Fulvestrant injection, 25 mg (Teva brand)

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

Inj, fulvestrant (teva)

Payers reporting HCPCS J9393

Payer pricing summary

Low

$11

Average

$170

Median

$70

High

$985

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +16 other terms	550	$56	$78	$140	181%	—	$3 – $1.1k
2	Aetna fee schedule · outpatient · +15 other terms	357	$42	$61	$92	152%	—	$16 – $616
3	Blue Cross Blue Shield fee schedule · outpatient · +14 other terms	280	$42	$102	$459	449%	—	$1 – $4.8k
4	Cigna fee schedule · outpatient · +15 other terms	261	$41	$77	$90	116%	—	$5 – $468
5	Humana fee schedule · outpatient · +13 other terms	218	$42	$41	$20	49%	—	$19 – $160
6	WellCare fee schedule · outpatient · +10 other terms	120	$43	$39	$11	28%	—	$20 – $56
7	Molina fee schedule · outpatient · +11 other terms	100	$50	$52	$22	43%	—	$20 – $92
8	Anthem fee schedule · outpatient · +12 other terms	98	$40	$220	$884	401%	—	$15 – $4.8k
9	Devoted fee schedule · outpatient · +3 other terms	64	$41	$37	$9	24%	—	$22 – $48
10	Kaiser fee schedule · outpatient · +8 other terms	59	$46	$54	$30	56%	—	$9 – $156
11	Ambetter facility · fee schedule · outpatient · +8 other terms	50	$59	$65	$21	32%	—	$21 – $112
12	Caresource fee schedule · outpatient · +6 other terms	40	$43	$36	$17	48%	—	$21 – $81
13	Optum fee schedule · outpatient · +6 other terms	33	$41	$55	$24	44%	—	$37 – $120
14	Bcbs Tx fee schedule · outpatient	31	$66	$61	$26	43%	—	$20 – $117
15	Clover fee schedule · outpatient · +5 other terms	29	$39	$36	$10	29%	—	$23 – $52
16	Oscar facility · fee schedule · outpatient · +6 other terms	25	$63	$63	$11	17%	—	$39 – $77
17	Medicare fee schedule · outpatient · +1 other terms	23	$41	$41	$0	1%	—	$41 – $42
18	Regence facility · fee schedule · outpatient · +2 other terms	20	$43	$41	$8	20%	—	$21 – $52
19	Aetna Better Health fee schedule · outpatient · +5 other terms	18	$21	$27	$12	42%	—	$20 – $46
20	Medica facility · fee schedule · outpatient · +7 other terms	18	$46	$56	$107	192%	—	$7 – $700
21	Medical Mutual facility · fee schedule · outpatient · +1 other terms	18	$45	$58	$24	42%	—	$23 – $166
22	Highmark fee schedule · outpatient · +6 other terms	16	$50	$50	$29	59%	—	$20 – $123
23	Tricare fee schedule · outpatient · +3 other terms	16	$40	$178	$208	117%	—	$37 – $487
24	MultiPlan fee schedule · outpatient · +8 other terms	15	$36	$36	$2	5%	—	$36 – $46
25	Bcbs Mn fee schedule · outpatient · +5 other terms	13	$47	$31	$13	41%	—	$21 – $47

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