Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

hydrocortisone Top 1% Lotion [HMC]

Facility

OP

$40.61

Service Code	NDC 41167003420
Hospital Charge Code	3805724
Hospital Revenue Code	250
Min. Negotiated Rate	$16.24
Max. Negotiated Rate	$38.58
Rate for Payer: Aetna Commercial	$36.55
Rate for Payer: Humana Medicare Advantage	$17.06
Rate for Payer: UnitedHealthcare Commercial	$38.58
Rate for Payer: UnitedHealthcare Medicaid	$16.24
Rate for Payer: WPPA Medicare Advantage	$24.37

hydrocortisone Top 1% Lotion [HMC]

Facility

IP

$37.46

Service Code	NDC 45802028306
Hospital Charge Code	3805724
Hospital Revenue Code	250
Min. Negotiated Rate	$33.71
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$33.71
Rate for Payer: UnitedHealthcare Commercial	$35.59
Rate for Payer: WPPA Medicare Advantage	$1,200.00

hydrocortisone Top 1% Lotion [HMC]

Facility

IP

$41.84

Service Code	NDC 41167003410
Hospital Charge Code	3805724
Hospital Revenue Code	250
Min. Negotiated Rate	$37.66
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$37.66
Rate for Payer: UnitedHealthcare Commercial	$39.75
Rate for Payer: WPPA Medicare Advantage	$1,200.00

hydrocortisone Top 1% Lotion [HMC]

Facility

IP

$40.61

Service Code	NDC 41167003420
Hospital Charge Code	3805724
Hospital Revenue Code	250
Min. Negotiated Rate	$36.55
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$36.55
Rate for Payer: UnitedHealthcare Commercial	$38.58
Rate for Payer: WPPA Medicare Advantage	$1,200.00

hydrocortisone Top 1% Lotion [HMC]

Facility

OP

$35.97

Service Code	NDC 00394085932
Hospital Charge Code	3805724
Hospital Revenue Code	250
Min. Negotiated Rate	$14.39
Max. Negotiated Rate	$34.17
Rate for Payer: Aetna Commercial	$32.37
Rate for Payer: Humana Medicare Advantage	$15.11
Rate for Payer: UnitedHealthcare Commercial	$34.17
Rate for Payer: UnitedHealthcare Medicaid	$14.39
Rate for Payer: WPPA Medicare Advantage	$21.58

hydrocortisone Top 1% Lotion [HMC]

Facility

IP

$35.97

Service Code	NDC 00394085932
Hospital Charge Code	3805724
Hospital Revenue Code	250
Min. Negotiated Rate	$32.37
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$32.37
Rate for Payer: UnitedHealthcare Commercial	$34.17
Rate for Payer: WPPA Medicare Advantage	$1,200.00

hydrocortisone Top 1% Lotion [HMC]

Facility

OP

$41.84

Service Code	NDC 41167003410
Hospital Charge Code	3805724
Hospital Revenue Code	250
Min. Negotiated Rate	$16.74
Max. Negotiated Rate	$39.75
Rate for Payer: Aetna Commercial	$37.66
Rate for Payer: Humana Medicare Advantage	$17.57
Rate for Payer: UnitedHealthcare Commercial	$39.75
Rate for Payer: UnitedHealthcare Medicaid	$16.74
Rate for Payer: WPPA Medicare Advantage	$25.10

hydrocortisone topical 2.5% Cream [HMC]

Facility

IP

$137.90

Service Code	NDC 64980032430
Hospital Charge Code	3809130
Hospital Revenue Code	250
Min. Negotiated Rate	$124.11
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$124.11
Rate for Payer: UnitedHealthcare Commercial	$131.00
Rate for Payer: WPPA Medicare Advantage	$1,200.00

hydrocortisone topical 2.5% Cream [HMC]

Facility

OP

$137.90

Service Code	NDC 64980032430
Hospital Charge Code	3809130
Hospital Revenue Code	250
Min. Negotiated Rate	$55.16
Max. Negotiated Rate	$131.00
Rate for Payer: Aetna Commercial	$124.11
Rate for Payer: Humana Medicare Advantage	$57.92
Rate for Payer: UnitedHealthcare Commercial	$131.00
Rate for Payer: UnitedHealthcare Medicaid	$55.16
Rate for Payer: WPPA Medicare Advantage	$82.74

hydrocortisone topical 2.5% Cre [HMC]

Facility

IP

$133.40

Service Code	NDC 69315031228
Hospital Charge Code	3809130
Hospital Revenue Code	250
Min. Negotiated Rate	$120.06
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$120.06
Rate for Payer: UnitedHealthcare Commercial	$126.73
Rate for Payer: WPPA Medicare Advantage	$1,200.00

hydrocortisone topical 2.5% Cre [HMC]

Facility

OP

$133.40

Service Code	NDC 69315031228
Hospital Charge Code	3809130
Hospital Revenue Code	250
Min. Negotiated Rate	$53.36
Max. Negotiated Rate	$126.73
Rate for Payer: Aetna Commercial	$120.06
Rate for Payer: Humana Medicare Advantage	$56.03
Rate for Payer: UnitedHealthcare Commercial	$126.73
Rate for Payer: UnitedHealthcare Medicaid	$53.36
Rate for Payer: WPPA Medicare Advantage	$80.04

HYDROmorphone 0.2 mg/mL-NaCl 0.9% Sol

Facility

IP

$58.77

Service Code	HCPCS J1171
Hospital Charge Code	3802659
Hospital Revenue Code	250
Min. Negotiated Rate	$52.89
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$52.89
Rate for Payer: UnitedHealthcare Commercial	$55.83
Rate for Payer: WPPA Medicare Advantage	$1,200.00

HYDROmorphone 0.2 mg/mL-NaCl 0.9% Sol

Facility

OP

$58.77

Service Code	HCPCS J1171
Hospital Charge Code	3802659
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$55.83
Rate for Payer: Aetna Commercial	$52.89
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$0.12
Rate for Payer: Humana Medicare Advantage	$24.68
Rate for Payer: UnitedHealthcare Commercial	$55.83
Rate for Payer: UnitedHealthcare Medicaid	$0.14
Rate for Payer: WPPA Medicare Advantage	$35.26

HYDROmorphone 0.2 mg/mL-NaCl 0.9% Sol 30 mL [HMC]

Facility

OP

$185.82

Service Code	HCPCS J1170
Hospital Charge Code	3800648
Hospital Revenue Code	259
Min. Negotiated Rate	$74.33
Max. Negotiated Rate	$176.53
Rate for Payer: Aetna Commercial	$167.24
Rate for Payer: Humana Medicare Advantage	$78.04
Rate for Payer: UnitedHealthcare Commercial	$176.53
Rate for Payer: UnitedHealthcare Medicaid	$74.33
Rate for Payer: WPPA Medicare Advantage	$111.49

HYDROmorphone 0.2 mg/mL-NaCl 0.9% Sol 30 mL [HMC]

Facility

IP

$185.82

Service Code	HCPCS J1170
Hospital Charge Code	3800648
Hospital Revenue Code	259
Min. Negotiated Rate	$167.24
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$167.24
Rate for Payer: UnitedHealthcare Commercial	$176.53
Rate for Payer: WPPA Medicare Advantage	$1,200.00

HYDROmorphone 20 mg/100 mL-NS IV Sol [HMC]

Facility

OP

$97.84

Service Code	HCPCS J1170
Hospital Charge Code	3800317
Hospital Revenue Code	250
Min. Negotiated Rate	$39.14
Max. Negotiated Rate	$92.95
Rate for Payer: Aetna Commercial	$88.06
Rate for Payer: Humana Medicare Advantage	$41.09
Rate for Payer: UnitedHealthcare Commercial	$92.95
Rate for Payer: UnitedHealthcare Medicaid	$39.14
Rate for Payer: WPPA Medicare Advantage	$58.70

HYDROmorphone 20 mg/100 mL-NS IV Sol [HMC]

Facility

IP

$97.84

Service Code	HCPCS J1170
Hospital Charge Code	3800317
Hospital Revenue Code	250
Min. Negotiated Rate	$88.06
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$88.06
Rate for Payer: UnitedHealthcare Commercial	$92.95
Rate for Payer: WPPA Medicare Advantage	$1,200.00

HYDROmorphone 2 mg/mL Inj Sol [HMC]

Facility

OP

$32.20

Service Code	HCPCS J1171
Hospital Charge Code	3805196
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$30.59
Rate for Payer: Aetna Commercial	$28.98
Rate for Payer: Aetna Commercial	$30.28
Rate for Payer: Aetna Commercial	$33.15
Rate for Payer: Aetna Commercial	$31.46
Rate for Payer: Aetna Commercial	$29.77
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$0.12
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$0.12
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$0.12
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$0.12
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$0.12
Rate for Payer: Humana Medicare Advantage	$14.13
Rate for Payer: Humana Medicare Advantage	$13.52
Rate for Payer: Humana Medicare Advantage	$13.89
Rate for Payer: Humana Medicare Advantage	$14.68
Rate for Payer: Humana Medicare Advantage	$15.47
Rate for Payer: UnitedHealthcare Commercial	$31.43
Rate for Payer: UnitedHealthcare Commercial	$31.96
Rate for Payer: UnitedHealthcare Commercial	$34.99
Rate for Payer: UnitedHealthcare Commercial	$33.21
Rate for Payer: UnitedHealthcare Commercial	$30.59
Rate for Payer: UnitedHealthcare Medicaid	$0.14
Rate for Payer: UnitedHealthcare Medicaid	$0.14
Rate for Payer: UnitedHealthcare Medicaid	$0.14
Rate for Payer: UnitedHealthcare Medicaid	$0.14
Rate for Payer: UnitedHealthcare Medicaid	$0.14
Rate for Payer: WPPA Medicare Advantage	$20.18
Rate for Payer: WPPA Medicare Advantage	$22.10
Rate for Payer: WPPA Medicare Advantage	$19.32
Rate for Payer: WPPA Medicare Advantage	$20.98
Rate for Payer: WPPA Medicare Advantage	$19.85

HYDROmorphone 2 mg/mL Inj Sol [HMC]

Facility

IP

$34.96

Service Code	HCPCS J1171
Hospital Charge Code	3805196
Hospital Revenue Code	636
Min. Negotiated Rate	$31.46
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$31.46
Rate for Payer: Aetna Commercial	$33.15
Rate for Payer: Aetna Commercial	$28.98
Rate for Payer: Aetna Commercial	$29.77
Rate for Payer: Aetna Commercial	$30.28
Rate for Payer: UnitedHealthcare Commercial	$30.59
Rate for Payer: UnitedHealthcare Commercial	$33.21
Rate for Payer: UnitedHealthcare Commercial	$31.96
Rate for Payer: UnitedHealthcare Commercial	$34.99
Rate for Payer: UnitedHealthcare Commercial	$31.43
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

HYDROmorphone 2 mg Tab [HMC]

Facility

IP

$7.14

Service Code	NDC 60687057901
Hospital Charge Code	3801351
Hospital Revenue Code	250
Min. Negotiated Rate	$6.43
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$6.43
Rate for Payer: UnitedHealthcare Commercial	$6.78
Rate for Payer: WPPA Medicare Advantage	$1,200.00

HYDROmorphone 2 mg Tab [HMC]

Facility

IP

$5.86

Service Code	NDC 42858030101
Hospital Charge Code	3801351
Hospital Revenue Code	250
Min. Negotiated Rate	$5.27
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$5.27
Rate for Payer: UnitedHealthcare Commercial	$5.57
Rate for Payer: WPPA Medicare Advantage	$1,200.00

HYDROmorphone 2 mg Tab [HMC]

Facility

OP

$6.44

Service Code	NDC 00406324301
Hospital Charge Code	3801351
Hospital Revenue Code	250
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$6.12
Rate for Payer: Aetna Commercial	$5.80
Rate for Payer: Humana Medicare Advantage	$2.70
Rate for Payer: UnitedHealthcare Commercial	$6.12
Rate for Payer: UnitedHealthcare Medicaid	$2.58
Rate for Payer: WPPA Medicare Advantage	$3.86

HYDROmorphone 2 mg Tab [HMC]

Facility

IP

$6.44

Service Code	NDC 00406324301
Hospital Charge Code	3801351
Hospital Revenue Code	250
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$5.80
Rate for Payer: UnitedHealthcare Commercial	$6.12
Rate for Payer: WPPA Medicare Advantage	$1,200.00

HYDROmorphone 2 mg Tab [HMC]

Facility

OP

$5.86

Service Code	NDC 42858030101
Hospital Charge Code	3801351
Hospital Revenue Code	250
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$5.57
Rate for Payer: Aetna Commercial	$5.27
Rate for Payer: Humana Medicare Advantage	$2.46
Rate for Payer: UnitedHealthcare Commercial	$5.57
Rate for Payer: UnitedHealthcare Medicaid	$2.34
Rate for Payer: WPPA Medicare Advantage	$3.52

HYDROmorphone 2 mg Tab [HMC]

Facility

OP

$7.14

Service Code	NDC 60687057901
Hospital Charge Code	3801351
Hospital Revenue Code	250
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$6.78
Rate for Payer: Aetna Commercial	$6.43
Rate for Payer: Humana Medicare Advantage	$3.00
Rate for Payer: UnitedHealthcare Commercial	$6.78
Rate for Payer: UnitedHealthcare Medicaid	$2.86
Rate for Payer: WPPA Medicare Advantage	$4.28

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