Mycophenolate 250 mg oral

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

MYCOPHENOLATE MOFETIL 250 MG CAPSULE

Payers reporting HCPCS J7517

Payer pricing summary

Low

Average

$267

Median

$104

High

$3.0k

Payer rate distribution

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#
1	Wellmark fee schedule · outpatient · +14 other terms	26	$0	$1	$14	1373%	35–350	$0 – $237
2	Cigna fee schedule · outpatient · +22 other terms	393	$0	$12	$83	721%	27–270	$0 – $3.6k
3	Blue Cross Blue Shield fee schedule · outpatient · +29 other terms	291	$1	$28	$168	611%	6–60	$0 – $2.6k
4	UnitedHealthcare fee schedule · outpatient · +28 other terms	497	$0	$35	$182	513%	5–50	$0 – $2.7k
5	Kaiser fee schedule · both · +15 other terms	44	$0	$12	$114	975%	4–40	$0 – $1.1k
6	Aetna fee schedule · outpatient · +25 other terms	282	$0	$5	$17	374%	—	$0 – $223
7	Humana fee schedule · outpatient · +21 other terms	176	$1	$32	$141	437%	—	$0 – $1.7k
8	Anthem fee schedule · outpatient · +24 other terms	109	$0	$1	$4	284%	—	$0 – $69
9	MultiPlan fee schedule · outpatient · +16 other terms	86	$28	$179	$438	245%	—	$0 – $2.7k
10	Medica fee schedule · outpatient · +15 other terms	45	$69	$145	$698	482%	—	$0 – $5.4k
11	Caresource fee schedule · outpatient · +15 other terms	44	$0	$2	$5	207%	—	$0 – $25
12	Highmark facility · fee schedule · outpatient · +13 other terms	42	$0	$8	$9	105%	—	$0 – $34
13	Molina fee schedule · outpatient · +19 other terms	40	$0	$14	$72	518%	—	$0 – $626
14	First Health fee schedule · outpatient · +13 other terms	37	$21	$15	$20	134%	—	$0 – $106
15	Healthcare Highways percent of total billed charges · outpatientfrom % of charges · +3 other terms	34	$21	$180	$614	341%	—	$0 – $3.2k
16	Medcost percent of total billed charges · bothfrom % of charges · +5 other terms	34	$6	$80	$402	503%	—	$0 – $2.6k
17	Oscar facility · fee schedule · outpatient · +11 other terms	27	$0	$0	$0	6%	—	$0 – $0
18	Baylor Scott White Health Plan facility · fee schedule · inpatient · +2 other terms	26	$3	$3	$0	2%	—	$3 – $3
19	Excellus facility · fee schedule · both · +8 other terms	26	$9	$33	$133	402%	—	$0 – $776
20	Amerihealth Caritas other · outpatient · +10 other terms	25	$6	$2.1k	$5.2k	245%	—	$0 – $15.1k
21	Carefirst facility · fee schedule · both · +10 other terms	25	$10	$46	$158	345%	—	$0 – $776
22	Medicaid facility · fee schedule · outpatient · +10 other terms	25	$1	$26	$78	298%	—	$0 – $282
23	Premera facility · fee schedule · both · +8 other terms	25	$10	$47	$161	341%	—	$0 – $776
24	Regence facility · fee schedule · both · +13 other terms	25	$10	$39	$143	363%	—	$0 – $776
25	Bcbs La fee schedule · outpatient · +3 other terms	23	$0	$0	$0	14%	—	$0 – $0

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