APC 9324

Phenylephrine and ketorolac eye solution

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-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Phenylep ketorolac opth soln

Payers reporting APC 9324

Payer pricing summary

Low

$51

Average

$268

Median

$124

High

$1.7k

Payer rate distribution

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#
1	Excellus case rate · outpatient	4	$226	$250	$80	32%	80	$167 – $394
2	Highmark case rate · outpatient · +1 other terms	5	$118	$136	$43	32%	1–10	$97 – $213
3	UnitedHealthcare fee schedule · outpatient · +4 other terms	172	$99	$98	$1	1%	—	$96 – $102
4	Humana fee schedule · outpatient · +4 other terms	159	$98	$101	$28	28%	—	$92 – $390
5	Aetna fee schedule · outpatient · +5 other terms	154	$98	$101	$12	12%	—	$95 – $169
6	WellCare fee schedule · outpatient · +2 other terms	130	$100	$101	$4	3%	—	$97 – $129
7	Blue Cross Blue Shield fee schedule · outpatient · +4 other terms	125	$98	$98	$1	1%	—	$96 – $101
8	Devoted fee schedule · outpatient · +1 other terms	122	$98	$97	$1	1%	—	$96 – $102
9	Cigna Healthspring fee schedule · outpatient	110	$101	$99	$3	3%	—	$96 – $104
10	Molina fee schedule · outpatient · +2 other terms	68	$144	$139	$54	39%	—	$97 – $256
11	Superior Healthplan fee schedule · outpatient	40	$102	$102	$0	0%	—	$101 – $102
12	Anthem fee schedule · outpatient · +2 other terms	31	$98	$98	$1	1%	—	$96 – $100
13	Oscar fee schedule · outpatient · +1 other terms	27	$96	$106	$23	21%	—	$95 – $169
14	Amerihealth Caritas fee schedule · outpatient	17	$117	$116	$3	2%	—	$110 – $117
15	Cigna fee schedule · outpatient · +2 other terms	15	$99	$100	$3	3%	—	$97 – $105
16	Clover fee schedule · outpatient · +2 other terms	15	$101	$102	$1	0%	—	$101 – $102
17	Kaiser fee schedule · outpatient · +1 other terms	15	$99	$99	$1	1%	—	$98 – $99
18	Ambetter case rate · outpatient · +2 other terms	12	$161	$185	$31	17%	—	$159 – $222
19	Medicare case rate · outpatient	8	$88	$89	$2	2%	—	$88 – $95
20	Optum fee schedule · outpatient · +1 other terms	8	$98	$145	$68	47%	—	$96 – $242
21	Tricare facility · fee schedule · outpatient	5	$97	$97	—	—	—	$97 – $97
22	Bcbs Nj facility · other · outpatient	3	$1.7k	$1.7k	—	—	—	$1.7k – $1.7k
23	Sanford Health Plan case rate · outpatient	3	$141	$142	$14	10%	—	$118 – $163
24	Aetna Better Health facility · case rate · outpatient	1	$75	$75	$24	32%	—	$51 – $99
25	Magellan fee schedule · outpatient	1	$98	$98	—	—	—	$98 – $98

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