Ganciclovir sodium injection, 500 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

Inj, ganciclovir (exela)

Payers reporting HCPCS J1574

Payer pricing summary

Low

Average

$93

Median

$59

High

$689

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +10 other terms	350	$99	$104	$49	47%	—	$30 – $375
2	Cigna fee schedule · outpatient · +7 other terms	186	$96	$155	$111	72%	—	$46 – $436
3	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	164	$117	$141	$81	57%	—	$1 – $343
4	Aetna fee schedule · outpatient · +9 other terms	119	$102	$108	$71	65%	—	$41 – $520
5	Anthem fee schedule · outpatient · +8 other terms	35	$57	$87	$40	46%	—	$50 – $237
6	Bcbs Tx fee schedule · outpatient	30	$216	$196	$65	33%	—	$80 – $339
7	Aetna Better Health fee schedule · outpatient · +2 other terms	17	$52	$53	$4	7%	—	$49 – $59
8	Humana fee schedule · outpatient · +6 other terms	16	$49	$100	$50	50%	—	$48 – $166
9	Caresource facility · case rate · outpatient · +3 other terms	15	$9	$10	$2	23%	—	$6 – $15
10	Molina facility · case rate · outpatient · +6 other terms	15	$9	$10	$2	23%	—	$6 – $15
11	Wellmark fee schedule · both · +2 other terms	13	$50	$50	—	—	—	$50 – $50
12	Bcbs Nj fee schedule · outpatient	12	$50	$50	—	—	—	$50 – $50
13	Highmark fee schedule · outpatient · +3 other terms	12	$56	$56	$1	2%	—	$51 – $66
14	Optum facility · case rate · outpatient	11	$8	$9	$2	22%	—	$7 – $13
15	Medica fee schedule · outpatient · +5 other terms	10	$105	$105	$26	25%	—	$63 – $135
16	Ucare fee schedule · both · +3 other terms	9	$78	$79	$2	3%	—	$77 – $81
17	Bcbs Mn fee schedule · both · +2 other terms	8	$63	$63	$17	27%	—	$51 – $87
18	Excellus facility · fee schedule · outpatient	5	$83	$93	$56	60%	—	$53 – $239
19	First Health facility · fee schedule · outpatient · +2 other terms	4	$150	$150	—	—	—	$150 – $150
20	MultiPlan percent of total billed charges · outpatientfrom % of charges	4	$587	$689	$395	57%	—	$191 – $1.2k
21	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$58	$58	—	—	—	$58 – $58
22	Sanford Health Plan fee schedule · outpatient · +1 other terms	3	$51	$51	—	—	—	$51 – $51
23	Ambetter fee schedule · outpatient	1	$45	$45	—	—	—	$45 – $45
24	Bcbs Ca fee schedule · outpatient · +1 other terms	1	$51	$51	—	—	—	$51 – $51
25	Bcbs Id professional · fee schedule · outpatient	1	$51	$51	—	—	—	$51 – $51

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