4006268 — Lupron Depot 45 Mg 6 Month Kit
Cite this view
HANK Price Transparency. (n.d.). LUPRON DEPOT 45 MG 6 MONTH KIT (CDM 4006268) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/4006268?code_type=CDM
“LUPRON DEPOT 45 MG 6 MONTH KIT (CDM 4006268) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/4006268?code_type=CDM. Accessed .
“LUPRON DEPOT 45 MG 6 MONTH KIT (CDM 4006268) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/4006268?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $14,232–$22,248 (25th–75th percentile) across 1 hospital · 18 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 4006268 — 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 |
|---|---|---|---|---|---|---|---|
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | TRICARE WEST - ALL PLANS | TRICARE WEST - ALL PLANS | $12,430.58 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | MODA MCR ADV | MODA MCR ADV | $14,125.66 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | ATRIO MCR ADV - ALLPLANS | ATRIO MCR ADV - ALLPLANS | $14,125.66 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | PACIFIC SOURCE MCR ADV | PACIFIC SOURCE MCR ADV | $14,125.66 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | AETNA MCR ADV | AETNA MCR ADV | $14,125.66 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | CONFEDERATED TRIBES - ALL PLANS | CONFEDERATED TRIBES - ALL PLANS | $14,125.66 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | BCBS MCR ADV | BCBS MCR ADV | $14,549.43 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | ADVANCED HEALTH - ALL PLANS | ADVANCED HEALTH - ALL PLANS | $14,831.95 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | HEALTHNET MCR ADV | HEALTHNET MCR ADV | $14,831.95 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | HEALTHNET - ALL OTHER PLANS | HEALTHNET - ALL OTHER PLANS | $19,540.50 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | MODA HEALTH PLAN - ALL OTHER PLANS | MODA HEALTH PLAN - ALL OTHER PLANS | $20,953.07 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | AETNA - ALL OTHER PLANS | AETNA - ALL OTHER PLANS | $21,188.49 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | PROV NETWRK OF AMERICA - ALL PLANS | PROV NETWRK OF AMERICA - ALL PLANS | $21,188.49 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | CIGNA - ALL PLANS | CIGNA - ALL PLANS | $21,188.49 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | THREE RIVERS - ALL PLANS | THREE RIVERS - ALL PLANS | $21,188.49 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | BCBS COMM - ALL OTHER PLANS | BCBS COMM - ALL OTHER PLANS | $21,894.78 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | PROVIDENCE COMM - ALL PLANS | PROVIDENCE COMM - ALL PLANS | $22,365.63 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | FIRST HEALTH - ALL PLANS | FIRST HEALTH - ALL PLANS | $22,365.63 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | UHC ALL PAYER - ALL PLANS | UHC ALL PAYER - ALL PLANS | $22,365.63 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | PACIFICSOURCE COMM - ALL OTHER PLANS | PACIFICSOURCE COMM - ALL OTHER PLANS | $22,365.63 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | FIRST CHOICE - ALL PLANS | FIRST CHOICE - ALL PLANS | $22,365.63 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |
| SOUTHERN COOS HOSPITAL & HEALTH CENTER Outpatient | MULTIPLAN - ALL PLANS | MULTIPLAN - ALL PLANS | $22,365.63 | $23,542.77 | $23,542.77 | 2026-10-09 | MRF ↗ |