Granisetron hydrochloride 1 mg injection

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

Granisetron HCl, 1mg (for circumstances falling under the Medicare Statute, use Q0166)

Payers reporting HCPCS S0091

Payer pricing summary

Low

Average

$87

Median

$45

High

$449

Payer rate distribution

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#
1	Cigna fee schedule · outpatient · +9 other terms	182	$6	$9	$7	76%	—	$3 – $68
2	Blue Cross Blue Shield fee schedule · outpatient · +8 other terms	156	$26	$44	$77	176%	—	$1 – $698
3	Aetna fee schedule · outpatient · +12 other terms	100	$6	$9	$27	293%	—	$2 – $259
4	Humana fee schedule · outpatient · +10 other terms	71	$204	$324	$216	67%	—	$3 – $599
5	Kaiser fee schedule · both · +3 other terms	43	$94	$89	$24	27%	—	$65 – $129
6	Anthem fee schedule · outpatient · +8 other terms	35	$3	$12	$66	540%	—	$3 – $722
7	Bcbs Tx fee schedule · outpatient · +1 other terms	30	$37	$33	$11	33%	—	$14 – $58
8	UnitedHealthcare fee schedule · both · +9 other terms	27	$3	$4	$1	29%	—	$3 – $9
9	Caresource facility · case rate · outpatient · +2 other terms	15	$9	$10	$2	23%	—	$6 – $15
10	Molina facility · case rate · outpatient · +4 other terms	15	$9	$10	$2	23%	—	$6 – $15
11	Wellmark fee schedule · both · +2 other terms	13	$3	$3	—	—	—	$3 – $3
12	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$59	$56	$16	29%	—	$31 – $73
13	Bcbs Nj fee schedule · outpatient	12	$40	$38	$19	51%	—	$3 – $49
14	Highmark fee schedule · outpatient · +3 other terms	11	$3	$3	$0	1%	—	$3 – $3
15	Optum facility · case rate · outpatient · +2 other terms	11	$8	$9	$2	22%	—	$7 – $13
16	Medica fee schedule · outpatient · +4 other terms	10	$6	$6	$2	25%	—	$4 – $8
17	Aetna Better Health fee schedule · inpatient · +1 other terms	7	$3	$3	—	—	—	$3 – $3
18	Medcost percent of total billed charges · outpatientfrom % of charges · +2 other terms	7	$6	$5	$1	24%	—	$4 – $7
19	WellCare percent of total billed charges · outpatientfrom % of charges	7	$2	$2	$1	59%	—	$1 – $5
20	Bcbs La fee schedule · outpatient · +1 other terms	6	$56	$56	—	—	—	$56 – $56
21	Excellus facility · fee schedule · outpatient	5	$54	$63	$77	122%	—	$3 – $235
22	Superior Healthplan percent of total billed charges · outpatientfrom % of charges	5	$20	$33	$33	99%	—	$1 – $92
23	First Health facility · fee schedule · outpatient · +3 other terms	4	$9	$9	—	—	—	$9 – $9
24	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$57	$57	—	—	—	$57 – $57
25	Sanford Health Plan fee schedule · outpatient · +1 other terms	3	$50	$50	—	—	—	$50 – $50

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