5073009 — Alteplase (activase) 100mg (nf)
Cite this view
HANK Price Transparency. (n.d.). ALTEPLASE (ACTIVASE) 100MG (NF) (OTHER 5073009) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/5073009?code_type=OTHER
“ALTEPLASE (ACTIVASE) 100MG (NF) (OTHER 5073009) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/5073009?code_type=OTHER. Accessed .
“ALTEPLASE (ACTIVASE) 100MG (NF) (OTHER 5073009) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/5073009?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $14,417–$23,170 (25th–75th percentile) across 1 hospital · 11 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 5073009 — 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 |
|---|---|---|---|---|---|---|---|
| GRAFTON CITY HOSPITAL, INC Outpatient | Healthplan Peia | Commercial | $14,417.06 | $25,744.75 | $12,872.38 | 2026-05-08 | MRF ↗ |
| GRAFTON CITY HOSPITAL, INC Outpatient | Aetna Medicaid | Medicaid | $14,417.06 | $25,744.75 | $12,872.38 | 2026-05-08 | MRF ↗ |
| GRAFTON CITY HOSPITAL, INC Outpatient | Healthplan Medicaid | Medicaid | $14,417.06 | $25,744.75 | $12,872.38 | 2026-05-08 | MRF ↗ |
| GRAFTON CITY HOSPITAL, INC Outpatient | Peia | Commercial | $14,417.06 | $25,744.75 | $12,872.38 | 2026-05-08 | MRF ↗ |
| GRAFTON CITY HOSPITAL, INC Outpatient | Highmark Bcbs Wv Aca | Commercial | $17,164.02 | $25,744.75 | $12,872.38 | 2026-05-08 | MRF ↗ |
| GRAFTON CITY HOSPITAL, INC Outpatient | Highmark Bcbs Wv Ppo Pos | Commercial | $19,594.33 | $25,744.75 | $12,872.38 | 2026-05-08 | MRF ↗ |
| GRAFTON CITY HOSPITAL, INC Outpatient | Highmark Bcbs Wv Traditional | Commercial | $19,594.33 | $25,744.75 | $12,872.38 | 2026-05-08 | MRF ↗ |
| GRAFTON CITY HOSPITAL, INC Outpatient | Healthplan | Commercial | $21,883.04 | $25,744.75 | $12,872.38 | 2026-05-08 | MRF ↗ |
| GRAFTON CITY HOSPITAL, INC Outpatient | Humana Choicecare Network | Commercial | $23,170.28 | $25,744.75 | $12,872.38 | 2026-05-08 | MRF ↗ |
| GRAFTON CITY HOSPITAL, INC Outpatient | Aetna | Commercial | $23,170.28 | $25,744.75 | $12,872.38 | 2026-05-08 | MRF ↗ |
| GRAFTON CITY HOSPITAL, INC Outpatient | United Healthcare | Commercial | $23,170.28 | $25,744.75 | $12,872.38 | 2026-05-08 | MRF ↗ |
| GRAFTON CITY HOSPITAL, INC Outpatient | Cigna | Commercial | $23,685.17 | $25,744.75 | $12,872.38 | 2026-05-08 | MRF ↗ |