4000053 — Fosphenytoin In 100 Ml
Cite this view
HANK Price Transparency. (n.d.). FOSPHENYTOIN IN 100 ML (CDM 4000053) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/4000053?code_type=CDM
“FOSPHENYTOIN IN 100 ML (CDM 4000053) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/4000053?code_type=CDM. Accessed .
“FOSPHENYTOIN IN 100 ML (CDM 4000053) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/4000053?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $86–$143 (25th–75th percentile) across 4 hospitals · 27 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 4000053 — 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 |
|---|---|---|---|---|---|---|---|
| GOTHENBURG HEALTH Outpatient | United Healthcare | Veterans Affair Community Care | $46.00 | $75.00 | $68.00 | 2025-06-11 | MRF ↗ |
| GOTHENBURG HEALTH Outpatient | Blue Cross Blue Shield | Medicare Advantage | $47.00 | $75.00 | $68.00 | 2025-06-11 | MRF ↗ |
| GOTHENBURG HEALTH Outpatient | Aetna | Medicare Advantage | $47.00 | $75.00 | $68.00 | 2025-06-11 | MRF ↗ |
| LARKIN COMMUNITY HOSPITAL PALM SPRINGS CAMPUS Outpatient | BCBS MCR ADV | BCBS MCR ADV | $51.48 | $286.00 | $200.20 | 2026-01-30 | MRF ↗ |
| GOTHENBURG HEALTH Outpatient | Nebraska Total Care | Commercial | $70.00 | $75.00 | $68.00 | 2025-06-11 | MRF ↗ |
| GOTHENBURG HEALTH Outpatient | Blue Cross Blue Shield | Commercial | $71.00 | $75.00 | $68.00 | 2025-06-11 | MRF ↗ |
| LARKIN COMMUNITY HOSPITAL PALM SPRINGS CAMPUS Outpatient | CIGNA-ALL PLANS | CIGNA-ALL PLANS | $71.50 | $286.00 | $200.20 | 2026-01-30 | MRF ↗ |
| GOTHENBURG HEALTH Outpatient | Aetna | Commercial | $72.00 | $75.00 | $68.00 | 2025-06-11 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | TRICARE WEST - ALL PLANS | TRICARE WEST - ALL PLANS | $85.23 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| LARKIN COMMUNITY HOSPITAL PALM SPRINGS CAMPUS Outpatient | HUMANA COMMERCIAL/PPO - ALL OTHER PLANS | HUMANA COMMERCIAL/PPO - ALL OTHER PLANS | $85.80 | $286.00 | $200.20 | 2026-01-30 | MRF ↗ |
| LARKIN COMMUNITY HOSPITAL PALM SPRINGS CAMPUS Outpatient | OSCAR HEALTH-ALL PLANS | OSCAR HEALTH-ALL PLANS | $85.80 | $286.00 | $200.20 | 2026-01-30 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | ADVANCED HEALTH - ALL PLANS | ADVANCED HEALTH - ALL PLANS | $92.45 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | PACIFIC SOURCE MCR ADV | PACIFIC SOURCE MCR ADV | $96.86 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | AETNA MCR ADV | AETNA MCR ADV | $96.86 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | MODA MCR ADV | MODA MCR ADV | $96.86 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | ATRIO MCR ADV - ALLPLANS | ATRIO MCR ADV - ALLPLANS | $96.86 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | CONFEDERATED TRIBES - ALL PLANS | CONFEDERATED TRIBES - ALL PLANS | $96.86 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $115.93 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | HEALTHNET - ALL PLANS | HEALTHNET - ALL PLANS | $121.80 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | MODA HEALTH PLAN - ALL OTHER PLANS | MODA HEALTH PLAN - ALL OTHER PLANS | $130.61 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | AETNA - ALL OTHER PLANS | AETNA - ALL OTHER PLANS | $132.08 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | THREE RIVERS - ALL PLANS | THREE RIVERS - ALL PLANS | $132.08 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | UHC - ALL PLANS | UHC - ALL PLANS | $132.08 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | PROV NETWRK OF AMERICA - ALL PLANS | PROV NETWRK OF AMERICA - ALL PLANS | $132.08 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | FIRST CHOICE - ALL PLANS | FIRST CHOICE - ALL PLANS | $135.01 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | MULTIPLAN - ALL PLANS | MULTIPLAN - ALL PLANS | $136.48 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | BLUE CROSS - ALL PLANS | BLUE CROSS - ALL PLANS | $136.48 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | PACIFIC SOURCE - ALL OTHER PLANS | PACIFIC SOURCE - ALL OTHER PLANS | $139.41 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | FIRST HEALTH - ALL PLANS | FIRST HEALTH - ALL PLANS | $139.41 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | PROVIDENCE PREFERRED - ALL PLANS | PROVIDENCE PREFERRED - ALL PLANS | $139.41 | $146.75 | $146.75 | 2025-05-29 | MRF ↗ |
| LARKIN COMMUNITY HOSPITAL PALM SPRINGS CAMPUS Outpatient | WELLCARE COMM (CHOICE) - ALL OTHER PLANS | WELLCARE COMM (CHOICE) - ALL OTHER PLANS | $143.00 | $286.00 | $200.20 | 2026-01-30 | MRF ↗ |
| LARKIN COMMUNITY HOSPITAL PALM SPRINGS CAMPUS Outpatient | WELLCARE MEDICARE | WELLCARE MEDICARE | $185.90 | $286.00 | $200.20 | 2026-01-30 | MRF ↗ |
| CALLAWAY DISTRICT HOSPITAL Both | United Healthcare | Commercial | $3,861.00 | $7,285.00 | $6,557.00 | 2025-08-20 | MRF ↗ |
| CALLAWAY DISTRICT HOSPITAL Both | Humana | Medicare Advantage | $3,861.00 | $7,285.00 | $6,557.00 | 2025-08-20 | MRF ↗ |
| CALLAWAY DISTRICT HOSPITAL Both | Aetna | Medicare Advantage | $3,861.00 | $7,285.00 | $6,557.00 | 2025-08-20 | MRF ↗ |
| CALLAWAY DISTRICT HOSPITAL Both | Health Net | Tricare | $3,861.00 | $7,285.00 | $6,557.00 | 2025-08-20 | MRF ↗ |
| CALLAWAY DISTRICT HOSPITAL Both | Great Plains | Medicare Advantage | $4,054.00 | $7,285.00 | $6,557.00 | 2025-08-20 | MRF ↗ |
| CALLAWAY DISTRICT HOSPITAL Both | Blue Cross and Blue Shield | Commercial | $6,921.00 | $7,285.00 | $6,557.00 | 2025-08-20 | MRF ↗ |
| CALLAWAY DISTRICT HOSPITAL Both | Ambetter | Commercial | $6,994.00 | $7,285.00 | $6,557.00 | 2025-08-20 | MRF ↗ |
| CALLAWAY DISTRICT HOSPITAL Both | Aetna | Commercial | $7,139.00 | $7,285.00 | $6,557.00 | 2025-08-20 | MRF ↗ |
| CALLAWAY DISTRICT HOSPITAL Both | Midland's Choice | Commercial | $7,139.00 | $7,285.00 | $6,557.00 | 2025-08-20 | MRF ↗ |