Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

nalbuphine 20 mg/mL Inj Sol [HMC]

Facility

OP

$47.60

Service Code	HCPCS J2300
Hospital Charge Code	3852070
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$45.22
Rate for Payer: Aetna Commercial	$42.84
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$3.57
Rate for Payer: Humana Medicare Advantage	$19.99
Rate for Payer: UnitedHealthcare Commercial	$45.22
Rate for Payer: UnitedHealthcare Medicaid	$3.45
Rate for Payer: WPPA Medicare Advantage	$28.56

nalbuphine 20 mg/mL Inj Sol [HMC]

Facility

IP

$47.60

Service Code	HCPCS J2300
Hospital Charge Code	3852070
Hospital Revenue Code	250
Min. Negotiated Rate	$42.84
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$42.84
Rate for Payer: UnitedHealthcare Commercial	$45.22
Rate for Payer: WPPA Medicare Advantage	$1,200.00

naloxone 1 mg/mL Inj Sol [HMC]

Facility

OP

$79.40

Service Code	HCPCS J2310
Hospital Charge Code	3806342
Hospital Revenue Code	250
Min. Negotiated Rate	$10.36
Max. Negotiated Rate	$75.43
Rate for Payer: Aetna Commercial	$71.46
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$10.36
Rate for Payer: Humana Medicare Advantage	$33.35
Rate for Payer: UnitedHealthcare Commercial	$75.43
Rate for Payer: UnitedHealthcare Medicaid	$31.76
Rate for Payer: WPPA Medicare Advantage	$47.64

naloxone 1 mg/mL Inj Sol [HMC]

Facility

IP

$79.40

Service Code	HCPCS J2310
Hospital Charge Code	3806342
Hospital Revenue Code	250
Min. Negotiated Rate	$71.46
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$71.46
Rate for Payer: UnitedHealthcare Commercial	$75.43
Rate for Payer: WPPA Medicare Advantage	$1,200.00

naproxen 375 mg Tab [HMC]

Facility

OP

$7.96

Service Code	NDC 50268059515
Hospital Charge Code	3806334
Hospital Revenue Code	250
Min. Negotiated Rate	$3.18
Max. Negotiated Rate	$7.56
Rate for Payer: Aetna Commercial	$7.16
Rate for Payer: Humana Medicare Advantage	$3.34
Rate for Payer: UnitedHealthcare Commercial	$7.56
Rate for Payer: UnitedHealthcare Medicaid	$3.18
Rate for Payer: WPPA Medicare Advantage	$4.78

naproxen 375 mg Tab [HMC]

Facility

IP

$8.18

Service Code	NDC 68462018901
Hospital Charge Code	3806334
Hospital Revenue Code	250
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$7.36
Rate for Payer: UnitedHealthcare Commercial	$7.77
Rate for Payer: WPPA Medicare Advantage	$1,200.00

naproxen 375 mg Tab [HMC]

Facility

OP

$8.18

Service Code	NDC 68462018901
Hospital Charge Code	3806334
Hospital Revenue Code	250
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$7.77
Rate for Payer: Aetna Commercial	$7.36
Rate for Payer: Humana Medicare Advantage	$3.44
Rate for Payer: UnitedHealthcare Commercial	$7.77
Rate for Payer: UnitedHealthcare Medicaid	$3.27
Rate for Payer: WPPA Medicare Advantage	$4.91

naproxen 375 mg Tab [HMC]

Facility

IP

$7.96

Service Code	NDC 50268059515
Hospital Charge Code	3806334
Hospital Revenue Code	250
Min. Negotiated Rate	$7.16
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$7.16
Rate for Payer: UnitedHealthcare Commercial	$7.56
Rate for Payer: WPPA Medicare Advantage	$1,200.00

naproxen sodium 220 mg Tab [HMC]

Facility

IP

$5.28

Service Code	NDC 00536109306
Hospital Charge Code	3804180
Hospital Revenue Code	250
Min. Negotiated Rate	$4.75
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$4.75
Rate for Payer: UnitedHealthcare Commercial	$5.02
Rate for Payer: WPPA Medicare Advantage	$1,200.00

naproxen sodium 220 mg Tab [HMC]

Facility

OP

$5.22

Service Code	NDC 00536109301
Hospital Charge Code	3804180
Hospital Revenue Code	250
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$4.96
Rate for Payer: Aetna Commercial	$4.70
Rate for Payer: Humana Medicare Advantage	$2.19
Rate for Payer: UnitedHealthcare Commercial	$4.96
Rate for Payer: UnitedHealthcare Medicaid	$2.09
Rate for Payer: WPPA Medicare Advantage	$3.13

naproxen sodium 220 mg Tab [HMC]

Facility

IP

$5.20

Service Code	NDC 45802049075
Hospital Charge Code	3804180
Hospital Revenue Code	250
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$4.68
Rate for Payer: UnitedHealthcare Commercial	$4.94
Rate for Payer: WPPA Medicare Advantage	$1,200.00

naproxen sodium 220 mg Tab [HMC]

Facility

OP

$5.20

Service Code	NDC 45802049075
Hospital Charge Code	3804180
Hospital Revenue Code	250
Min. Negotiated Rate	$2.08
Max. Negotiated Rate	$4.94
Rate for Payer: Aetna Commercial	$4.68
Rate for Payer: Humana Medicare Advantage	$2.18
Rate for Payer: UnitedHealthcare Commercial	$4.94
Rate for Payer: UnitedHealthcare Medicaid	$2.08
Rate for Payer: WPPA Medicare Advantage	$3.12

naproxen sodium 220 mg Tab [HMC]

Facility

IP

$5.22

Service Code	NDC 00536109301
Hospital Charge Code	3804180
Hospital Revenue Code	250
Min. Negotiated Rate	$4.70
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$4.70
Rate for Payer: UnitedHealthcare Commercial	$4.96
Rate for Payer: WPPA Medicare Advantage	$1,200.00

naproxen sodium 220 mg Tab [HMC]

Facility

OP

$5.24

Service Code	NDC 45802049071
Hospital Charge Code	3804180
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.98
Rate for Payer: Aetna Commercial	$4.72
Rate for Payer: Humana Medicare Advantage	$2.20
Rate for Payer: UnitedHealthcare Commercial	$4.98
Rate for Payer: UnitedHealthcare Medicaid	$2.10
Rate for Payer: WPPA Medicare Advantage	$3.14

naproxen sodium 220 mg Tab [HMC]

Facility

OP

$5.28

Service Code	NDC 00536109306
Hospital Charge Code	3804180
Hospital Revenue Code	250
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$5.02
Rate for Payer: Aetna Commercial	$4.75
Rate for Payer: Humana Medicare Advantage	$2.22
Rate for Payer: UnitedHealthcare Commercial	$5.02
Rate for Payer: UnitedHealthcare Medicaid	$2.11
Rate for Payer: WPPA Medicare Advantage	$3.17

naproxen sodium 220 mg Tab [HMC]

Facility

IP

$5.24

Service Code	NDC 45802049071
Hospital Charge Code	3804180
Hospital Revenue Code	250
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$4.72
Rate for Payer: UnitedHealthcare Commercial	$4.98
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Nasal Alar SpO2 Sensor

Facility

IP

$106.00

Hospital Charge Code	3253675
Hospital Revenue Code	270
Min. Negotiated Rate	$95.40
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$95.40
Rate for Payer: UnitedHealthcare Commercial	$100.70
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Nasal Alar SpO2 Sensor

Facility

OP

$106.00

Hospital Charge Code	3253675
Hospital Revenue Code	270
Min. Negotiated Rate	$42.40
Max. Negotiated Rate	$100.70
Rate for Payer: Aetna Commercial	$95.40
Rate for Payer: Humana Medicare Advantage	$44.52
Rate for Payer: UnitedHealthcare Commercial	$100.70
Rate for Payer: UnitedHealthcare Medicaid	$42.40
Rate for Payer: WPPA Medicare Advantage	$63.60

Nasal Endoscopy with Dilation [ bilateral ]

Facility

OP

$751.00

Service Code	HCPCS 69706
Hospital Charge Code	3159706
Hospital Revenue Code	975
Min. Negotiated Rate	$315.42
Max. Negotiated Rate	$3,305.93
Rate for Payer: Aetna Commercial	$675.90
Rate for Payer: Blue Cross Blue Shield of Kansas Commercial	$541.36
Rate for Payer: Humana Medicare Advantage	$315.42
Rate for Payer: UnitedHealthcare Commercial	$713.45
Rate for Payer: UnitedHealthcare Medicaid	$3,305.93
Rate for Payer: WPPA Medicare Advantage	$450.60

Nasal Endoscopy with Dilation [ bilateral ]

Facility

IP

$751.00

Service Code	HCPCS 69706
Hospital Charge Code	3159706
Hospital Revenue Code	975
Min. Negotiated Rate	$675.90
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$675.90
Rate for Payer: UnitedHealthcare Commercial	$713.45
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Nasal Prongs -5.0 mm nare diameter/4.0mm septal width

Facility

IP

$35.55

Hospital Charge Code	3254953
Hospital Revenue Code	270
Min. Negotiated Rate	$32.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$32.00
Rate for Payer: UnitedHealthcare Commercial	$33.77
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Nasal Prongs -5.0 mm nare diameter/4.0mm septal width

Facility

OP

$35.55

Hospital Charge Code	3254953
Hospital Revenue Code	270
Min. Negotiated Rate	$14.22
Max. Negotiated Rate	$33.77
Rate for Payer: Aetna Commercial	$32.00
Rate for Payer: Humana Medicare Advantage	$14.93
Rate for Payer: UnitedHealthcare Commercial	$33.77
Rate for Payer: UnitedHealthcare Medicaid	$14.22
Rate for Payer: WPPA Medicare Advantage	$21.33

Nasal Prongs -5.5 mm nare diameter/5.0 septal width

Facility

OP

$35.55

Hospital Charge Code	3254954
Hospital Revenue Code	270
Min. Negotiated Rate	$14.22
Max. Negotiated Rate	$33.77
Rate for Payer: Aetna Commercial	$32.00
Rate for Payer: Humana Medicare Advantage	$14.93
Rate for Payer: UnitedHealthcare Commercial	$33.77
Rate for Payer: UnitedHealthcare Medicaid	$14.22
Rate for Payer: WPPA Medicare Advantage	$21.33

Nasal Prongs -5.5 mm nare diameter/5.0 septal width

Facility

IP

$35.55

Hospital Charge Code	3254954
Hospital Revenue Code	270
Min. Negotiated Rate	$32.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$32.00
Rate for Payer: UnitedHealthcare Commercial	$33.77
Rate for Payer: WPPA Medicare Advantage	$1,200.00

Nasal Septal Button 3 cm Diameter Silicone

Facility

OP

$574.83

Hospital Charge Code	3256122
Hospital Revenue Code	270
Min. Negotiated Rate	$229.93
Max. Negotiated Rate	$546.09
Rate for Payer: Aetna Commercial	$517.35
Rate for Payer: Humana Medicare Advantage	$241.43
Rate for Payer: UnitedHealthcare Commercial	$546.09
Rate for Payer: UnitedHealthcare Medicaid	$229.93
Rate for Payer: WPPA Medicare Advantage	$344.90

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