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.
Original text from hospital filings
ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLN [90877]
Arlington, TX
See all hospitals reporting HCPCS J1300 →Price type
AMH Cath Labs LLC’s median price of $11.8k is 3183% above the median hospital's median price ($359), higher than 90% of the 941 hospitals reporting HCPCS J1300. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 25 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield hmo fee schedule · outpatient | $440 | $440 | — | — | — | $440 – $440 |
| 2 | Blue Cross Blue Shield exchange fee schedule · outpatient | $451 | $451 | — | — | — | $451 – $451 |
| 3 | Blue Cross Blue Shield ppo fee schedule · outpatient | $488 | $488 | — | — | — | $488 – $488 |
| 4 | UnitedHealthcare all payer fee schedule · outpatient | $873 | $873 | — | — | — | $873 – $873 |
| 5 | UnitedHealthcare ppo fee schedule · outpatient | $873 | $873 | — | — | — | $873 – $873 |
| 6 | Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 7 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 8 | Blue Cross Blue Shield traditional fee schedule · outpatient | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 9 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 10 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 11 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 12 | Aetna whole health percent of total billed charges · inpatientfrom % of charges | $7.4k | $7.4k | — | — | — | $7.4k – $7.4k |
| 13 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $8.8k | $8.8k | — | — | — | $8.8k – $8.8k |
| 14 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $9.9k | $9.9k | — | — | — | $9.9k – $9.9k |
| 15 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $11.8k | $11.8k | — | — | — | $11.8k – $11.8k |
| 16 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 17 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $15.0k | $15.0k | — | — | — | $15.0k – $15.0k |
| 18 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $15.0k | $15.0k | — | — | — | $15.0k – $15.0k |
| 19 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $15.1k | $15.1k | — | — | — | $15.1k – $15.1k |
| 20 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $15.1k | $15.1k | — | — | — | $15.1k – $15.1k |
| 21 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $16.0k | $16.0k | — | — | — | $16.0k – $16.0k |
| 22 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $18.7k | $18.7k | — | — | — | $18.7k – $18.7k |
| 23 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $18.7k | $18.7k | — | — | — | $18.7k – $18.7k |
| 24 | Cigna indemnity percent of total billed charges · inpatientfrom % of charges | $20.3k | $20.3k | — | — | — | $20.3k – $20.3k |
| 25 | Cigna indemnity percent of total billed charges · outpatientfrom % of charges | $20.3k | $20.3k | — | — | — | $20.3k – $20.3k |
Last updated: Apr 21, 2026
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