Glatiramer acetate injection, 20 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

Injection glatiramer acetate

Payers reporting HCPCS J1595

Payer pricing summary

Low

$52

Average

$992

Median

$332

High

$9.6k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +23 other terms	549	$268	$294	$178	61%	—	$1 – $1.0k
2	Blue Cross Blue Shield fee schedule · outpatient · +20 other terms	264	$199	$237	$155	65%	—	$0 – $1.5k
3	Cigna fee schedule · outpatient · +21 other terms	238	$153	$237	$633	268%	—	$58 – $13.0k
4	Aetna fee schedule · outpatient · +22 other terms	232	$163	$180	$120	66%	—	$1 – $1.0k
5	Humana fee schedule · outpatient · +21 other terms	185	$188	$350	$400	114%	—	$1 – $1.7k
6	Anthem fee schedule · outpatient · +17 other terms	110	$140	$125	$79	63%	—	$34 – $507
7	WellCare fee schedule · outpatient · +12 other terms	78	$167	$190	$61	32%	—	$160 – $402
8	Molina fee schedule · outpatient · +17 other terms	59	$168	$181	$224	123%	—	$1 – $2.1k
9	Kaiser fee schedule · both · +12 other terms	43	$196	$196	$52	26%	—	$114 – $270
10	Bcbs Tx fee schedule · outpatient · +1 other terms	31	$370	$341	$133	39%	—	$151 – $637
11	Devoted fee schedule · outpatient · +6 other terms	31	$180	$177	$8	5%	—	$167 – $190
12	MultiPlan fee schedule · outpatient · +12 other terms	31	$537	$2.3k	$5.5k	240%	—	$160 – $21.3k
13	Highmark facility · fee schedule · outpatient · +9 other terms	27	$254	$236	$136	58%	—	$62 – $761
14	Optum facility · fee schedule · outpatient · +14 other terms	27	$173	$176	$31	17%	—	$134 – $377
15	Ambetter facility · fee schedule · outpatient · +10 other terms	24	$402	$352	$99	28%	—	$0 – $438
16	Caresource fee schedule · outpatient · +11 other terms	24	$53	$114	$71	63%	—	$53 – $202
17	Tricare facility · fee schedule · outpatient · +8 other terms	24	$530	$5.3k	$9.8k	185%	—	$114 – $37.0k
18	Clover fee schedule · outpatient · +4 other terms	19	$188	$183	$10	5%	—	$171 – $202
19	First Health fee schedule · outpatient · +14 other terms	15	$665	$4.4k	$7.1k	161%	—	$160 – $20.8k
20	Medicaid fee schedule · both · +8 other terms	14	$69	$66	$7	11%	—	$53 – $74
21	Oscar facility · fee schedule · outpatient · +9 other terms	14	$288	$272	$37	13%	—	$184 – $320
22	Bcbs Mn fee schedule · outpatient · +8 other terms	13	$225	$218	$76	35%	—	$126 – $304
23	Cigna Healthspring fee schedule · outpatient · +4 other terms	13	$176	$175	$3	1%	—	$160 – $176
24	Regence fee schedule · outpatient · +8 other terms	13	$251	$282	$88	31%	—	$150 – $481
25	Wellmark fee schedule · both · +9 other terms	13	$58	$58	—	—	—	$58 – $58

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