Dipyridamole injection, per 10 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

DIPYRIDAMOLE 5 MG/ML INTRAVENOUS SOLUTION

Payers reporting HCPCS J1245

Payer pricing summary

Low

Average

$69

Median

$49

High

$441

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +22 other terms	425	$13	$41	$230	568%	—	$0 – $2.1k
2	Cigna fee schedule · outpatient · +19 other terms	353	$7	$17	$44	257%	—	$1 – $402
3	Aetna fee schedule · outpatient · +20 other terms	242	$8	$34	$91	266%	—	$0 – $708
4	Blue Cross Blue Shield fee schedule · outpatient · +21 other terms	242	$7	$17	$57	330%	—	$0 – $1.6k
5	Humana fee schedule · outpatient · +17 other terms	174	$4	$17	$35	209%	—	$1 – $249
6	Anthem fee schedule · outpatient · +17 other terms	89	$8	$12	$14	120%	—	$3 – $109
7	Caresource fee schedule · outpatient · +14 other terms	49	$5	$34	$76	225%	—	$1 – $325
8	Kaiser fee schedule · both · +14 other terms	43	$5	$5	$1	26%	—	$3 – $7
9	MultiPlan fee schedule · outpatient · +14 other terms	42	$60	$164	$229	139%	—	$15 – $724
10	Molina fee schedule · outpatient · +18 other terms	33	$9	$31	$64	207%	—	$1 – $278
11	Bcbs Tx fee schedule · outpatient · +3 other terms	30	$12	$11	$4	33%	—	$4 – $19
12	Regence professional · fee schedule · outpatient · +6 other terms	21	$4	$4	$1	33%	—	$4 – $10
13	First Health fee schedule · inpatient · +13 other terms	20	$38	$39	$23	59%	—	$13 – $84
14	Ambetter other · outpatient · +13 other terms	19	$454	$597	$493	83%	—	$15 – $1.4k
15	Oscar facility · fee schedule · outpatient · +11 other terms	19	$5	$5	$1	24%	—	$5 – $8
16	Healthpartners fee schedule · outpatient · +5 other terms	18	$5	$5	$0	2%	—	$5 – $5
17	Highmark facility · fee schedule · outpatient · +12 other terms	18	$7	$11	$7	66%	—	$4 – $24
18	Tricare facility · fee schedule · outpatient · +11 other terms	18	$36	$89	$166	187%	—	$8 – $879
19	Aetna Better Health fee schedule · outpatient · +9 other terms	17	$4	$6	$2	40%	—	$4 – $9
20	WellCare fee schedule · outpatient · +9 other terms	15	$4	$13	$20	159%	—	$4 – $61
21	Phcs fee schedule · outpatient · +10 other terms	14	$56	$77	$72	94%	—	$20 – $288
22	Wellmark fee schedule · both · +4 other terms	14	$4	$4	—	—	—	$4 – $4
23	Medica fee schedule · outpatient · +10 other terms	13	$8	$13	$14	109%	—	$5 – $67
24	Medical Mutual facility · fee schedule · outpatient · +6 other terms	13	$11	$12	$5	45%	—	$5 – $27
25	Bcbs Mn fee schedule · outpatient · +5 other terms	12	$2	$2	$1	49%	—	$1 – $4

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