Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

THP Azithromycin 250 mg (6 Tab) [HMC]

Facility

IP

$71.65

Service Code	NDC 51224002230
Hospital Charge Code	3806778
Hospital Revenue Code	253
Min. Negotiated Rate	$64.48
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$64.48
Rate for Payer: UnitedHealthcare Commercial	$68.07
Rate for Payer: WPPA Medicare Advantage	$1,200.00

THP Azithromycin 250 mg (6 Tab) [HMC]

Facility

OP

$26.44

Service Code	NDC 00781808926
Hospital Charge Code	3806778
Hospital Revenue Code	253
Min. Negotiated Rate	$10.58
Max. Negotiated Rate	$25.12
Rate for Payer: Aetna Commercial	$23.80
Rate for Payer: Humana Medicare Advantage	$11.10
Rate for Payer: UnitedHealthcare Commercial	$25.12
Rate for Payer: UnitedHealthcare Medicaid	$10.58
Rate for Payer: WPPA Medicare Advantage	$15.86

THP Cefadroxil 500 mg (4 Tab) [HMC]

Facility

OP

$54.76

Service Code	NDC 68180018008
Hospital Charge Code	3803525
Hospital Revenue Code	253
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$52.02
Rate for Payer: Aetna Commercial	$49.28
Rate for Payer: Humana Medicare Advantage	$23.00
Rate for Payer: UnitedHealthcare Commercial	$52.02
Rate for Payer: UnitedHealthcare Medicaid	$21.90
Rate for Payer: WPPA Medicare Advantage	$32.86

THP Cefadroxil 500 mg (4 Tab) [HMC]

Facility

IP

$54.76

Service Code	NDC 68180018008
Hospital Charge Code	3803525
Hospital Revenue Code	253
Min. Negotiated Rate	$49.28
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$49.28
Rate for Payer: UnitedHealthcare Commercial	$52.02
Rate for Payer: WPPA Medicare Advantage	$1,200.00

THP Cefdinir 300 mg (4 Tab) [HMC]

Facility

OP

$45.44

Service Code	NDC 68180071160
Hospital Charge Code	3805687
Hospital Revenue Code	253
Min. Negotiated Rate	$18.18
Max. Negotiated Rate	$43.17
Rate for Payer: Aetna Commercial	$40.90
Rate for Payer: Humana Medicare Advantage	$19.08
Rate for Payer: UnitedHealthcare Commercial	$43.17
Rate for Payer: UnitedHealthcare Medicaid	$18.18
Rate for Payer: WPPA Medicare Advantage	$27.26

THP Cefdinir 300 mg (4 Tab) [HMC]

Facility

IP

$45.44

Service Code	NDC 68180071160
Hospital Charge Code	3805687
Hospital Revenue Code	253
Min. Negotiated Rate	$40.90
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$40.90
Rate for Payer: UnitedHealthcare Commercial	$43.17
Rate for Payer: WPPA Medicare Advantage	$1,200.00

THP Cephalexin 250 mg (4 Tab) [HMC]

Facility

IP

$33.31

Service Code	NDC 68180012101
Hospital Charge Code	3804784
Hospital Revenue Code	253
Min. Negotiated Rate	$29.98
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$29.98
Rate for Payer: UnitedHealthcare Commercial	$31.64
Rate for Payer: WPPA Medicare Advantage	$1,200.00

THP Cephalexin 250 mg (4 Tab) [HMC]

Facility

OP

$33.31

Service Code	NDC 68180012101
Hospital Charge Code	3804784
Hospital Revenue Code	253
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$31.64
Rate for Payer: Aetna Commercial	$29.98
Rate for Payer: Humana Medicare Advantage	$13.99
Rate for Payer: UnitedHealthcare Commercial	$31.64
Rate for Payer: UnitedHealthcare Medicaid	$13.32
Rate for Payer: WPPA Medicare Advantage	$19.99

THP cephalexin 250 mg/5 mL Oral Liq 100 mL [HMC]

Facility

OP

$47.85

Service Code	NDC 67877054588
Hospital Charge Code	3807445
Hospital Revenue Code	250
Min. Negotiated Rate	$19.14
Max. Negotiated Rate	$45.46
Rate for Payer: Aetna Commercial	$43.06
Rate for Payer: Humana Medicare Advantage	$20.10
Rate for Payer: UnitedHealthcare Commercial	$45.46
Rate for Payer: UnitedHealthcare Medicaid	$19.14
Rate for Payer: WPPA Medicare Advantage	$28.71

THP cephalexin 250 mg/5 mL Oral Liq 100 mL [HMC]

Facility

OP

$53.75

Service Code	NDC 68180044101
Hospital Charge Code	3807445
Hospital Revenue Code	250
Min. Negotiated Rate	$21.50
Max. Negotiated Rate	$51.06
Rate for Payer: Aetna Commercial	$48.38
Rate for Payer: Humana Medicare Advantage	$22.57
Rate for Payer: UnitedHealthcare Commercial	$51.06
Rate for Payer: UnitedHealthcare Medicaid	$21.50
Rate for Payer: WPPA Medicare Advantage	$32.25

THP cephalexin 250 mg/5 mL Oral Liq 100 mL [HMC]

Facility

IP

$47.85

Service Code	NDC 67877054588
Hospital Charge Code	3807445
Hospital Revenue Code	250
Min. Negotiated Rate	$43.06
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$43.06
Rate for Payer: UnitedHealthcare Commercial	$45.46
Rate for Payer: WPPA Medicare Advantage	$1,200.00

THP cephalexin 250 mg/5 mL Oral Liq 100 mL [HMC]

Facility

IP

$53.75

Service Code	NDC 68180044101
Hospital Charge Code	3807445
Hospital Revenue Code	250
Min. Negotiated Rate	$48.38
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$48.38
Rate for Payer: UnitedHealthcare Commercial	$51.06
Rate for Payer: WPPA Medicare Advantage	$1,200.00

THP cephalexin 250 mg/5 mL Oral Liq 100 mL [HMC]

Facility

OP

$53.75

Service Code	NDC 68180012401
Hospital Charge Code	3807445
Hospital Revenue Code	250
Min. Negotiated Rate	$21.50
Max. Negotiated Rate	$51.06
Rate for Payer: Aetna Commercial	$48.38
Rate for Payer: Humana Medicare Advantage	$22.57
Rate for Payer: UnitedHealthcare Commercial	$51.06
Rate for Payer: UnitedHealthcare Medicaid	$21.50
Rate for Payer: WPPA Medicare Advantage	$32.25

THP cephalexin 250 mg/5 mL Oral Liq 100 mL [HMC]

Facility

IP

$53.75

Service Code	NDC 68180012401
Hospital Charge Code	3807445
Hospital Revenue Code	250
Min. Negotiated Rate	$48.38
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$48.38
Rate for Payer: UnitedHealthcare Commercial	$51.06
Rate for Payer: WPPA Medicare Advantage	$1,200.00

THP Cephalexin 500 mg (4 Tab) [HMC]

Facility

IP

$38.75

Service Code	NDC 68180012201
Hospital Charge Code	3804792
Hospital Revenue Code	253
Min. Negotiated Rate	$34.88
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$34.88
Rate for Payer: UnitedHealthcare Commercial	$36.81
Rate for Payer: WPPA Medicare Advantage	$1,200.00

THP Cephalexin 500 mg (4 Tab) [HMC]

Facility

OP

$38.75

Service Code	NDC 68180012201
Hospital Charge Code	3804792
Hospital Revenue Code	253
Min. Negotiated Rate	$15.50
Max. Negotiated Rate	$36.81
Rate for Payer: Aetna Commercial	$34.88
Rate for Payer: Humana Medicare Advantage	$16.27
Rate for Payer: UnitedHealthcare Commercial	$36.81
Rate for Payer: UnitedHealthcare Medicaid	$15.50
Rate for Payer: WPPA Medicare Advantage	$23.25

THP Ciprofloxacin 500 mg (4 Tab) [HMC]

Facility

OP

$50.40

Service Code	NDC 68084007001
Hospital Charge Code	3803349
Hospital Revenue Code	253
Min. Negotiated Rate	$20.16
Max. Negotiated Rate	$47.88
Rate for Payer: Aetna Commercial	$45.36
Rate for Payer: Humana Medicare Advantage	$21.17
Rate for Payer: UnitedHealthcare Commercial	$47.88
Rate for Payer: UnitedHealthcare Medicaid	$20.16
Rate for Payer: WPPA Medicare Advantage	$30.24

THP Ciprofloxacin 500 mg (4 Tab) [HMC]

Facility

IP

$50.40

Service Code	NDC 68084007001
Hospital Charge Code	3803349
Hospital Revenue Code	253
Min. Negotiated Rate	$45.36
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$45.36
Rate for Payer: UnitedHealthcare Commercial	$47.88
Rate for Payer: WPPA Medicare Advantage	$1,200.00

THP Clindamycin 150 mg (4 Tab) [HMC]

Facility

OP

$38.80

Service Code	NDC 51079059820
Hospital Charge Code	3809039
Hospital Revenue Code	253
Min. Negotiated Rate	$15.52
Max. Negotiated Rate	$36.86
Rate for Payer: Aetna Commercial	$34.92
Rate for Payer: Humana Medicare Advantage	$16.30
Rate for Payer: UnitedHealthcare Commercial	$36.86
Rate for Payer: UnitedHealthcare Medicaid	$15.52
Rate for Payer: WPPA Medicare Advantage	$23.28

THP Clindamycin 150 mg (4 Tab) [HMC]

Facility

IP

$38.80

Service Code	NDC 51079059820
Hospital Charge Code	3809039
Hospital Revenue Code	253
Min. Negotiated Rate	$34.92
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$34.92
Rate for Payer: UnitedHealthcare Commercial	$36.86
Rate for Payer: WPPA Medicare Advantage	$1,200.00

THP Clindamycin 300 mg (4 tab) [HMC]

Facility

OP

$38.00

Service Code	NDC 68084024411
Hospital Charge Code	3808442
Hospital Revenue Code	253
Min. Negotiated Rate	$15.20
Max. Negotiated Rate	$36.10
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Humana Medicare Advantage	$15.96
Rate for Payer: UnitedHealthcare Commercial	$36.10
Rate for Payer: UnitedHealthcare Medicaid	$15.20
Rate for Payer: WPPA Medicare Advantage	$22.80

THP Clindamycin 300 mg (4 tab) [HMC]

Facility

IP

$38.00

Service Code	NDC 68084024411
Hospital Charge Code	3808442
Hospital Revenue Code	253
Min. Negotiated Rate	$34.20
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: UnitedHealthcare Commercial	$36.10
Rate for Payer: WPPA Medicare Advantage	$1,200.00

THP Cyclobenzaprine 10 mg (4 Tab) [HMC]

Facility

OP

$26.11

Service Code	NDC 63739053110
Hospital Charge Code	3805161
Hospital Revenue Code	253
Min. Negotiated Rate	$10.44
Max. Negotiated Rate	$24.80
Rate for Payer: Aetna Commercial	$23.50
Rate for Payer: Humana Medicare Advantage	$10.97
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Medicaid	$10.44
Rate for Payer: WPPA Medicare Advantage	$15.67

THP Cyclobenzaprine 10 mg (4 Tab) [HMC]

Facility

IP

$26.11

Service Code	NDC 63739053110
Hospital Charge Code	3805161
Hospital Revenue Code	253
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$23.50
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: WPPA Medicare Advantage	$1,200.00

THP Dexamethasone 4 mg (6 Tab) [HMC]

Facility

OP

$43.05

Service Code	NDC 00054817525
Hospital Charge Code	3800861
Hospital Revenue Code	253
Min. Negotiated Rate	$17.22
Max. Negotiated Rate	$40.90
Rate for Payer: Aetna Commercial	$38.74
Rate for Payer: Humana Medicare Advantage	$18.08
Rate for Payer: UnitedHealthcare Commercial	$40.90
Rate for Payer: UnitedHealthcare Medicaid	$17.22
Rate for Payer: WPPA Medicare Advantage	$25.83

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