Injection of daptomycin (Xellia brand), per 1 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-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

DAPTOMYCIN 50 MG/ML IV [940836989]

Payers reporting HCPCS J0873

Payer pricing summary

Low

Average

$45

Median

$16

High

$392

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +22 other terms	491	$0	$1	$9	592%	—	$0 – $98
2	Cigna fee schedule · outpatient · +17 other terms	292	$0	$0	$1	512%	—	$0 – $12
3	Aetna fee schedule · outpatient · +18 other terms	242	$0	$1	$6	577%	—	$0 – $54
4	Blue Cross Blue Shield fee schedule · outpatient · +22 other terms	229	$0	$2	$10	583%	—	$0 – $95
5	Humana fee schedule · outpatient · +20 other terms	206	$0	$1	$6	736%	—	$0 – $61
6	Anthem fee schedule · outpatient · +13 other terms	74	$0	$3	$12	455%	—	$0 – $72
7	WellCare fee schedule · outpatient · +13 other terms	67	$0	$0	$0	50%	—	$0 – $0
8	Molina fee schedule · outpatient · +17 other terms	58	$0	$3	$14	496%	—	$0 – $98
9	Caresource fee schedule · outpatient · +7 other terms	43	$0	$0	$0	20%	—	$0 – $0
10	Kaiser fee schedule · both · +9 other terms	43	$0	$0	$1	712%	—	$0 – $11
11	Bcbs Tx fee schedule · outpatient	31	$0	$0	$0	48%	—	$0 – $0
12	Devoted fee schedule · outpatient · +4 other terms	31	$0	$0	—	—	—	$0 – $0
13	Oscar facility · fee schedule · outpatient · +9 other terms	24	$0	$0	$0	20%	—	$0 – $0
14	Ambetter facility · fee schedule · outpatient · +13 other terms	23	$0	$0	$0	25%	—	$0 – $0
15	Aetna Better Health fee schedule · outpatient · +9 other terms	22	$0	$0	$0	25%	—	$0 – $0
16	Medica fee schedule · outpatient · +11 other terms	21	$0	$16	$31	194%	—	$0 – $96
17	Optum facility · fee schedule · outpatient · +11 other terms	20	$0	$0	—	—	—	$0 – $0
18	Clover fee schedule · outpatient · +5 other terms	19	$0	$0	—	—	—	$0 – $0
19	Healthpartners fee schedule · outpatient · +7 other terms	18	$0	$0	$0	20%	—	$0 – $0
20	Beechstreet percent of total billed charges · outpatientfrom % of charges · +3 other terms	16	$78	$90	$28	31%	—	$49 – $146
21	Medical Mutual fee schedule · outpatient · +1 other terms	16	$0	$0	$0	13%	—	$0 – $0
22	Wellmark fee schedule · both · +10 other terms	14	$0	$0	—	—	—	$0 – $0
23	Bcbs Mn fee schedule · outpatient · +8 other terms	13	$0	$0	$0	136%	—	$0 – $1
24	Bcbs Nj fee schedule · outpatient	12	$0	$0	$0	80%	—	$0 – $0
25	Cigna Healthspring fee schedule · outpatient · +2 other terms	12	$0	$0	—	—	—	$0 – $0

Page 1 of 3 · 54 payers