25682-0028-01 — Ultomiris
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). ULTOMIRIS (NDC 25682-0028-01) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/25682-0028-01?code_type=NDC
MLA (9th ed.)
“ULTOMIRIS (NDC 25682-0028-01) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/25682-0028-01?code_type=NDC. Accessed .
Chicago (notes-bibliography)
“ULTOMIRIS (NDC 25682-0028-01) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/25682-0028-01?code_type=NDC.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $72,078–$290,406 (25th–75th percentile) across 1 hospital · 18 payers.
“Negotiated” is the hospital’s negotiated facility rate for this NDC 25682-0028-01 — 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 |
|---|---|---|---|---|---|---|---|
| COOPER UNIVERSITY HOSPITAL Outpatient | Horizon | Braven Health | $198.28 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Horizon | Braven Health | $198.28 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Horizon | Braven Health | $198.28 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Aetna | Medicare Advantage | $239.46 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Aetna | Medicare Advantage | $239.46 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Aetna | Medicare Advantage | $239.46 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Horizon | Omnia | $694.70 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Horizon | Omnia | $694.70 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Horizon | Omnia | $694.70 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Horizon | Ppo Hmo | $732.07 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Horizon | Ppo Hmo | $732.07 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Horizon | Ppo Hmo | $732.07 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | United Healthcare | Medicaid | $55,997.09 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | United Healthcare | Medicaid | $55,997.09 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | United Healthcare | Medicaid | $55,997.09 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Cigna | Commercial | $58,416.13 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Cigna | Commercial | $58,416.13 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Cigna | Commercial | $58,416.13 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Fidelis Wellcare | Medicaid | $64,859.60 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Aetna | Better Health Medicaid | $64,859.60 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Aetna | Better Health Medicaid | $64,859.60 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Aetna | Better Health Medicaid | $64,859.60 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Fidelis Wellcare | Medicaid | $64,859.60 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Fidelis Wellcare | Medicaid | $64,859.60 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Healthnet Federal | Ppo Pc3 | $66,921.92 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Healthnet Federal | Ppo Pc3 | $66,921.92 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Healthnet Federal | Ppo Pc3 | $66,921.92 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Aetna | Pos, Epo, Ppo | $73,797.26 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Aetna | Hmo | $73,797.26 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Aetna | Pos, Epo, Ppo | $73,797.26 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Aetna | Pos, Epo, Ppo | $73,797.26 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Aetna | Hmo | $73,797.26 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Aetna | Hmo | $73,797.26 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Amerigroup | Wellcare Medicaid | $85,413.50 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Amerigroup | Wellcare Medicaid | $85,413.50 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Amerigroup | Wellcare Medicaid | $85,413.50 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Qualcare Health Republic Nj | Commercial | $88,830.04 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Qualcare Health Republic Nj | Commercial | $88,830.04 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Qualcare Health Republic Nj | Commercial | $88,830.04 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | United Healthcare | Oxford | $151,861.41 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | United Healthcare | Oxford | $151,861.41 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | United Healthcare | Oxford | $151,861.41 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Brighton | Commercial | $187,909.70 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Brighton | Commercial | $187,909.70 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Brighton | Commercial | $187,909.70 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Amerihealth | Lvn | $204,992.40 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Amerihealth | Lvn | $204,992.40 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Amerihealth | Lvn | $204,992.40 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Liberty Mutual | Commercial | $207,452.31 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Liberty Mutual | Commercial | $207,452.31 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Liberty Mutual | Commercial | $207,452.31 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Horizon | State Health Benefit Plan | $224,978.83 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Horizon | State Health Benefit Plan | $224,978.83 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Horizon | State Health Benefit Plan | $224,978.83 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | United Healthcare | Commercial | $227,780.72 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | United Healthcare | Commercial | $227,780.72 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | United Healthcare | Commercial | $227,780.72 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Chn | Municiple Joint Insurance Fund | $239,157.80 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Chn | Municiple Joint Insurance Fund | $239,157.80 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Chn | Municiple Joint Insurance Fund | $239,157.80 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Horizon | Indemnity | $241,583.54 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Horizon | Indemnity | $241,583.54 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Horizon | Indemnity | $241,583.54 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Amerihealth | Rp | $256,240.50 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Healthnet | Tricare | $256,240.50 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Healthnet | Tricare | $256,240.50 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Healthnet | Tricare | $256,240.50 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Amerihealth | Rp | $256,240.50 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Amerihealth | Rp | $256,240.50 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | First Mco | Workers Comp | $256,240.50 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | First Mco | Workers Comp | $256,240.50 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | First Mco | Workers Comp | $256,240.50 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Qualcare Health Republic Of Nj Humana | Workers' Comp | $256,240.50 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Qualcare Health Republic Of Nj Humana | Workers' Comp | $256,240.50 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Qualcare Health Republic Of Nj Humana | Workers' Comp | $256,240.50 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Chn | Workers Compensation | $273,323.20 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Chn | Workers Compensation | $273,323.20 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Chn | Workers Compensation | $273,323.20 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Chn | Commercial | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Mulitplan | Commercial | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Magnacare | Auto Personal Injury Protection No Fault | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Magnacare | Commercial | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Chn | Commercial | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Magnacare | Workers' Compensation | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Magnacare | Auto Personal Injury Protection No Fault | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Magnacare | Workers' Compensation | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | First Mco | Group Health | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | First Mco | Group Health | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Magnacare | Auto Personal Injury Protection No Fault | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | First Mco | Group Health | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Magnacare | Workers' Compensation | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Magnacare | Commercial | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Mulitplan | Commercial | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Mulitplan | Commercial | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Chn | Commercial | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Magnacare | Commercial | $290,405.90 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Chn | Automobile/Pip | $307,488.60 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Galaxy | Commercial | $307,488.60 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Chn | Automobile/Pip | $307,488.60 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Galaxy | Commercial | $307,488.60 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Chn | Automobile/Pip | $307,488.60 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Galaxy | Commercial | $307,488.60 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Galaxy | Workers Comp | $324,571.30 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Galaxy | Workers Comp | $324,571.30 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Galaxy | Workers Comp | $324,571.30 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Multiplan | Auto Workers' Compensation | $341,654.00 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Multiplan | Auto Workers' Compensation | $341,654.00 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |
| COOPER UNIVERSITY HOSPITAL Outpatient | Multiplan | Auto Workers' Compensation | $341,654.00 | $341,654.00 | $341,654.00 | 2026-07-15 | MRF ↗ |