6019068 (CDM) — raw rate rows

CDM · raw rates

6019068 — Alteplase (tpa) 100mg Vial Kit

Per-row negotiated rates, exactly as filed by each hospital. Aggregated views below summarize across hospitals; the bottom table shows the underlying rows.

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Typical negotiated price $22,095

Usually $22,095–$22,095 (25th–75th percentile) across 1 hospital · 6 payers.

“Negotiated” is the hospital’s negotiated facility rate for this CDM 6019068 — the consumer-grade median across the country. It covers the facility charge only; the surgeon’s and anesthesiologist’s fees are billed separately.

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This estimate runs on the hospital’s facility charge only. The surgeon’s and anesthesiologist’s fees are billed separately and aren’t in this number — your EOB shows your complete total.

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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
FORKS COMMUNITY HOSPITAL Both	Cigna	All Commercial Plans	$21,245.50	$42,491.00	$16,996.40	2026-08-24	MRF ↗
FORKS COMMUNITY HOSPITAL Both	Humana	Gold Medicare Advantage	$22,095.32	$42,491.00	$16,996.40	2026-08-24	MRF ↗
FORKS COMMUNITY HOSPITAL Both	Uhc	Aarp Medicare Advantage	$22,095.32	$42,491.00	$16,996.40	2026-08-24	MRF ↗
FORKS COMMUNITY HOSPITAL Both	Centene	Wellcare By Allwell Medicare Advantage	$22,095.32	$42,491.00	$16,996.40	2026-08-24	MRF ↗
FORKS COMMUNITY HOSPITAL Both	Aetna	Medicare Advantage	$22,095.32	$42,491.00	$16,996.40	2026-08-24	MRF ↗
FORKS COMMUNITY HOSPITAL Both	Arkansasbcbs	Blue Medicare Advantage	$22,095.32	$42,491.00	$16,996.40	2026-08-24	MRF ↗