5005663 — Phenytoin(dilantin) Susp: 100mg/4ml Cups
Cite this view
APA (7th ed.)
HANK Price Transparency. (n.d.). PHENYTOIN(DILANTIN) SUSP: 100MG/4ML CUPS (CDM 5005663) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/5005663?code_type=CDM
MLA (9th ed.)
“PHENYTOIN(DILANTIN) SUSP: 100MG/4ML CUPS (CDM 5005663) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/5005663?code_type=CDM. Accessed .
Chicago (notes-bibliography)
“PHENYTOIN(DILANTIN) SUSP: 100MG/4ML CUPS (CDM 5005663) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/5005663?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $92–$121 (25th–75th percentile) across 2 hospitals · 23 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 5005663 — 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 |
|---|---|---|---|---|---|---|---|
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Meridian Health Plan Commercial | Meridian Health Plan Commercial | $48.60 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Meridian Health Plan Commercial | Meridian Health Plan Commercial | $48.60 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $48.60 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Humana | Commercial | — | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Humana | Medicare Advantage | $48.60 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Humana | Commercial | — | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | HealthNet Commercial | HealthNet Commercial | $54.68 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | HealthNet Commercial | HealthNet Commercial | $54.68 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | United Healthcare | Medicare Advantage | $55.35 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | United Healthcare | Medicare Advantage | $55.35 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | $63.45 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Aetna | Medicare Advantage | $63.45 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $63.45 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Medicare Advantage | $63.45 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | HealthNet Commercial | HealthNet Commercial | $83.97 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | HealthNet Commercial | HealthNet Commercial | $83.97 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Cigna Commercial | Cigna Commercial | $88.43 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Cigna Commercial | Cigna Commercial | $88.43 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Aetna | Commercial | $92.21 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Aetna | Commercial | $92.21 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Medical Associates Health Plan Commercial | Medical Associates Health Plan Commercial | $94.50 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Aetna Workers Comp | Aetna Workers Comp | $94.50 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Blue Cross Blue Shield Workers Comp | Blue Cross Blue Shield Workers Comp | $94.50 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Health Choices Commercial | Health Choices Commercial | $94.50 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | HealthLink Commercial HMO | HealthLink Commercial HMO | $94.50 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Preferred Health Choices Commercial | Preferred Health Choices Commercial | $94.50 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Aetna Workers Comp | Aetna Workers Comp | $94.50 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Blue Cross Blue Shield Workers Comp | Blue Cross Blue Shield Workers Comp | $94.50 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Health Choices Commercial | Health Choices Commercial | $94.50 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | HealthLink Commercial HMO | HealthLink Commercial HMO | $94.50 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Medical Associates Health Plan Commercial | Medical Associates Health Plan Commercial | $94.50 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Preferred Health Choices Commercial | Preferred Health Choices Commercial | $94.50 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Great West | Commercial | $99.90 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Great West | Commercial | $99.90 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Blue Cross Blue Shield Workers Comp | Blue Cross Blue Shield Workers Comp | $103.95 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Blue Cross Blue Shield Medical Rental | Blue Cross Blue Shield Medical Rental | $103.95 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Blue Cross Blue Shield Auto | Blue Cross Blue Shield Auto | $103.95 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Blue Cross Blue Shield Medical Rental | Blue Cross Blue Shield Medical Rental | $103.95 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Blue Cross Blue Shield Auto | Blue Cross Blue Shield Auto | $103.95 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Blue Cross Blue Shield Workers Comp | Blue Cross Blue Shield Workers Comp | $103.95 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | HealthLink Commercial PPO | HealthLink Commercial PPO | $108.00 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Integrated Health Plan Commercial | Integrated Health Plan Commercial | $108.00 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | HealthLink Commercial PPO | HealthLink Commercial PPO | $108.00 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | CorVel Workers Comp | CorVel Workers Comp | $108.00 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | CorVel Auto Medical | CorVel Auto Medical | $108.00 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Health Alliance Commercial | Health Alliance Commercial | $108.00 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Health Alliance Commercial | Health Alliance Commercial | $108.00 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Integrated Health Plan Commercial | Integrated Health Plan Commercial | $108.00 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | CorVel Auto Medical | CorVel Auto Medical | $108.00 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | CorVel Workers Comp | CorVel Workers Comp | $108.00 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | United Healthcare | Commercial | $114.75 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | United Healthcare | Commercial | $114.75 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Velocity Commercial | Velocity Commercial | $124.20 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Velocity Commercial | Velocity Commercial | $124.20 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Harmony Health Plan Commercial | Harmony Health Plan Commercial | $135.00 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Harmony Health Plan Medicaid/CHIP | Harmony Health Plan Medicaid/CHIP | $135.00 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Harmony Health Plan Medicaid/CHIP | Harmony Health Plan Medicaid/CHIP | $135.00 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL InpatientFacility | Harmony Health Plan Commercial | Harmony Health Plan Commercial | $135.00 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Commercial | $192.86 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| CARLINVILLE AREA HOSPITAL OutpatientFacility | Blue Cross Blue Shield | Commercial | $192.86 | $135.00 | $94.50 | 2026-03-21 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | Superior Health Plan | Commercial | $6,105.00 | $12,460.00 | $8,722.00 | 2026-05-06 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | Humana | Medicare Advantage | $6,105.00 | $12,460.00 | $8,722.00 | 2026-05-06 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | Aetna | Medicare Advantage | $6,105.00 | $12,460.00 | $8,722.00 | 2026-05-06 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | Aetna | Commercial | $10,591.00 | $12,460.00 | $8,722.00 | 2026-05-06 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | FirstCare | Commercial | $11,214.00 | $12,460.00 | $8,722.00 | 2026-05-06 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | Cigna | Commercial | $11,214.00 | $12,460.00 | $8,722.00 | 2026-05-06 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | Blue Cross Blue Shield of Texas | PPO | $11,214.00 | $12,460.00 | $8,722.00 | 2026-05-06 | MRF ↗ |
| OCHILTREE GENERAL HOSPITAL Outpatient | Blue Cross Blue Shield of Texas | Commercial | $11,214.00 | $12,460.00 | $8,722.00 | 2026-05-06 | MRF ↗ |