Sulfamethoxazole-trimethoprim 800/160 mg multi-dose vial

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

SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION

Payers reporting HCPCS J2865

Payer pricing summary

Low

Average

$293

Median

$47

High

$4.2k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +24 other terms	322	$0	$35	$306	870%	1–10	$0 – $9.6k
2	Wellmark fee schedule · outpatient · +11 other terms	20	$0	$0	—	—	1–10	$0 – $0
3	Cigna fee schedule · outpatient · +20 other terms	228	$0	$18	$54	308%	—	$0 – $587
4	Blue Cross Blue Shield fee schedule · outpatient · +26 other terms	155	$0	$6	$24	396%	—	$0 – $206
5	Aetna fee schedule · outpatient · +23 other terms	120	$0	$53	$139	263%	—	$0 – $807
6	Humana fee schedule · outpatient · +17 other terms	94	$0	$4	$19	495%	—	$0 – $177
7	Anthem fee schedule · outpatient · +21 other terms	75	$0	$25	$52	207%	—	$0 – $301
8	Kaiser fee schedule · both · +14 other terms	41	$0	$0	$0	33%	—	$0 – $0
9	MultiPlan fee schedule · inpatient · +12 other terms	38	$98	$128	$168	131%	—	$6 – $825
10	Highmark facility · fee schedule · outpatient · +8 other terms	31	$0	$0	—	—	—	$0 – $0
11	Medcost percent of total billed charges · outpatientfrom % of charges · +5 other terms	27	$51	$50	$46	92%	—	$0 – $224
12	Baylor Scott White Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	26	$101	$89	$46	52%	—	$36 – $162
13	Caresource fee schedule · outpatient · +12 other terms	26	$0	$0	$0	193%	—	$0 – $1
14	First Health fee schedule · outpatient · +13 other terms	26	$67	$72	$57	79%	—	$6 – $256
15	Beechstreet percent of total billed charges · outpatientfrom % of charges · +4 other terms	22	$83	$94	$77	82%	—	$14 – $436
16	Amerihealth Caritas facility · fee schedule · outpatient · +9 other terms	20	$0	$0	—	—	—	$0 – $0
17	Oscar facility · fee schedule · outpatient · +9 other terms	19	$0	$0	$0	20%	—	$0 – $0
18	Healthcare Highways facility · percent of total billed charges · bothfrom % of charges · +2 other terms	18	$38	$39	$24	63%	—	$5 – $103
19	Molina facility · case rate · outpatient · +15 other terms	15	$47	$53	$12	22%	—	$33 – $80
20	Medicaid fee schedule · outpatient · +8 other terms	14	$1	$23	$41	180%	—	$1 – $144
21	Bcbs Nc percent of total billed charges · outpatientfrom % of charges · +2 other terms	13	$28	$28	$18	64%	—	$9 – $74
22	WellCare professional · fee schedule · outpatient · +9 other terms	12	$0	$0	—	—	—	$0 – $0
23	Optum facility · case rate · outpatient · +11 other terms	11	$45	$49	$11	23%	—	$40 – $73
24	Medical Mutual facility · fee schedule · outpatient · +5 other terms	10	$0	$0	$0	31%	—	$0 – $0
25	Tricare facility · fee schedule · outpatient · +7 other terms	10	$37	$54	$60	110%	—	$2 – $251

Page 1 of 3 · 59 payers