Injection of omadacycline, per milligram

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

OMADACYCLINE 100 MG IV SOLR [174171]

Payers reporting HCPCS J0121

Payer pricing summary

Low

Average

$254

Median

$117

High

$1.9k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +22 other terms	565	$6	$21	$162	778%	—	$2 – $4.9k
2	Aetna fee schedule · outpatient · +21 other terms	368	$5	$42	$227	544%	—	$3 – $3.3k
3	Cigna fee schedule · outpatient · +17 other terms	326	$6	$25	$175	706%	—	$3 – $4.1k
4	Humana fee schedule · outpatient · +18 other terms	307	$4	$25	$119	476%	—	$3 – $1.2k
5	Blue Cross Blue Shield fee schedule · outpatient · +18 other terms	299	$6	$14	$101	706%	—	$1 – $2.5k
6	Molina fee schedule · outpatient · +17 other terms	134	$6	$82	$255	310%	—	$3 – $1.3k
7	WellCare fee schedule · outpatient · +11 other terms	126	$4	$25	$87	343%	—	$4 – $452
8	Anthem fee schedule · outpatient · +18 other terms	111	$6	$26	$110	415%	—	$4 – $1.2k
9	Caresource fee schedule · outpatient · +9 other terms	71	$5	$12	$77	628%	—	$4 – $904
10	Devoted fee schedule · outpatient · +5 other terms	62	$4	$4	$0	5%	—	$4 – $4
11	Kaiser fee schedule · outpatient · +13 other terms	62	$6	$8	$6	70%	—	$3 – $28
12	Ambetter facility · fee schedule · outpatient · +8 other terms	56	$7	$31	$132	429%	—	$4 – $775
13	Bcbs Tx fee schedule · outpatient · +1 other terms	31	$13	$12	$5	44%	—	$4 – $23
14	Clover fee schedule · outpatient · +3 other terms	29	$4	$6	$6	88%	—	$4 – $21
15	Medicare fee schedule · outpatient · +4 other terms	28	$4	$4	$2	54%	—	$3 – $21
16	Optum fee schedule · outpatient · +16 other terms	28	$4	$5	$2	41%	—	$4 – $12
17	Oscar facility · fee schedule · outpatient · +10 other terms	25	$5	$6	$1	18%	—	$4 – $7
18	Aetna Better Health fee schedule · outpatient · +10 other terms	22	$4	$4	$0	6%	—	$4 – $5
19	MultiPlan fee schedule · outpatient · +10 other terms	22	$6	$291	$579	199%	—	$4 – $1.5k
20	Medical Mutual facility · fee schedule · outpatient · +4 other terms	21	$7	$8	$4	46%	—	$2 – $17
21	Regence facility · fee schedule · outpatient · +7 other terms	21	$4	$5	$1	30%	—	$3 – $9
22	Healthpartners fee schedule · outpatient · +3 other terms	19	$5	$5	$0	3%	—	$4 – $5
23	Highmark fee schedule · outpatient · +7 other terms	18	$6	$11	$58	535%	—	$2 – $884
24	Medica fee schedule · both · +13 other terms	15	$6	$6	$2	29%	—	$4 – $8
25	Wellmark fee schedule · both · +6 other terms	14	$4	$4	$0	1%	—	$4 – $4

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