3500041 — Alteplase 100mg/100 Ml Inj (activase)
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). ALTEPLASE 100MG/100 ML INJ (ACTIVASE) (OTHER 3500041) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/3500041?code_type=OTHER
MLA (9th ed.)
“ALTEPLASE 100MG/100 ML INJ (ACTIVASE) (OTHER 3500041) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/3500041?code_type=OTHER. Accessed .
Chicago (notes-bibliography)
“ALTEPLASE 100MG/100 ML INJ (ACTIVASE) (OTHER 3500041) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/3500041?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $448–$7,536 (25th–75th percentile) across 4 hospitals · 33 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 3500041 — 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 |
|---|---|---|---|---|---|---|---|
| FRANKLIN MEDICAL CENTER Outpatient | Medicare | Medicare | — | $552.00 | $331.20 | 2026-05-08 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Scott & White | Medicare Advantage | $88.97 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Community Health | Medicare Advantage | $88.97 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Molina | Medicare Advantage | $88.97 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Superior | Medicare Advantage | $88.97 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Superior | Commericial | $88.97 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | United | Medicare Advantage | $88.97 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Triwest | Medicare Advantage | $88.97 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Blue Cross Blue Sheild | Medicare Advantage Hmo | $88.97 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Blue Cross Blue Sheild | Medicare Advantage Ppo | $88.97 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Aetna Health Inc. | Medicare Advantage | $88.97 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Collective Health | Commercial | $113.82 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Bcbs Hmo Bav Advantage | Commercial | $126.47 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| FRANKLIN MEDICAL CENTER Outpatient | Uhc Medicaid | Medicaid | $176.36 | $552.00 | $331.20 | 2026-05-08 | MRF ↗ |
| FRANKLIN MEDICAL CENTER Outpatient | Medicaid | Medicaid | $176.36 | $552.00 | $331.20 | 2026-05-08 | MRF ↗ |
| FRANKLIN MEDICAL CENTER Outpatient | Humana Medicaid | Medicaid | $194.03 | $552.00 | $331.20 | 2026-05-08 | MRF ↗ |
| FRANKLIN MEDICAL CENTER Outpatient | Uhc | Commercial | $209.76 | $552.00 | $331.20 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Humana Employers Health | Commercial | $385.05 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| FRANKLIN MEDICAL CENTER Outpatient | Aetna | Commercial | $469.20 | $552.00 | $331.20 | 2026-05-08 | MRF ↗ |
| FRANKLIN MEDICAL CENTER Outpatient | Bcbs Ppo | Commercial | $567.44 | $552.00 | $331.20 | 2026-05-08 | MRF ↗ |
| FRANKLIN MEDICAL CENTER Outpatient | Bcbs Hmo | Commercial | $567.44 | $552.00 | $331.20 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Aetna Medicare | Medicare | $744.43 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Tricare North Region | Medicare | $744.43 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Tricare West Region | Medicare | $744.43 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Tricare Wps Vac3 | Medicare | $744.43 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Tricare East | Medicare | $744.43 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Humana Medicare Gold Choice | Medicare | $751.87 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | United Healthcarevrr Medicare | Medicare | $751.87 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | United Healthcare Medicare | Medicare | $751.87 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Humana Medicare Advantage | Medicare | $751.87 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Humana Gold Plus Medicare | Medicare | $751.87 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Cigna Healthsmart | Commercial | $1,411.85 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Cigna Health Care Tx | Commercial | $1,411.85 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Cigna | Commercial | $1,411.85 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Allied Group Insurance | Commercial | $1,925.25 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Aetna Ppo | Commercial | $1,925.25 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Insurance Management Service | Commercial | $1,925.25 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Aetna Hmo | Commercial | $1,925.25 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Bcbs Of Texas | Commercial | $2,053.60 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | First Care Hmo | Commercial | $2,053.60 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Allied Benefit Mchd Employee | Commercial | $2,181.95 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | First Health | Commercial | $2,181.95 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Golden Rule Insurance In | Commercial | $2,310.30 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | United Healthcare | Commercial | $2,310.30 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Ntca Benefit Ppo | Commercial | $2,310.30 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Tml Iebp | Commercial | $2,310.30 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Umr | Commercial | $2,310.30 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | First Care Ppo | Commercial | $2,310.30 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| MEMORIAL HOSPITAL Outpatient | Geha | Commercial | $2,310.30 | $2,567.00 | $2,053.60 | 2026-05-08 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Multiplan | Managed Medicaid | $7,535.85 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | United | Managed Medicaid | $7,535.85 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Tesas Children'S Health Plan | Managed Medicaid | $7,535.85 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Community Health | Managed Medicaid | $7,535.85 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Amerigroup | Managed Medicaid | $7,535.85 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Molina | Managed Medicaid | $7,535.85 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Scott & White | Managed Medicaid | $7,535.85 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Blue Cross Blue Sheild | Medicare Advantage | $9,688.95 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Blue Cross Blue Sheild | Essentials | $9,688.95 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | United | Commericial | $10,765.50 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Scott & White | Commericial | $10,765.50 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Blue Cross Blue Sheild | Traditional | $10,765.50 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| PALACIOS COMMUNITY MEDICAL CENTER Both | Aetna Health Inc. | Medicare Advantage | $11,411.43 | $21,531.00 | $21,531.00 | 2026-05-15 | MRF ↗ |
| PALACIOS COMMUNITY MEDICAL CENTER Both | Molina | Medicare Advantage | $11,411.43 | $21,531.00 | $21,531.00 | 2026-05-15 | MRF ↗ |
| PALACIOS COMMUNITY MEDICAL CENTER Both | Blue Cross Blue Sheild | Bav | $11,842.05 | $21,531.00 | $21,531.00 | 2026-05-15 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Cigna | Commericial | $13,112.38 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| PALACIOS COMMUNITY MEDICAL CENTER Both | Blue Cross Blue Shield | Par | $13,995.15 | $21,531.00 | $21,531.00 | 2026-05-15 | MRF ↗ |
| PALACIOS COMMUNITY MEDICAL CENTER Both | Blue Cross Blue Shield | Ppo | $13,995.15 | $21,531.00 | $21,531.00 | 2026-05-15 | MRF ↗ |
| PALACIOS COMMUNITY MEDICAL CENTER Both | Aetna Health Inc. | Commercial | $15,071.70 | $21,531.00 | $21,531.00 | 2026-05-15 | MRF ↗ |
| BELLVILLE MEDICAL CENTER Both | Healthsmart | Commericial | $17,224.80 | $21,531.00 | $21,531.00 | 2026-05-18 | MRF ↗ |
| PALACIOS COMMUNITY MEDICAL CENTER Both | Blue Cross Blue Shield | Managed Medicaid | $19,507.09 | $21,531.00 | $21,531.00 | 2026-05-15 | MRF ↗ |
| PALACIOS COMMUNITY MEDICAL CENTER Both | Community Health Choice | Managed Medicaid | $19,507.09 | $21,531.00 | $21,531.00 | 2026-05-15 | MRF ↗ |
| PALACIOS COMMUNITY MEDICAL CENTER Both | Molina | Managed Medicaid | $19,507.09 | $21,531.00 | $21,531.00 | 2026-05-15 | MRF ↗ |