904092320 — Delandistrogene Moxeparvovec (16.5-17.4) Kit
Cite this view
HANK Price Transparency. (n.d.). Delandistrogene Moxeparvovec (16.5-17.4) Kit (OTHER 904092320) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/904092320?code_type=OTHER
“Delandistrogene Moxeparvovec (16.5-17.4) Kit (OTHER 904092320) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/904092320?code_type=OTHER. Accessed .
“Delandistrogene Moxeparvovec (16.5-17.4) Kit (OTHER 904092320) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/904092320?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $1,440,048–$1,664,056 (25th–75th percentile) across 2 hospitals · 2 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER 904092320 — 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 |
|---|---|---|---|---|---|---|---|
| CHILDREN'S MERCY SOUTH Outpatient | Sunflower Health Plan | All Ks Medicaid Plans | $1,440,048.15 | $3,200,107.00 | $3,200,107.00 | 2026-05-14 | MRF ↗ |
| THE CHILDREN'S MERCY HOSPITAL Outpatient | Sunflower Health Plan | All Ks Medicaid Plans | $1,440,048.15 | $3,200,107.00 | $3,200,107.00 | 2026-05-24 | MRF ↗ |
| CHILDREN'S MERCY SOUTH Outpatient | Sunflower Health Plan | All Ks Medicaid Plans | $1,440,048.15 | $3,200,107.00 | $3,200,107.00 | 2026-05-24 | MRF ↗ |
| CHILDREN'S MERCY SOUTH Outpatient | United Healthcare Community Plan | All Ks Medicaid Plans | $1,664,055.64 | $3,200,107.00 | $3,200,107.00 | 2026-05-14 | MRF ↗ |
| THE CHILDREN'S MERCY HOSPITAL Outpatient | United Healthcare Community Plan | All Ks Medicaid Plans | $1,664,055.64 | $3,200,107.00 | $3,200,107.00 | 2026-05-24 | MRF ↗ |
| CHILDREN'S MERCY SOUTH Outpatient | United Healthcare Community Plan | All Ks Medicaid Plans | $1,664,055.64 | $3,200,107.00 | $3,200,107.00 | 2026-05-24 | MRF ↗ |