8935574_1 — Lupron Depot 45 Mg 6mo Kit
Cite this view
HANK Price Transparency. (n.d.). LUPRON DEPOT 45 MG 6MO KIT (CDM 8935574_1) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/8935574_1?code_type=CDM
“LUPRON DEPOT 45 MG 6MO KIT (CDM 8935574_1) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/8935574_1?code_type=CDM. Accessed .
“LUPRON DEPOT 45 MG 6MO KIT (CDM 8935574_1) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/8935574_1?code_type=CDM.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $19,529–$22,513 (25th–75th percentile) across 1 hospital · 11 payers.
“Negotiated” is the hospital’s negotiated facility rate for this CDM 8935574_1 — 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 |
|---|---|---|---|---|---|---|---|
| DAVIS COUNTY HOSPITAL Outpatient | AETNA MCR ADV-ALL PLANS | AETNA MCR ADV-ALL PLANS | $18,082.50 | $36,165.00 | $36,165.00 | 2026-04-10 | MRF ↗ |
| DAVIS COUNTY HOSPITAL Outpatient | TRICARE-ALL PLANS | TRICARE-ALL PLANS | $19,529.10 | $36,165.00 | $36,165.00 | 2026-04-10 | MRF ↗ |
| DAVIS COUNTY HOSPITAL Outpatient | CHOICECARE MCR ADV | CHOICECARE MCR ADV | $19,529.10 | $36,165.00 | $36,165.00 | 2026-04-10 | MRF ↗ |
| DAVIS COUNTY HOSPITAL Outpatient | HOME STATE HLTH MCR | HOME STATE HLTH MCR | $19,529.10 | $36,165.00 | $36,165.00 | 2026-04-10 | MRF ↗ |
| DAVIS COUNTY HOSPITAL Outpatient | MT CARMEL HP-ALL PLANS | MT CARMEL HP-ALL PLANS | $19,529.10 | $36,165.00 | $36,165.00 | 2026-04-10 | MRF ↗ |
| DAVIS COUNTY HOSPITAL Outpatient | HOME STATE HLTH EXCH - ALL OTHER PLANS | HOME STATE HLTH EXCH - ALL OTHER PLANS | $19,529.10 | $36,165.00 | $36,165.00 | 2026-04-10 | MRF ↗ |
| DAVIS COUNTY HOSPITAL Outpatient | AMERIGROUP MCR ADV-ALL OTHER PLANS | AMERIGROUP MCR ADV-ALL OTHER PLANS | $19,919.68 | $36,165.00 | $36,165.00 | 2026-04-10 | MRF ↗ |
| DAVIS COUNTY HOSPITAL Outpatient | AMERICAN HP MCR ADV-ALL PLANS | AMERICAN HP MCR ADV-ALL PLANS | $20,505.56 | $36,165.00 | $36,165.00 | 2026-04-10 | MRF ↗ |
| DAVIS COUNTY HOSPITAL Outpatient | HOME STATE HLTH MCAID | HOME STATE HLTH MCAID | $21,699.00 | $36,165.00 | $36,165.00 | 2026-04-10 | MRF ↗ |
| DAVIS COUNTY HOSPITAL Outpatient | IOWA TOTAL CARE MCAID-ALL PLANS | IOWA TOTAL CARE MCAID-ALL PLANS | $22,132.98 | $36,165.00 | $36,165.00 | 2026-04-10 | MRF ↗ |
| DAVIS COUNTY HOSPITAL Outpatient | MOLINA MCAID-ALL PLANS | MOLINA MCAID-ALL PLANS | $22,458.47 | $36,165.00 | $36,165.00 | 2026-04-10 | MRF ↗ |
| DAVIS COUNTY HOSPITAL Outpatient | AMERIGROUP MCAID | AMERIGROUP MCAID | $22,566.96 | $36,165.00 | $36,165.00 | 2026-04-10 | MRF ↗ |
| DAVIS COUNTY HOSPITAL Outpatient | MIDLANDS CHOICE - ALL PLANS | MIDLANDS CHOICE - ALL PLANS | $25,315.50 | $36,165.00 | $36,165.00 | 2026-04-10 | MRF ↗ |
| DAVIS COUNTY HOSPITAL Outpatient | PREFERRED HLTH CHOICES - ALL PLANS | PREFERRED HLTH CHOICES - ALL PLANS | $27,123.75 | $36,165.00 | $36,165.00 | 2026-04-10 | MRF ↗ |
| DAVIS COUNTY HOSPITAL Outpatient | CHOICECARE COMM - ALL OTHER PLANS | CHOICECARE COMM - ALL OTHER PLANS | $34,356.75 | $36,165.00 | $36,165.00 | 2026-04-10 | MRF ↗ |