Fluorescein dye injection for eye imaging at Proctor Community Hospital

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

FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION

Peoria, IL

See all hospitals reporting HCPCS A9612 →

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How this price compares nationally

Proctor Community Hospital’s median price of $249 is 135% above the median hospital's median price ($106), higher than 84% of the 455 hospitals reporting HCPCS A9612. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS A9612 at Proctor Community Hospital

Negotiated rates from the hospital’s own file: 6 payers, 15 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	Aetna Better Health managed medicaid percent of total billed charges · inpatientfrom % of charges	$134	$238	$177	74%	—	$93 – $487
2	Aetna Better Health managed medicaid percent of total billed charges · outpatientfrom % of charges	$134	$238	$177	74%	—	$93 – $487
3	Molina managed medicaid percent of total billed charges · inpatientfrom % of charges	$161	$285	$212	74%	—	$112 – $584
4	Molina managed medicaid percent of total billed charges · outpatientfrom % of charges	$161	$285	$212	74%	—	$112 – $584
5	Molina medicare-medicaid (mmai/dual) percent of total billed charges · inpatientfrom % of charges	$161	$285	$212	74%	—	$112 – $584
6	Molina medicare-medicaid (mmai/dual) percent of total billed charges · outpatientfrom % of charges	$161	$285	$212	74%	—	$112 – $584
7	Blue Cross Blue Shield blue choice percent of total billed charges · outpatientfrom % of charges	$209	$371	$276	74%	—	$145 – $759
8	Blue Cross Blue Shield blue choice options percent of total billed charges · outpatientfrom % of charges	$209	$371	$276	74%	—	$145 – $759
9	Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges	$212	$376	$279	74%	—	$147 – $769
10	Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges	$258	$459	$341	74%	—	$179 – $938
11	Aetna commercial ppo percent of total billed charges · outpatientfrom % of charges	$262	$466	$346	74%	—	$182 – $954
12	Aetna medicare advantage percent of total billed charges · outpatientfrom % of charges	$268	$476	$354	74%	—	$186 – $974
13	MultiPlan ppo percent of total billed charges · inpatientfrom % of charges	$268	$476	$354	74%	—	$186 – $974
14	MultiPlan ppo percent of total billed charges · outpatientfrom % of charges	$268	$476	$354	74%	—	$186 – $974
15	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$359	$638	$474	74%	—	$249 – $1.3k

Last updated: Apr 15, 2026

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