Emicizumab injection, 0.5 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

EMICIZUMAB-KXWH 30 MG/ML SUBCU SOLN

Payers reporting HCPCS J7170

Payer pricing summary

Low

$30

Average

$8.6k

Median

$4.3k

High

$43.3k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +24 other terms	565	$84	$487	$3.8k	789%	—	$24 – $51.3k
2	Aetna fee schedule · outpatient · +22 other terms	378	$63	$1.4k	$10.3k	743%	—	$31 – $222.0k
3	Cigna fee schedule · outpatient · +18 other terms	344	$78	$1.0k	$7.7k	759%	—	$42 – $76.4k
4	Humana fee schedule · outpatient · +19 other terms	331	$55	$2.2k	$10.9k	484%	—	$36 – $71.0k
5	Blue Cross Blue Shield fee schedule · outpatient · +22 other terms	305	$79	$106	$66	62%	—	$1 – $407
6	Molina fee schedule · outpatient · +18 other terms	125	$81	$1.1k	$4.4k	400%	—	$44 – $21.7k
7	WellCare fee schedule · outpatient · +15 other terms	119	$56	$60	$15	24%	—	$49 – $122
8	Anthem fee schedule · outpatient · +20 other terms	110	$75	$298	$2.7k	898%	—	$45 – $32.6k
9	Devoted fee schedule · outpatient · +8 other terms	66	$56	$55	$2	4%	—	$51 – $60
10	Caresource fee schedule · outpatient · +11 other terms	60	$69	$67	$14	21%	—	$52 – $109
11	Kaiser fee schedule · outpatient · +15 other terms	60	$79	$1.1k	$5.4k	482%	—	$45 – $38.6k
12	Ambetter facility · fee schedule · outpatient · +8 other terms	57	$100	$103	$20	19%	—	$52 – $144
13	Optum fee schedule · outpatient · +18 other terms	40	$56	$15.0k	$27.0k	180%	—	$50 – $90.2k
14	Oscar facility · fee schedule · outpatient · +10 other terms	34	$72	$70	$14	20%	—	$56 – $104
15	Bcbs Tx fee schedule · outpatient · +1 other terms	31	$171	$159	$69	43%	—	$49 – $303
16	Clover fee schedule · outpatient · +5 other terms	24	$57	$57	$3	5%	—	$53 – $63
17	MultiPlan fee schedule · outpatient · +13 other terms	24	$86	$16.4k	$30.5k	186%	—	$57 – $81.9k
18	Aetna Better Health fee schedule · outpatient · +12 other terms	22	$56	$55	$3	5%	—	$52 – $63
19	Highmark facility · fee schedule · outpatient · +8 other terms	22	$62	$79	$47	59%	—	$35 – $292
20	Medical Mutual facility · fee schedule · outpatient · +5 other terms	21	$107	$124	$56	45%	—	$30 – $245
21	Regence facility · fee schedule · outpatient · +7 other terms	21	$59	$65	$20	31%	—	$48 – $125
22	Tricare facility · fee schedule · outpatient · +6 other terms	21	$56	$1.2k	$5.5k	454%	—	$52 – $34.6k
23	Medicare fee schedule · outpatient · +6 other terms	20	$55	$55	$1	3%	—	$48 – $55
24	Healthpartners fee schedule · outpatient · +6 other terms	19	$62	$62	$2	3%	—	$57 – $63
25	Wellmark fee schedule · outpatient · +6 other terms	16	$52	$52	—	—	—	$52 – $52

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