Amphotericin B liposome injection, 50 mg

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

AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION

Payers reporting HCPCS J0289

Payer pricing summary

Low

$11

Average

$276

Median

$225

High

$1.0k

Payer rate distribution

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#
1	Blue Cross Blue Shield fee schedule · outpatient · +30 other terms	430	$50	$119	$192	161%	13	$0 – $1.8k
2	Medicare other · both · +14 other terms	40	$21	$24	$37	152%	2–20	$21 – $484
3	UnitedHealthcare fee schedule · outpatient · +32 other terms	715	$34	$89	$361	406%	1–10	$0 – $9.0k
4	Aetna fee schedule · outpatient · +27 other terms	481	$33	$167	$758	452%	—	$1 – $10.4k
5	Cigna fee schedule · outpatient · +24 other terms	431	$36	$135	$460	341%	—	$0 – $5.5k
6	Humana fee schedule · outpatient · +25 other terms	408	$23	$96	$259	271%	—	$0 – $4.3k
7	Anthem fee schedule · outpatient · +25 other terms	160	$34	$62	$139	224%	—	$17 – $1.7k
8	Molina fee schedule · outpatient · +26 other terms	158	$32	$146	$401	274%	—	$1 – $3.8k
9	WellCare fee schedule · outpatient · +18 other terms	142	$23	$30	$34	112%	—	$20 – $267
10	MultiPlan fee schedule · outpatient · +17 other terms	101	$561	$1.1k	$2.0k	184%	—	$21 – $9.9k
11	Ambetter facility · fee schedule · outpatient · +16 other terms	98	$39	$45	$30	66%	—	$7 – $278
12	Kaiser fee schedule · outpatient · +18 other terms	98	$51	$257	$674	262%	—	$15 – $6.6k
13	Caresource fee schedule · outpatient · +17 other terms	75	$27	$42	$53	127%	—	$1 – $267
14	Highmark facility · fee schedule · outpatient · +15 other terms	71	$37	$91	$107	117%	—	$17 – $564
15	Optum facility · fee schedule · outpatient · +21 other terms	65	$21	$32	$32	99%	—	$17 – $163
16	Devoted facility · fee schedule · outpatient · +13 other terms	60	$23	$23	$1	5%	—	$21 – $25
17	Medica fee schedule · outpatient · +18 other terms	48	$116	$135	$243	181%	—	$8 – $1.4k
18	Oscar facility · fee schedule · outpatient · +14 other terms	45	$29	$28	$6	21%	—	$20 – $43
19	Amerihealth Caritas facility · fee schedule · outpatient · +13 other terms	41	$22	$42	$118	279%	—	$4 – $1.1k
20	Tricare facility · fee schedule · outpatient · +18 other terms	39	$25	$615	$601	98%	—	$20 – $2.1k
21	First Health fee schedule · outpatient · +16 other terms	36	$509	$458	$457	100%	—	$17 – $2.0k
22	Medicaid facility · fee schedule · outpatient · +13 other terms	34	$116	$154	$308	200%	—	$10 – $1.5k
23	Clover facility · fee schedule · outpatient · +8 other terms	29	$22	$22	$1	5%	—	$21 – $27
24	Aetna Better Health fee schedule · outpatient · +15 other terms	26	$29	$31	$41	130%	—	$21 – $365
25	Baylor Scott White Health Plan facility · fee schedule · outpatient · +2 other terms	25	$29	$29	$6	20%	—	$22 – $38

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