Tetanus immune globulin 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

TETANUS IMMUNE GLOBULIN SOLN 250U

Payers reporting CPT 90389

Payer pricing summary

Low

$19

Average

$2.5k

Median

$685

High

$33.5k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +18 other terms	400	$1.3k	$1.3k	$690	54%	—	$15 – $4.9k
2	Cigna fee schedule · outpatient · +16 other terms	207	$1.2k	$2.1k	$1.5k	74%	—	$451 – $6.2k
3	Blue Cross Blue Shield fee schedule · outpatient · +14 other terms	177	$1.3k	$1.5k	$909	60%	—	$0 – $4.2k
4	Aetna fee schedule · outpatient · +17 other terms	101	$803	$1.6k	$1.7k	107%	—	$10 – $11.9k
5	Humana fee schedule · outpatient · +12 other terms	84	$1.3k	$2.2k	$1.6k	75%	—	$86 – $8.3k
6	Anthem fee schedule · outpatient · +11 other terms	61	$714	$658	$587	89%	—	$131 – $3.1k
7	Bcbs Tx fee schedule · outpatient · +1 other terms	30	$2.3k	$2.1k	$696	33%	—	$853 – $3.6k
8	Molina facility · case rate · outpatient · +10 other terms	28	$121	$111	$41	36%	—	$56 – $218
9	Caresource facility · case rate · outpatient · +4 other terms	16	$134	$204	$177	87%	—	$87 – $682
10	Aetna Better Health fee schedule · outpatient · +3 other terms	13	$682	$419	$284	68%	—	$112 – $682
11	Optum facility · case rate · outpatient · +4 other terms	13	$116	$122	$37	31%	—	$62 – $197
12	Wellmark fee schedule · both · +4 other terms	13	$649	$653	$22	3%	—	$649 – $787
13	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$1	$247	$320	130%	—	$1 – $674
14	Bcbs Nj fee schedule · outpatient	12	$647	$647	—	—	—	$647 – $647
15	Regence fee schedule · outpatient · +5 other terms	12	$106	$110	$32	29%	—	$75 – $275
16	Highmark fee schedule · outpatient · +4 other terms	11	$865	$854	$261	31%	—	$14 – $943
17	Medica fee schedule · outpatient · +5 other terms	10	$1.3k	$1.3k	$331	25%	—	$798 – $1.7k
18	Premera fee schedule · outpatient · +3 other terms	9	$1.4k	$1.3k	$227	17%	—	$974 – $1.7k
19	Ucare fee schedule · both · +4 other terms	9	$112	$112	$3	3%	—	$109 – $116
20	Bcbs Il professional · fee schedule · both	8	$197	$252	$384	153%	—	$0 – $1.1k
21	First Health professional · fee schedule · both · +8 other terms	8	$1	$276	$356	129%	—	$1 – $736
22	WellCare professional · fee schedule · both · +2 other terms	8	$0	$0	—	—	—	$0 – $0
23	Amerihealth Caritas facility · case rate · outpatient · +3 other terms	7	$72	$73	$2	3%	—	$72 – $78
24	Bcbs La fee schedule · outpatient · +1 other terms	6	$666	$674	$23	3%	—	$666 – $740
25	Excellus facility · fee schedule · outpatient	5	$1.1k	$1.2k	$745	63%	—	$649 – $3.1k

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