04505126 — Xolair 75 Mg/0.5 Ml Syringe
Cite this view
HANK Price Transparency. (n.d.). XOLAIR 75 MG/0.5 ML SYRINGE (CDM 04505126) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/04505126?code_type=CDM
“XOLAIR 75 MG/0.5 ML SYRINGE (CDM 04505126) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/04505126?code_type=CDM. Accessed .
“XOLAIR 75 MG/0.5 ML SYRINGE (CDM 04505126) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/04505126?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $3,385–$4,978 (25th–75th percentile) across 1 hospital · 16 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 04505126 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.
Per-month price trends are temporarily unavailable while we rebuild them on quality-filtered rates. The medians, percentiles, and per-hospital rates on this page are the quality-filtered figures.
Hospital rates (per row)
Showing consumer-grade rates only. Flagged / outlier filings (excluded from the medians above) are hidden — tick “Show flagged / outlier rates” to include them.
| Hospital | Payer | Plan | Negotiated rate | Gross | Cash | Observed | Source |
|---|---|---|---|---|---|---|---|
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | AETNA COMM-ALL OTHER PLANS | AETNA COMM-ALL OTHER PLANS | $2,000.00 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | UHC VA | UHC VA | $3,385.38 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | HEALTH ALLIANCE MCR ADV | HEALTH ALLIANCE MCR ADV | $3,385.38 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | BCBS MCR ADV | BCBS MCR ADV | $3,385.38 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | AETNA MCR ADV | AETNA MCR ADV | $3,385.38 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | WELLCARE MCR ADV-ALL PLANS | WELLCARE MCR ADV-ALL PLANS | $3,385.38 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | HUMANA MCR ADV-ALL PLANS | HUMANA MCR ADV-ALL PLANS | $3,419.23 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | UHC MCR ADV | UHC MCR ADV | $3,453.09 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | HEALTH ALLIANCE-ALL OTHER PLANS | HEALTH ALLIANCE-ALL OTHER PLANS | $4,062.46 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | AMBETTER - ALL PLANS | AMBETTER - ALL PLANS | $4,400.99 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | CIGNA-ALL PLANS | CIGNA-ALL PLANS | $4,732.89 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | BCBS BLUE CHOICE | BCBS BLUE CHOICE | $4,845.74 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | BCBS HMO | BCBS HMO | $4,845.74 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | BCBS PPO - ALL OTHER PLANS | BCBS PPO - ALL OTHER PLANS | $4,978.50 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | MULTIPLAN-ALL PLANS | MULTIPLAN-ALL PLANS | $4,978.50 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | HEALTHLINK HMO | HEALTHLINK HMO | $5,044.88 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | HEALTHLINK IL ONLY | HEALTHLINK IL ONLY | $5,044.88 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | HEALTHLINK PPO-ALL OTHER PLANS | HEALTHLINK PPO-ALL OTHER PLANS | $5,708.68 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |
| THOMAS H BOYD MEMORIAL HOSPITAL Outpatient | HFN ZELIS-ALL PLANS | HFN ZELIS-ALL PLANS | $6,040.58 | $6,638.00 | $5,310.40 | 2026-04-24 | MRF ↗ |