Phenylephrine and ketorolac eye irrigation 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-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

PHENYLEPHRINE-KETOROLAC 1-0.3 % IO SOLN

Payers reporting HCPCS J1097

Payer pricing summary

Low

$51

Average

$506

Median

$299

High

$2.4k

Payer rate distribution

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#
1	Blue Cross Blue Shield fee schedule · outpatient · +21 other terms	269	$174	$303	$312	103%	1–10	$1 – $2.3k
2	Wellmark fee schedule · outpatient · +8 other terms	15	$118	$118	—	—	1–10	$118 – $118
3	UnitedHealthcare fee schedule · outpatient · +21 other terms	526	$156	$190	$198	105%	—	$1 – $2.9k
4	Aetna fee schedule · outpatient · +19 other terms	345	$98	$183	$108	59%	—	$88 – $1.2k
5	Cigna fee schedule · outpatient · +16 other terms	260	$166	$315	$241	77%	—	$90 – $1.7k
6	Humana fee schedule · outpatient · +20 other terms	208	$97	$102	$49	48%	—	$88 – $921
7	WellCare fee schedule · outpatient · +12 other terms	118	$98	$109	$32	30%	—	$90 – $227
8	Anthem facility · fee schedule · outpatient · +15 other terms	105	$107	$163	$102	63%	—	$12 – $847
9	Molina fee schedule · outpatient · +17 other terms	101	$111	$124	$44	35%	—	$57 – $294
10	Devoted fee schedule · outpatient · +5 other terms	66	$97	$97	$5	5%	—	$88 – $107
11	Kaiser fee schedule · outpatient · +13 other terms	53	$121	$185	$152	82%	—	$95 – $884
12	Ambetter facility · fee schedule · outpatient · +10 other terms	50	$167	$183	$45	24%	—	$97 – $247
13	Optum fee schedule · outpatient · +13 other terms	40	$96	$118	$52	44%	—	$86 – $352
14	Caresource fee schedule · outpatient · +8 other terms	35	$124	$126	$14	11%	—	$96 – $189
15	Oscar facility · fee schedule · outpatient · +8 other terms	31	$147	$147	$21	14%	—	$112 – $179
16	Bcbs Tx fee schedule · outpatient · +3 other terms	29	$432	$396	$179	45%	—	$91 – $792
17	Medicare fee schedule · outpatient · +4 other terms	25	$95	$114	$6	5%	—	$93 – $116
18	Clover fee schedule · outpatient · +5 other terms	24	$107	$103	$7	7%	—	$92 – $114
19	Aetna Better Health fee schedule · outpatient · +9 other terms	19	$117	$143	$134	94%	—	$91 – $709
20	Medica fee schedule · outpatient · +14 other terms	19	$238	$355	$385	108%	—	$6 – $1.6k
21	Medical Mutual facility · fee schedule · outpatient · +6 other terms	19	$217	$238	$137	57%	—	$53 – $526
22	Phcs percent of total billed charges · outpatientfrom % of charges · +5 other terms	19	$1.1k	$1.1k	$712	65%	—	$165 – $2.2k
23	Highmark fee schedule · outpatient · +5 other terms	18	$132	$180	$254	141%	—	$44 – $2.3k
24	Regence facility · fee schedule · outpatient · +7 other terms	18	$101	$101	$7	6%	—	$82 – $120
25	Sanford Health Plan fee schedule · outpatient · +9 other terms	17	$120	$375	$504	135%	—	$94 – $1.6k

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