fee schedule · outpatient	17	$192	$191	$2	1%	—	$188 – $192
13	Cigna fee schedule · outpatient · +2 other terms	15	$163	$163	$6	4%	—	$155 – $173
14	Clover fee schedule · outpatient · +2 other terms	15	$168	$168	$1	1%	—	$168 – $173
15	Kaiser fee schedule · outpatient · +2 other terms	15	$163	$162	$2	1%	—	$158 – $163
16	Ambetter case rate · outpatient · +2 other terms	12	$287	$314	$32	10%	—	$287 – $353
17	Medicare case rate · outpatient · +1 other terms	8	$159	$159	—	—	—	$159 – $159
18	Optum fee schedule · outpatient · +1 other terms	8	$162	$242	$115	47%	—	$159 – $412
19	Highmark case rate · outpatient · +1 other terms	5	$159	$159	—	—	—	$159 – $159
20	Tricare facility · fee schedule · outpatient	5	$159	$159	—	—	—	$159 – $159
21	Excellus case rate · outpatient	4	$218	$222	$81	37%	—	$159 – $358
22	Bcbs Nj facility · other · outpatient	3	$160	$160	—	—	—	$160 – $160
23	Sanford Health Plan case rate · outpatient	3	$225	$227	$23	10%	—	$188 – $259
24	Aetna Better Health facility · case rate · outpatient	1	$123	$123	$40	32%	—	$83 – $163
25	Magellan fee schedule · outpatient	1	$160	$160	—	—	—	$160 – $160

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