1264 — Maalox Sus 30ml
Cite this view
HANK Price Transparency. (n.d.). MAALOX SUS 30ML (CDM 1264) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/1264?code_type=CDM
“MAALOX SUS 30ML (CDM 1264) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/1264?code_type=CDM. Accessed .
“MAALOX SUS 30ML (CDM 1264) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/1264?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $7–$22 (25th–75th percentile) across 6 hospitals · 20 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 1264 — 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 |
|---|---|---|---|---|---|---|---|
| MOUNTAINVIEW HOSPITAL Outpatient | Health Services Coalition | COMM | $3.94 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| ARKANSAS HEART HOSPITAL, LLC Outpatient | UHC MCAID | UHC MCAID | $4.22 | $16.88 | $10.63 | 2026-03-25 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Imperial NV | MCR | $4.35 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| ARKANSAS HEART HOSPITAL, LLC Outpatient | AETNA MCR ADV | AETNA MCR ADV | $5.91 | $16.88 | $10.63 | 2026-03-25 | MRF ↗ |
| ARKANSAS HEART HOSPITAL, LLC Outpatient | AETNA COMM - ALL OTHER PLANS | AETNA COMM - ALL OTHER PLANS | $5.91 | $16.88 | $10.63 | 2026-03-25 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Centene | HIX | $6.09 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Select Health | HIX | $6.26 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | United | OptionsPPO | $6.32 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | CIGNA | OAP | $6.50 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Select Health | COMM | $6.68 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| ARKANSAS HEART HOSPITAL, LLC Outpatient | WPPA - ALL PLANS | WPPA - ALL PLANS | $6.75 | $16.88 | $10.63 | 2026-03-25 | MRF ↗ |
| KANSAS HEART HOSPITAL Both | WPPA | COMMERCIAL | $6.75 | $16.88 | — | 2024-07-10 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Aetna | HMO | $7.39 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Aetna | PPO | $7.39 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Prominence HealthFirst | COMM | $8.70 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | CMN Global | COMM | $12.18 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Emerging Therapy Solutions | MGMCR | $14.21 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Hometown Health Providers | ThirdPartyAdministratior(TPA) | $14.50 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Hometown Health Providers | HMO/PPO/POS | $14.50 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| ARKANSAS HEART HOSPITAL, LLC Outpatient | MULTIPLAN - ALL PLANS | MULTIPLAN - ALL PLANS | $15.19 | $16.88 | $10.63 | 2026-03-25 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | NV Health & Welfare Trust | COMM | $17.40 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | MultiPlan | PRIMARY | $18.27 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | MultiPlan | INTERNATIONAL | $18.27 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | First Health | COMM | $19.14 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Emerging Therapy Solutions | COMM | $19.43 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | MultiPlan | COMPLEMENTARY | $21.17 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | MedCare International | COMM | $21.75 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Olympus MedSave USA | COMM | $21.75 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | First Health | WCOMP | $23.20 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| MOUNTAINVIEW HOSPITAL Outpatient | Elevance (Anthem BCBS) | MCR | $29.00 | $29.00 | $29.00 | 2026-03-01 | MRF ↗ |
| SARATOGA HOSPITAL BothFacility | — | — | — | $495.00 | $247.50 | 2025-01-01 | MRF ↗ |
| GLENS FALLS HOSPITAL BothFacility | — | — | — | $495.00 | $247.50 | 2025-01-01 | MRF ↗ |
| EASTLAND MEMORIAL HOSPITAL Outpatient | United Healthcare | Medicare Advantage | $1,636.00 | $2,638.00 | $1,319.00 | 2026-06-26 | MRF ↗ |
| EASTLAND MEMORIAL HOSPITAL Outpatient | Blue Cross Blue Shield | Blue Essentials HMO | $1,794.00 | $2,638.00 | $1,319.00 | 2026-06-26 | MRF ↗ |
| EASTLAND MEMORIAL HOSPITAL Outpatient | Blue Cross Blue Shield | PPO | $1,979.00 | $2,638.00 | $1,319.00 | 2026-06-26 | MRF ↗ |
| EASTLAND MEMORIAL HOSPITAL Outpatient | Scott and Whte | Commercial | $2,374.00 | $2,638.00 | $1,319.00 | 2026-06-26 | MRF ↗ |