Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

ceFAZolin 1 g Inj [HMC]

Facility

OP

$42.50

Service Code	HCPCS J0690
Hospital Charge Code	3804750
Hospital Revenue Code	250
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$40.38
Rate for Payer: Aetna Commercial	$38.25
Rate for Payer: Aetna Commercial	$25.39
Rate for Payer: Aetna Commercial	$23.68
Rate for Payer: Aetna Commercial	$29.75
Rate for Payer: Aetna Commercial	$29.75
Rate for Payer: Aetna Commercial	$26.91
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1.23
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1.23
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1.23
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1.23
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1.23
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$1.23
Rate for Payer: Humana Medicare Advantage	$17.85
Rate for Payer: Humana Medicare Advantage	$11.05
Rate for Payer: Humana Medicare Advantage	$13.89
Rate for Payer: Humana Medicare Advantage	$13.88
Rate for Payer: Humana Medicare Advantage	$12.56
Rate for Payer: Humana Medicare Advantage	$11.85
Rate for Payer: UnitedHealthcare Commercial	$31.41
Rate for Payer: UnitedHealthcare Commercial	$28.41
Rate for Payer: UnitedHealthcare Commercial	$26.80
Rate for Payer: UnitedHealthcare Commercial	$24.99
Rate for Payer: UnitedHealthcare Commercial	$31.40
Rate for Payer: UnitedHealthcare Commercial	$40.38
Rate for Payer: UnitedHealthcare Medicaid	$0.83
Rate for Payer: UnitedHealthcare Medicaid	$0.83
Rate for Payer: UnitedHealthcare Medicaid	$0.83
Rate for Payer: UnitedHealthcare Medicaid	$0.83
Rate for Payer: UnitedHealthcare Medicaid	$0.83
Rate for Payer: UnitedHealthcare Medicaid	$0.83
Rate for Payer: WPPA Medicare Advantage	$25.50
Rate for Payer: WPPA Medicare Advantage	$15.79
Rate for Payer: WPPA Medicare Advantage	$16.93
Rate for Payer: WPPA Medicare Advantage	$17.94
Rate for Payer: WPPA Medicare Advantage	$19.83
Rate for Payer: WPPA Medicare Advantage	$19.84

ceFAZolin 1 g Inj [HMC]

Facility

IP

$33.06

Service Code	HCPCS J0690
Hospital Charge Code	3804750
Hospital Revenue Code	250
Min. Negotiated Rate	$29.75
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$29.75
Rate for Payer: Aetna Commercial	$29.75
Rate for Payer: Aetna Commercial	$23.68
Rate for Payer: Aetna Commercial	$38.25
Rate for Payer: Aetna Commercial	$25.39
Rate for Payer: Aetna Commercial	$26.91
Rate for Payer: UnitedHealthcare Commercial	$24.99
Rate for Payer: UnitedHealthcare Commercial	$26.80
Rate for Payer: UnitedHealthcare Commercial	$28.41
Rate for Payer: UnitedHealthcare Commercial	$31.40
Rate for Payer: UnitedHealthcare Commercial	$31.41
Rate for Payer: UnitedHealthcare Commercial	$40.38
Rate for Payer: WPPA Medicare Advantage	$1,200.00
Rate for Payer: WPPA Medicare Advantage	$1,200.00
Rate for Payer: WPPA Medicare Advantage	$1,200.00
Rate for Payer: WPPA Medicare Advantage	$1,200.00
Rate for Payer: WPPA Medicare Advantage	$1,200.00
Rate for Payer: WPPA Medicare Advantage	$1,200.00

cefdinir 250 mg/5 mL Oral Susp [HMC]

Facility

IP

$154.12

Service Code	NDC 65862021960
Hospital Charge Code	3804020
Hospital Revenue Code	253
Min. Negotiated Rate	$138.71
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$138.71
Rate for Payer: UnitedHealthcare Commercial	$146.41
Rate for Payer: WPPA Medicare Advantage	$1,200.00

cefdinir 250 mg/5 mL Oral Susp [HMC]

Facility

IP

$154.03

Service Code	NDC 67877054898
Hospital Charge Code	3804020
Hospital Revenue Code	253
Min. Negotiated Rate	$138.63
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$138.63
Rate for Payer: UnitedHealthcare Commercial	$146.33
Rate for Payer: WPPA Medicare Advantage	$1,200.00

cefdinir 250 mg/5 mL Oral Susp [HMC]

Facility

OP

$154.30

Service Code	NDC 68180072320
Hospital Charge Code	3804020
Hospital Revenue Code	253
Min. Negotiated Rate	$61.72
Max. Negotiated Rate	$146.59
Rate for Payer: Aetna Commercial	$138.87
Rate for Payer: Humana Medicare Advantage	$64.81
Rate for Payer: UnitedHealthcare Commercial	$146.59
Rate for Payer: UnitedHealthcare Medicaid	$61.72
Rate for Payer: WPPA Medicare Advantage	$92.58

cefdinir 250 mg/5 mL Oral Susp [HMC]

Facility

OP

$154.30

Service Code	NDC 68180072304
Hospital Charge Code	3804020
Hospital Revenue Code	253
Min. Negotiated Rate	$61.72
Max. Negotiated Rate	$146.59
Rate for Payer: Aetna Commercial	$138.87
Rate for Payer: Humana Medicare Advantage	$64.81
Rate for Payer: UnitedHealthcare Commercial	$146.59
Rate for Payer: UnitedHealthcare Medicaid	$61.72
Rate for Payer: WPPA Medicare Advantage	$92.58

cefdinir 250 mg/5 mL Oral Susp [HMC]

Facility

OP

$154.03

Service Code	NDC 67877054898
Hospital Charge Code	3804020
Hospital Revenue Code	253
Min. Negotiated Rate	$61.61
Max. Negotiated Rate	$146.33
Rate for Payer: Aetna Commercial	$138.63
Rate for Payer: Humana Medicare Advantage	$64.69
Rate for Payer: UnitedHealthcare Commercial	$146.33
Rate for Payer: UnitedHealthcare Medicaid	$61.61
Rate for Payer: WPPA Medicare Advantage	$92.42

cefdinir 250 mg/5 mL Oral Susp [HMC]

Facility

IP

$154.30

Service Code	NDC 68180072320
Hospital Charge Code	3804020
Hospital Revenue Code	253
Min. Negotiated Rate	$138.87
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$138.87
Rate for Payer: UnitedHealthcare Commercial	$146.59
Rate for Payer: WPPA Medicare Advantage	$1,200.00

cefdinir 250 mg/5 mL Oral Susp [HMC]

Facility

OP

$154.12

Service Code	NDC 65862021960
Hospital Charge Code	3804020
Hospital Revenue Code	253
Min. Negotiated Rate	$61.65
Max. Negotiated Rate	$146.41
Rate for Payer: Aetna Commercial	$138.71
Rate for Payer: Humana Medicare Advantage	$64.73
Rate for Payer: UnitedHealthcare Commercial	$146.41
Rate for Payer: UnitedHealthcare Medicaid	$61.65
Rate for Payer: WPPA Medicare Advantage	$92.47

cefdinir 250 mg/5 mL Oral Susp [HMC]

Facility

IP

$154.30

Service Code	NDC 68180072304
Hospital Charge Code	3804020
Hospital Revenue Code	253
Min. Negotiated Rate	$138.87
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$138.87
Rate for Payer: UnitedHealthcare Commercial	$146.59
Rate for Payer: WPPA Medicare Advantage	$1,200.00

cefdinir 300 mg Cap [HMC]

Facility

IP

$17.77

Service Code	NDC 65862017760
Hospital Charge Code	3805685
Hospital Revenue Code	250
Min. Negotiated Rate	$15.99
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$15.99
Rate for Payer: UnitedHealthcare Commercial	$16.88
Rate for Payer: WPPA Medicare Advantage	$1,200.00

cefdinir 300 mg Cap [HMC]

Facility

IP

$17.78

Service Code	NDC 68180071160
Hospital Charge Code	3805685
Hospital Revenue Code	250
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$16.00
Rate for Payer: UnitedHealthcare Commercial	$16.89
Rate for Payer: WPPA Medicare Advantage	$1,200.00

cefdinir 300 mg Cap [HMC]

Facility

OP

$17.77

Service Code	NDC 65862017760
Hospital Charge Code	3805685
Hospital Revenue Code	250
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$16.88
Rate for Payer: Aetna Commercial	$15.99
Rate for Payer: Humana Medicare Advantage	$7.46
Rate for Payer: UnitedHealthcare Commercial	$16.88
Rate for Payer: UnitedHealthcare Medicaid	$7.11
Rate for Payer: WPPA Medicare Advantage	$10.66

cefdinir 300 mg Cap [HMC]

Facility

OP

$17.78

Service Code	NDC 68180071160
Hospital Charge Code	3805685
Hospital Revenue Code	250
Min. Negotiated Rate	$7.11
Max. Negotiated Rate	$16.89
Rate for Payer: Aetna Commercial	$16.00
Rate for Payer: Humana Medicare Advantage	$7.47
Rate for Payer: UnitedHealthcare Commercial	$16.89
Rate for Payer: UnitedHealthcare Medicaid	$7.11
Rate for Payer: WPPA Medicare Advantage	$10.67

cefepime 1 g Inj [HMC]

Facility

OP

$50.50

Service Code	HCPCS J0692
Hospital Charge Code	3805586
Hospital Revenue Code	250
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$47.98
Rate for Payer: Aetna Commercial	$45.45
Rate for Payer: Aetna Commercial	$36.47
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$2.02
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$2.02
Rate for Payer: Humana Medicare Advantage	$17.02
Rate for Payer: Humana Medicare Advantage	$21.21
Rate for Payer: UnitedHealthcare Commercial	$47.98
Rate for Payer: UnitedHealthcare Commercial	$38.49
Rate for Payer: UnitedHealthcare Medicaid	$0.87
Rate for Payer: UnitedHealthcare Medicaid	$0.87
Rate for Payer: WPPA Medicare Advantage	$24.31
Rate for Payer: WPPA Medicare Advantage	$30.30

cefepime 1 g Inj [HMC]

Facility

OP

$50.50

Service Code	NDC 60505614404
Hospital Charge Code	3805586
Hospital Revenue Code	250
Min. Negotiated Rate	$20.20
Max. Negotiated Rate	$47.98
Rate for Payer: Aetna Commercial	$45.45
Rate for Payer: Humana Medicare Advantage	$21.21
Rate for Payer: UnitedHealthcare Commercial	$47.98
Rate for Payer: UnitedHealthcare Medicaid	$20.20
Rate for Payer: WPPA Medicare Advantage	$30.30

cefepime 1 g Inj [HMC]

Facility

IP

$50.50

Service Code	NDC 60505614404
Hospital Charge Code	3805586
Hospital Revenue Code	250
Min. Negotiated Rate	$45.45
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$45.45
Rate for Payer: UnitedHealthcare Commercial	$47.98
Rate for Payer: WPPA Medicare Advantage	$1,200.00

cefepime 1 g Inj [HMC]

Facility

IP

$40.52

Service Code	HCPCS J0692
Hospital Charge Code	3805586
Hospital Revenue Code	250
Min. Negotiated Rate	$36.47
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$36.47
Rate for Payer: Aetna Commercial	$45.45
Rate for Payer: UnitedHealthcare Commercial	$38.49
Rate for Payer: UnitedHealthcare Commercial	$47.98
Rate for Payer: WPPA Medicare Advantage	$1,200.00
Rate for Payer: WPPA Medicare Advantage	$1,200.00

cefepime 2 g Inj [HMC]

Facility

IP

$80.53

Service Code	NDC 60505603104
Hospital Charge Code	3850060
Hospital Revenue Code	250
Min. Negotiated Rate	$72.48
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$72.48
Rate for Payer: UnitedHealthcare Commercial	$76.50
Rate for Payer: WPPA Medicare Advantage	$1,200.00

cefepime 2 g Inj [HMC]

Facility

OP

$80.53

Service Code	NDC 60505603104
Hospital Charge Code	3850060
Hospital Revenue Code	250
Min. Negotiated Rate	$32.21
Max. Negotiated Rate	$76.50
Rate for Payer: Aetna Commercial	$72.48
Rate for Payer: Humana Medicare Advantage	$33.82
Rate for Payer: UnitedHealthcare Commercial	$76.50
Rate for Payer: UnitedHealthcare Medicaid	$32.21
Rate for Payer: WPPA Medicare Advantage	$48.32

cefepime 2 g Inj [HMC]

Facility

IP

$80.54

Service Code	HCPCS J0692
Hospital Charge Code	3850060
Hospital Revenue Code	250
Min. Negotiated Rate	$72.49
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$72.49
Rate for Payer: Aetna Commercial	$39.71
Rate for Payer: Aetna Commercial	$72.48
Rate for Payer: UnitedHealthcare Commercial	$41.91
Rate for Payer: UnitedHealthcare Commercial	$76.50
Rate for Payer: UnitedHealthcare Commercial	$76.51
Rate for Payer: WPPA Medicare Advantage	$1,200.00
Rate for Payer: WPPA Medicare Advantage	$1,200.00
Rate for Payer: WPPA Medicare Advantage	$1,200.00

cefepime 2 g Inj [HMC]

Facility

OP

$44.12

Service Code	HCPCS J0692
Hospital Charge Code	3850060
Hospital Revenue Code	250
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$41.91
Rate for Payer: Aetna Commercial	$39.71
Rate for Payer: Aetna Commercial	$72.49
Rate for Payer: Aetna Commercial	$72.48
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$2.02
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$2.02
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$2.02
Rate for Payer: Humana Medicare Advantage	$33.83
Rate for Payer: Humana Medicare Advantage	$18.53
Rate for Payer: Humana Medicare Advantage	$33.82
Rate for Payer: UnitedHealthcare Commercial	$41.91
Rate for Payer: UnitedHealthcare Commercial	$76.50
Rate for Payer: UnitedHealthcare Commercial	$76.51
Rate for Payer: UnitedHealthcare Medicaid	$0.87
Rate for Payer: UnitedHealthcare Medicaid	$0.87
Rate for Payer: UnitedHealthcare Medicaid	$0.87
Rate for Payer: WPPA Medicare Advantage	$48.32
Rate for Payer: WPPA Medicare Advantage	$26.47
Rate for Payer: WPPA Medicare Advantage	$48.32

cefOXitin 1 g Pow [HMC]

Facility

OP

$38.80

Service Code	HCPCS J0694
Hospital Charge Code	3800520
Hospital Revenue Code	250
Min. Negotiated Rate	$4.74
Max. Negotiated Rate	$36.86
Rate for Payer: Aetna Commercial	$34.92
Rate for Payer: Aetna Commercial	$41.24
Rate for Payer: Aetna Commercial	$39.20
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$7.39
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$7.39
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$7.39
Rate for Payer: Humana Medicare Advantage	$18.29
Rate for Payer: Humana Medicare Advantage	$19.24
Rate for Payer: Humana Medicare Advantage	$16.30
Rate for Payer: UnitedHealthcare Commercial	$41.37
Rate for Payer: UnitedHealthcare Commercial	$36.86
Rate for Payer: UnitedHealthcare Commercial	$43.53
Rate for Payer: UnitedHealthcare Medicaid	$4.74
Rate for Payer: UnitedHealthcare Medicaid	$4.74
Rate for Payer: UnitedHealthcare Medicaid	$4.74
Rate for Payer: WPPA Medicare Advantage	$23.28
Rate for Payer: WPPA Medicare Advantage	$26.13
Rate for Payer: WPPA Medicare Advantage	$27.49

cefOXitin 1 g Pow [HMC]

Facility

IP

$38.80

Service Code	HCPCS J0694
Hospital Charge Code	3800520
Hospital Revenue Code	250
Min. Negotiated Rate	$34.92
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$34.92
Rate for Payer: Aetna Commercial	$39.20
Rate for Payer: Aetna Commercial	$41.24
Rate for Payer: UnitedHealthcare Commercial	$43.53
Rate for Payer: UnitedHealthcare Commercial	$41.37
Rate for Payer: UnitedHealthcare Commercial	$36.86
Rate for Payer: WPPA Medicare Advantage	$1,200.00
Rate for Payer: WPPA Medicare Advantage	$1,200.00
Rate for Payer: WPPA Medicare Advantage	$1,200.00

ceftaroline 600 mg Pow [HMC]

Facility

IP

$627.90

Service Code	HCPCS J0712
Hospital Charge Code	3807037
Hospital Revenue Code	250
Min. Negotiated Rate	$565.11
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$565.11
Rate for Payer: UnitedHealthcare Commercial	$596.50
Rate for Payer: WPPA Medicare Advantage	$1,200.00

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