Phentolamine mesylate injection

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

PHENTOLAMINE 5 MG INJECTION SOLUTION

Payers reporting HCPCS J2760

Payer pricing summary

Low

$220

Average

$818

Median

$754

High

$2.1k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +33 other terms	734	$628	$743	$1.1k	146%	1–10	$0 – $12.0k
2	Aetna fee schedule · outpatient · +30 other terms	506	$539	$741	$718	97%	—	$1 – $17.1k
3	Cigna fee schedule · outpatient · +26 other terms	441	$620	$912	$688	75%	—	$30 – $3.7k
4	Blue Cross Blue Shield fee schedule · outpatient · +31 other terms	433	$564	$725	$521	72%	—	$0 – $4.2k
5	Humana fee schedule · outpatient · +27 other terms	427	$436	$564	$558	99%	—	$0 – $6.9k
6	Anthem fee schedule · outpatient · +26 other terms	174	$494	$520	$420	81%	—	$32 – $6.3k
7	Molina fee schedule · outpatient · +26 other terms	166	$454	$521	$240	46%	—	$1 – $1.8k
8	WellCare fee schedule · outpatient · +17 other terms	158	$431	$498	$518	104%	—	$189 – $4.3k
9	MultiPlan fee schedule · outpatient · +18 other terms	101	$1.2k	$1.4k	$1.2k	85%	—	$58 – $6.9k
10	Kaiser fee schedule · outpatient · +20 other terms	99	$539	$860	$797	93%	—	$72 – $4.3k
11	Caresource fee schedule · outpatient · +16 other terms	92	$449	$548	$554	101%	—	$1 – $4.3k
12	Ambetter facility · fee schedule · outpatient · +16 other terms	88	$613	$691	$337	49%	—	$303 – $2.7k
13	Devoted fee schedule · outpatient · +12 other terms	60	$431	$428	$15	3%	—	$400 – $493
14	Optum fee schedule · outpatient · +20 other terms	58	$437	$455	$208	46%	—	$1 – $1.2k
15	Highmark facility · fee schedule · outpatient · +15 other terms	56	$475	$544	$410	75%	—	$39 – $2.0k
16	Medica fee schedule · outpatient · +20 other terms	48	$830	$918	$417	45%	—	$2 – $2.0k
17	Oscar facility · fee schedule · outpatient · +17 other terms	44	$556	$527	$112	21%	—	$297 – $799
18	Amerihealth Caritas facility · fee schedule · outpatient · +14 other terms	37	$432	$485	$325	67%	—	$259 – $3.1k
19	First Health fee schedule · outpatient · +18 other terms	36	$834	$979	$875	89%	—	$50 – $4.3k
20	Medicare fee schedule · outpatient · +13 other terms	36	$423	$486	$433	89%	—	$245 – $4.2k
21	Medicaid facility · fee schedule · outpatient · +12 other terms	34	$177	$266	$149	56%	—	$27 – $432
22	Regence facility · fee schedule · both · +18 other terms	33	$529	$619	$244	39%	—	$237 – $1.4k
23	Carefirst facility · fee schedule · both · +10 other terms	32	$486	$596	$244	41%	—	$279 – $1.4k
24	Excellus facility · fee schedule · both · +10 other terms	32	$465	$558	$226	41%	—	$279 – $1.4k
25	Premera facility · fee schedule · both · +10 other terms	32	$486	$598	$246	41%	—	$279 – $1.4k

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