Mitomycin eye treatment, 0.2 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

mitoMYcin 0.5 mg/mL Drop 1 mL BOTTLE

Payers reporting HCPCS J7315

Payer pricing summary

Low

$127

Average

$791

Median

$675

High

$2.7k

Payer rate distribution

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#
1	Cigna fee schedule · outpatient · +15 other terms	201	$822	$1.3k	$941	72%	—	$1 – $3.8k
2	Blue Cross Blue Shield fee schedule · outpatient · +18 other terms	188	$877	$1.0k	$655	64%	—	$1 – $3.3k
3	Aetna fee schedule · outpatient · +18 other terms	127	$773	$870	$560	64%	—	$1 – $4.5k
4	Humana fee schedule · outpatient · +13 other terms	83	$851	$1.5k	$1.1k	72%	—	$21 – $3.1k
5	UnitedHealthcare fee schedule · outpatient · +17 other terms	60	$199	$431	$366	85%	—	$11 – $1.8k
6	Anthem fee schedule · outpatient · +16 other terms	54	$473	$619	$321	52%	—	$144 – $2.0k
7	Molina facility · case rate · outpatient · +14 other terms	39	$78	$100	$40	40%	—	$56 – $218
8	Medica fee schedule · outpatient · +12 other terms	30	$529	$587	$411	70%	—	$2 – $1.2k
9	MultiPlan fee schedule · outpatient · +10 other terms	30	$246	$479	$479	100%	—	$1 – $1.7k
10	Bcbs Tx fee schedule · outpatient · +3 other terms	29	$1.5k	$1.4k	$454	32%	—	$578 – $2.4k
11	Medcost percent of total billed charges · outpatientfrom % of charges · +5 other terms	21	$995	$927	$399	43%	—	$398 – $2.2k
12	Beechstreet percent of total billed charges · outpatientfrom % of charges · +3 other terms	18	$1.6k	$1.6k	$503	31%	—	$542 – $2.6k
13	Wellmark fee schedule · outpatient · +5 other terms	16	$430	$407	$56	14%	—	$269 – $430
14	Caresource facility · case rate · outpatient · +9 other terms	15	$131	$141	$32	23%	—	$87 – $222
15	Medical Mutual facility · percent of total billed charges · outpatientfrom % of charges · +2 other terms	14	$828	$938	$363	39%	—	$283 – $1.6k
16	Highmark facility · fee schedule · outpatient · +8 other terms	13	$1.0k	$1.2k	$661	57%	—	$345 – $3.0k
17	Optum facility · case rate · outpatient · +9 other terms	13	$116	$122	$37	31%	—	$62 – $197
18	Bcbs Mn fee schedule · outpatient · +7 other terms	12	$30	$70	$133	192%	—	$1 – $439
19	Bcbs Nj fee schedule · outpatient · +4 other terms	12	$428	$428	—	—	—	$428 – $428
20	Bcbs La fee schedule · outpatient · +1 other terms	11	$464	$457	$10	2%	—	$443 – $464
21	Phcs fee schedule · inpatient · +7 other terms	11	$191	$276	$180	65%	—	$191 – $836
22	Tricare facility · fee schedule · outpatient · +6 other terms	10	$566	$512	$693	135%	—	$33 – $1.7k
23	Medicaid fee schedule · both · +10 other terms	9	$69	$92	$92	99%	—	$66 – $459
24	Ucare fee schedule · both · +5 other terms	9	$375	$376	$27	7%	—	$347 – $412
25	Aetna Better Health fee schedule · outpatient · +8 other terms	8	$425	$418	$20	5%	—	$366 – $425

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