Urofollitropin fertility injection, 75 IU

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

Urofollitropin, 75 iu

Payers reporting HCPCS J3355

Payer pricing summary

Low

$63

Average

$177

Median

$150

High

$536

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +7 other terms	198	$98	$113	$61	54%	—	$51 – $370
2	Cigna fee schedule · outpatient · +5 other terms	174	$120	$206	$140	68%	—	$58 – $542
3	Blue Cross Blue Shield fee schedule · outpatient · +6 other terms	137	$170	$283	$224	79%	—	$0 – $861
4	Aetna fee schedule · outpatient · +8 other terms	119	$157	$200	$212	106%	—	$0 – $1.3k
5	Humana fee schedule · outpatient · +5 other terms	75	$447	$737	$534	72%	—	$62 – $1.5k
6	Anthem fee schedule · outpatient · +6 other terms	37	$0	$11	$47	442%	—	$0 – $372
7	Bcbs Tx fee schedule · outpatient · +1 other terms	30	$542	$493	$164	33%	—	$201 – $852
8	Molina facility · case rate · outpatient · +4 other terms	27	$171	$151	$62	41%	—	$78 – $308
9	Caresource facility · case rate · outpatient	15	$185	$199	$46	23%	—	$124 – $314
10	Optum facility · case rate · outpatient · +2 other terms	13	$164	$171	$57	33%	—	$74 – $279
11	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$149	$142	$41	29%	—	$78 – $187
12	Regence fee schedule · outpatient · +1 other terms	12	$70	$76	$20	26%	—	$55 – $181
13	Bcbs Nj fee schedule · outpatient	10	$125	$125	—	—	—	$125 – $125
14	Medica fee schedule · outpatient · +4 other terms	10	$254	$256	$64	25%	—	$154 – $328
15	Aetna Better Health fee schedule · inpatient · +2 other terms	7	$124	$124	—	—	—	$124 – $124
16	Amerihealth Caritas facility · case rate · outpatient · +1 other terms	7	$86	$87	$3	3%	—	$86 – $93
17	Bcbs La fee schedule · outpatient · +1 other terms	6	$135	$135	—	—	—	$135 – $135
18	Tricare facility · fee schedule · outpatient · +1 other terms	5	$158	$158	—	—	—	$158 – $158
19	First Health facility · fee schedule · outpatient	4	$375	$375	—	—	—	$375 – $375
20	Kaiser fee schedule · both · +2 other terms	4	$89	$85	$20	23%	—	$65 – $110
21	Bcbs Id facility · fee schedule · outpatient	3	$80	$84	$39	46%	—	$42 – $134
22	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$148	$148	—	—	—	$148 – $148
23	Bcbs Sc fee schedule · outpatient	3	$184	$184	—	—	—	$184 – $184
24	Wellmark facility · case rate · outpatient · +1 other terms	3	$290	$254	$80	32%	—	$118 – $320
25	Bcbs Vt professional · fee schedule · outpatient	2	$186	$187	$43	23%	—	$128 – $264

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