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
TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSC SYRG [96902]
Arlington, TX
See all hospitals reporting HCPCS J1670 →Price type
AMH Cath Labs LLC’s median price of $1.1k is 39% above the median hospital's median price ($788), higher than 68% of the 2,080 hospitals reporting HCPCS J1670. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 33 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 managed medicaid percent of total billed charges · outpatientfrom % of charges | $191 | $191 | — | — | — | $191 – $191 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $191 | $191 | — | — | — | $191 – $191 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $200 | $200 | — | — | — | $200 – $200 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $206 | $206 | — | — | — | $206 – $206 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $210 | $210 | — | — | — | $210 – $210 |
| 6 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $593 | $593 | — | — | — | $593 – $593 |
| 7 | Humana medicare advantage case rate · outpatient | $617 | $617 | — | — | — | $617 – $617 |
| 8 | Humana medicare advantage ppo case rate · outpatient | $617 | $617 | — | — | — | $617 – $617 |
| 9 | Molina medicare advantage case rate · outpatient | $623 | $623 | — | — | — | $623 – $623 |
| 10 | WellCare medicare advantage hmo case rate · outpatient | $623 | $623 | — | — | — | $623 – $623 |
| 11 | WellCare medicare advantage mmp case rate · outpatient | $652 | $652 | — | — | — | $652 – $652 |
| 12 | UnitedHealthcare medicare advantage ppo case rate · outpatient | $658 | $658 | — | — | — | $658 – $658 |
| 13 | UnitedHealthcare medicare advantage hmo case rate · outpatient | $670 | $670 | — | — | — | $670 – $670 |
| 14 | Aetna whole health percent of total billed charges · inpatientfrom % of charges | $741 | $741 | — | — | — | $741 – $741 |
| 15 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $880 | $880 | — | — | — | $880 – $880 |
| 16 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $988 | $988 | — | — | — | $988 – $988 |
| 17 | Blue Cross Blue Shield hmo fee schedule · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 18 | Blue Cross Blue Shield exchange fee schedule · outpatient | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 19 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 20 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 21 | Blue Cross Blue Shield ppo fee schedule · outpatient | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 22 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 23 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 24 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 25 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
Last updated: Apr 21, 2026
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