Ticarcillin and clavulanate injection, 3.1 grams

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

Injection, ticarcillin disodium and clavulanate potassium, 3.1 g

Payers reporting HCPCS S0040

Payer pricing summary

Low

$14

Average

$390

Median

$85

High

$2.5k

Payer rate distribution

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#
1	Cigna fee schedule · outpatient · +9 other terms	183	$25	$41	$30	72%	—	$12 – $116
2	Blue Cross Blue Shield fee schedule · outpatient · +8 other terms	164	$27	$35	$23	65%	—	$0 – $91
3	Aetna fee schedule · outpatient · +12 other terms	85	$17	$57	$250	442%	—	$0 – $1.7k
4	Humana fee schedule · outpatient · +13 other terms	77	$36	$135	$352	261%	—	$10 – $1.8k
5	Kaiser fee schedule · both · +2 other terms	43	$17	$16	$4	26%	—	$11 – $23
6	UnitedHealthcare fee schedule · outpatient · +12 other terms	42	$22	$87	$327	376%	—	$6 – $1.7k
7	Anthem fee schedule · outpatient · +10 other terms	39	$0	$56	$298	537%	—	$0 – $1.7k
8	Bcbs Tx fee schedule · outpatient · +1 other terms	30	$58	$52	$17	33%	—	$21 – $90
9	Molina facility · case rate · outpatient · +6 other terms	29	$1.8k	$1.9k	$1.0k	54%	—	$786 – $4.4k
10	Caresource facility · case rate · outpatient · +2 other terms	15	$2.7k	$2.8k	$653	23%	—	$1.8k – $4.5k
11	Aetna Better Health fee schedule · outpatient · +2 other terms	13	$10	$12	$2	18%	—	$10 – $15
12	Medica fee schedule · outpatient · +6 other terms	13	$32	$32	$9	27%	—	$16 – $45
13	Optum facility · case rate · outpatient · +1 other terms	13	$2.4k	$2.4k	$896	37%	—	$747 – $4.0k
14	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$16	$15	$4	29%	—	$8 – $20
15	Ucare fee schedule · outpatient · +4 other terms	11	$14	$21	$10	49%	—	$14 – $41
16	Amerihealth Caritas facility · case rate · outpatient · +2 other terms	7	$865	$876	$28	3%	—	$865 – $943
17	Bcbs La fee schedule · outpatient · +1 other terms	6	$14	$14	—	—	—	$14 – $14
18	First Health facility · fee schedule · outpatient · +3 other terms	4	$40	$40	—	—	—	$40 – $40
19	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$19	$19	—	—	—	$19 – $19
20	Sanford Health Plan fee schedule · inpatient · +1 other terms	3	$44	$43	$2	4%	—	$41 – $44
21	Wellmark facility · case rate · outpatient · +1 other terms	3	$3.0k	$2.6k	$831	32%	—	$1.2k – $3.3k
22	Bcbs Sc percent of total billed charges · bothfrom % of charges	2	$187	$187	$82	44%	—	$88 – $359
23	Clover percent of total billed charges · bothfrom % of charges	2	$186	$186	$29	16%	—	$156 – $215
24	Devoted percent of total billed charges · bothfrom % of charges	2	$155	$155	$25	16%	—	$130 – $179
25	Medcost percent of total billed charges · bothfrom % of charges	2	$355	$355	$50	14%	—	$305 – $405

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