Menotropins injection, 75 IU

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, menotropins, 75 IU

Payers reporting HCPCS S0122

Payer pricing summary

Low

$47

Average

$352

Median

$258

High

$1.5k

Payer rate distribution

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#
1	Cigna fee schedule · outpatient · +9 other terms	183	$482	$777	$566	73%	—	$131 – $2.2k
2	Blue Cross Blue Shield fee schedule · outpatient · +10 other terms	165	$454	$571	$333	58%	—	$1 – $1.6k
3	Aetna fee schedule · outpatient · +10 other terms	110	$456	$495	$314	63%	—	$190 – $2.6k
4	Humana fee schedule · outpatient · +8 other terms	71	$224	$292	$173	59%	—	$56 – $516
5	Kaiser fee schedule · both · +1 other terms	43	$81	$77	$21	27%	—	$56 – $111
6	Anthem fee schedule · outpatient · +6 other terms	35	$267	$428	$197	46%	—	$103 – $1.2k
7	Bcbs Tx fee schedule · outpatient · +1 other terms	30	$856	$778	$259	33%	—	$318 – $1.3k
8	UnitedHealthcare fee schedule · outpatient · +11 other terms	27	$329	$370	$198	54%	—	$152 – $825
9	Caresource facility · case rate · outpatient · +1 other terms	15	$48	$52	$12	23%	—	$32 – $82
10	Molina facility · case rate · outpatient · +6 other terms	15	$47	$52	$12	23%	—	$33 – $80
11	Wellmark fee schedule · both · +2 other terms	13	$243	$243	—	—	—	$243 – $243
12	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$58	$126	$90	72%	—	$30 – $248
13	Bcbs Nj fee schedule · outpatient	12	$242	$242	—	—	—	$242 – $242
14	Highmark fee schedule · outpatient · +3 other terms	11	$272	$267	$34	13%	—	$43 – $288
15	Optum facility · case rate · outpatient · +1 other terms	11	$45	$49	$11	22%	—	$40 – $73
16	Medica fee schedule · outpatient · +4 other terms	10	$474	$477	$119	25%	—	$287 – $612
17	MultiPlan percent of total billed charges · outpatientfrom % of charges · +3 other terms	8	$886	$827	$172	21%	—	$591 – $1.0k
18	Aetna Better Health fee schedule · inpatient · +3 other terms	7	$231	$231	—	—	—	$231 – $231
19	Bcbs La fee schedule · outpatient · +1 other terms	6	$210	$213	$7	3%	—	$210 – $235
20	Excellus facility · fee schedule · outpatient	5	$409	$461	$290	63%	—	$252 – $1.2k
21	First Health facility · fee schedule · outpatient · +2 other terms	4	$700	$700	—	—	—	$700 – $700
22	Bcbs Ks fee schedule · outpatient · +1 other terms	3	$269	$269	—	—	—	$269 – $269
23	Sanford Health Plan fee schedule · outpatient · +1 other terms	3	$258	$258	—	—	—	$258 – $258
24	Bcbs Ca fee schedule · outpatient · +1 other terms	1	$258	$258	—	—	—	$258 – $258
25	Bcbs Id professional · fee schedule · outpatient · +1 other terms	1	$248	$248	—	—	—	$248 – $248

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