INJECTION, SULFAMETHOXAZOLE

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.

Generation details were not recorded for this description.

Original text from hospital filings

Injection, sulfamethoxazole and trimethoprim, 10 ml

Payers reporting HCPCS S0039

Payer pricing summary

Low

Average

$46

Median

$42

High

$133

Payer rate distribution

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#
1	Blue Cross Blue Shield fee schedule · outpatient · +11 other terms	115	$27	$31	$19	62%	—	$8 – $125
2	Aetna fee schedule · outpatient · +12 other terms	88	$26	$26	$16	59%	—	$10 – $130
3	Cigna fee schedule · outpatient · +11 other terms	73	$19	$24	$11	46%	—	$6 – $80
4	Humana fee schedule · outpatient · +9 other terms	72	$47	$61	$37	61%	—	$5 – $107
5	Bcbs Tx fee schedule · outpatient · +1 other terms	30	$38	$34	$11	33%	—	$14 – $59
6	Anthem facility · fee schedule · outpatient · +9 other terms	26	$19	$22	$15	65%	—	$5 – $66
7	UnitedHealthcare fee schedule · both · +13 other terms	26	$13	$15	$5	30%	—	$13 – $37
8	Optum other · outpatient · +4 other terms	23	$85	$119	$123	103%	—	$14 – $465
9	Aetna Better Health other · outpatient · +4 other terms	19	$18	$30	$33	109%	—	$5 – $167
10	Amerihealth Caritas other · outpatient · +2 other terms	19	$18	$30	$33	109%	—	$5 – $167
11	Bcbs La other · outpatient · +2 other terms	19	$51	$66	$62	94%	—	$9 – $233
12	Superior Healthplan percent of total billed charges · outpatientfrom % of charges	19	$5	$7	$8	106%	—	$0 – $30
13	Caresource facility · case rate · outpatient · +1 other terms	15	$48	$52	$12	23%	—	$32 – $82
14	Molina facility · case rate · outpatient · +5 other terms	15	$47	$52	$12	23%	—	$33 – $80
15	Medica fee schedule · outpatient · +8 other terms	13	$27	$36	$29	81%	—	$15 – $152
16	Bcbs Mn fee schedule · outpatient · +1 other terms	12	$15	$14	$4	29%	—	$8 – $19
17	Bcbs Nj fee schedule · outpatient	12	$12	$12	—	—	—	$12 – $12
18	Healthcare Highways percent of total billed charges · outpatientfrom % of charges	11	$36	$43	$42	98%	—	$1 – $147
19	WellCare other · outpatient · +2 other terms	8	$86	$115	$90	78%	—	$19 – $233
20	MultiPlan other · outpatient · +7 other terms	7	$56	$61	$39	64%	—	$14 – $163
21	First Health other · outpatient · +5 other terms	6	$55	$57	$35	62%	—	$15 – $109
22	Highmark facility · fee schedule · outpatient · +2 other terms	6	$15	$52	$38	74%	—	$14 – $136
23	Sanford Health Plan fee schedule · outpatient · +2 other terms	6	$76	$40	$54	135%	—	$13 – $150
24	Tricare other · outpatient · +2 other terms	5	$174	$179	$144	80%	—	$13 – $349
25	Ambetter other · outpatient · +1 other terms	4	$32	$34	$32	94%	—	$8 – $122

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