50242004406 — Alteplase 100 Mg IV Solution For Pulmonary Embolism
Cite this view
HANK Price Transparency. (n.d.). ALTEPLASE 100 MG IV SOLUTION FOR PULMONARY EMBOLISM (NDC 50242004406) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/50242004406?code_type=NDC
“ALTEPLASE 100 MG IV SOLUTION FOR PULMONARY EMBOLISM (NDC 50242004406) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/50242004406?code_type=NDC. Accessed .
“ALTEPLASE 100 MG IV SOLUTION FOR PULMONARY EMBOLISM (NDC 50242004406) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/50242004406?code_type=NDC.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $4,632–$8,399 (25th–75th percentile) across 3 hospitals · 13 payers.
“Negotiated” is the hospital’s negotiated facility rate for this NDC 50242004406 — 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 |
|---|---|---|---|---|---|---|---|
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | Self Insured | $2.10 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | HAP | Self Insured | $2.10 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | WellCare | Medicare Advantage | $3,387.22 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | MOLINA | MARKETPLACE | $3,961.66 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Molina MI Health Link | MEDICARE ADVANTAGE | $3,961.66 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Molina MI Health Link | MEDICARE ADVANTAGE | $3,961.66 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | MOLINA | MARKETPLACE | $3,961.66 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| RUSSELL MEDICAL CENTER OutpatientFacility | Aetna | Medicare Advantage | $3,979.20 | $16,175.61 | $5,823.22 | 2026-04-01 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | WellCare | Medicare Advantage | $3,988.07 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL InpatientFacility | Cofinity Group Health | New Business All Products | $4,846.43 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL BothFacility | AETNA | New Business Discount | $5,836.85 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | VitalCore Physicians Group of MI | All Products | $6,602.77 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | VitalCore Physicians Group of MI | All Products | $6,602.77 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL BothFacility | Cofinity Group Health | New Business All Products | $6,708.41 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | HAP | Fully Insured | $6,844.43 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | HAP | Fully Insured | $6,857.64 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | NFL Health Services - Cigna | ALL PRODUCTS | $6,866.88 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL BothFacility | McLaren Health | Health Advantage PPO | $6,955.36 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL BothFacility | McLaren Health | Commercial HMO | $6,955.36 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL BothFacility | Priority Health | HMO/PPO | $7,084.77 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL InpatientFacility | AETNA | New Business Discount | $7,117.79 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL BothFacility | Priority Health | HMO/PPO | $7,253.80 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL BothFacility | McLaren Health | Health Advantage PPO | $7,619.60 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL BothFacility | McLaren Health | Commercial HMO | $7,619.60 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| RUSSELL MEDICAL CENTER OutpatientFacility | Devoted Health | All Products | $8,087.81 | $16,175.61 | $5,823.22 | 2026-04-01 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | AETNA | ALL PRODUCTS | $8,253.46 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | AETNA | ALL PRODUCTS | $8,293.08 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL BothFacility | MULTIPLAN, INC. | Complementary Network | $8,715.66 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL BothFacility | MULTIPLAN, INC. | Complementary Network | $8,847.71 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | Cofinity Group Health | ALL PRODUCTS | $9,772.10 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL OutpatientFacility | University of Michigan | ALL PRODUCTS | $10,564.43 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | University of Michigan | ALL PRODUCTS | $10,564.43 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD MACOMB HOSPITAL BothFacility | Priority Cigna | ALL PRODUCTS | $10,604.05 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL BothFacility | Priority Cigna | ALL PRODUCTS | $10,734.78 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL OutpatientFacility | Cofinity Group Health | ALL PRODUCTS | $11,383.18 | $13,205.54 | — | 2025-06-28 | MRF ↗ |
| RUSSELL MEDICAL CENTER BothFacility | Aetna | All Products | $13,749.27 | $16,175.61 | $5,823.22 | 2026-04-01 | MRF ↗ |