Indocyanine green injection, 25 mg at Samaritan 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

METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION

Troy, NY

See all hospitals reporting HCPCS Q9968 →

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Pricing by billing methodology

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How this price compares nationally

Samaritan Hospital’s median price of $77 is 170% above the median hospital's median price ($29), higher than 58% of the 2,066 hospitals reporting HCPCS Q9968. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q9968 at Samaritan Hospital

Negotiated rates from the hospital’s own file: 14 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	WellCare wellcare ep 1&2 medicaid facility · other · both	$16	$16	—	—	—	$16 – $16
2	Blue Cross Blue Shield blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$77	$77	—	—	—	$77 – $77
3	Blue Cross Blue Shield blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$77	$77	—	—	—	$77 – $77
4	Carefirst blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$77	$77	—	—	—	$77 – $77
5	Carefirst blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$77	$77	—	—	—	$77 – $77
6	Excellus blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$77	$77	—	—	—	$77 – $77
7	Highmark blue shield of ne new york ascend facility · percent of total billed charges · bothfrom % of charges	$77	$77	—	—	—	$77 – $77
8	Highmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$77	$77	—	—	—	$77 – $77
9	Highmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$77	$77	—	—	—	$77 – $77
10	Premera blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$77	$77	—	—	—	$77 – $77
11	Regence blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$77	$77	—	—	—	$77 – $77
12	Wellmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges	$77	$77	—	—	—	$77 – $77
13	Wellmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges	$77	$77	—	—	—	$77 – $77
14	UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges	$109	$109	$32	29%	16	$77 – $141
15	First Health first health facility · percent of total billed charges · bothfrom % of charges	$113	$113	—	—	—	$113 – $113
16	Cigna cigna facility · percent of total billed charges · bothfrom % of charges	$120	$120	—	—	—	$120 – $120
17	MultiPlan beech street facility · percent of total billed charges · bothfrom % of charges	$127	$127	—	—	—	$127 – $127
18	MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges	$127	$127	—	—	—	$127 – $127
19	Phcs multiplan facility · percent of total billed charges · bothfrom % of charges	$127	$127	—	—	—	$127 – $127
20	Anthem empire medicaid facility · percent of total billed charges · bothfrom % of charges	$141	$141	—	—	—	$141 – $141
21	Anthem empire medicaid essential 1 2 3 4 facility · percent of total billed charges · bothfrom % of charges	$141	$141	—	—	—	$141 – $141
22	Excellus empire medicaid facility · percent of total billed charges · bothfrom % of charges	$141	$141	—	—	—	$141 – $141
23	Excellus empire medicaid essential 1 2 3 4 facility · percent of total billed charges · bothfrom % of charges	$141	$141	—	—	—	$141 – $141
24	UnitedHealthcare united healthcare medicaid harp chip facility · fee schedule · both	$299	$299	—	—	—	$299 – $299
25	UnitedHealthcare uhc essential plan medicaid facility · fee schedule · both	$1.0k	$1.0k	—	—	—	$1.0k – $1.0k

Last updated: Mar 31, 2026

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