Rx68382039601_J3490_100094_000 — Sodium Benzoate 10 -sodium Phenylacetate 10 Intra
Cite this view
HANK Price Transparency. (n.d.). SODIUM BENZOATE 10 -SODIUM PHENYLACETATE 10 INTRA (OTHER Rx68382039601_J3490_100094_000) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Rx68382039601_J3490_100094_000?code_type=OTHER
“SODIUM BENZOATE 10 -SODIUM PHENYLACETATE 10 INTRA (OTHER Rx68382039601_J3490_100094_000) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Rx68382039601_J3490_100094_000?code_type=OTHER. Accessed .
“SODIUM BENZOATE 10 -SODIUM PHENYLACETATE 10 INTRA (OTHER Rx68382039601_J3490_100094_000) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Rx68382039601_J3490_100094_000?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $58,393–$227,760 (25th–75th percentile) across 1 hospital · 16 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER Rx68382039601_J3490_100094_000 — 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 |
|---|---|---|---|---|---|---|---|
| Prisma Health North Greenville Ltach | Blue Choice Medicaid (Greenville County Only) | — | $2,230.27 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Absolute Total Care Medicaid | — | $2,491.24 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Tricare | — | $35,777.95 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | First Health-Wc | — | $57,225.03 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Humana Gold Plus Medicare Advantage Hmo | — | $57,824.52 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Medicare | — | $57,824.52 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Wellcare Medicare | — | $58,392.89 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Bcbs Medicare Advantage | — | $58,392.89 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Aetna Medicare Prime Hmo | — | $58,392.89 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Aetna Prisma Health | — | $99,645.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Select Health First Choice Vip | — | $99,645.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Aetna Whole Health Of Sc | — | $145,197.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Cigna Local Plus | — | $150,606.30 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Aetna Sc Preferred | — | $170,820.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Cigna Hmo Ppo | — | $184,200.90 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Aetna | — | $210,678.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Aetna Medicare | — | $210,678.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | United Healthcare | — | $211,247.40 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Tricare Humana Military | — | $213,525.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Tricare | — | $227,760.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Cigna Behavioral Health | — | $227,760.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Tricare Humana Military | — | $227,760.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | First Health-Aetna Rental Network | — | $227,760.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Multiplan | — | $241,995.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Humana Choicecare Ppo | — | $241,995.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Cigna Hmo Ppo | — | $284,700.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Bcbs Upstate Reedy (Greenville Co Only) | — | $284,700.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Cigna Local Plus | — | $284,700.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Bcbs Preferred Ppc | — | $284,700.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |
| Prisma Health North Greenville Ltach | Bcbs Exchange | — | $284,700.00 | $284,700.00 | $185,055.00 | 2026-07-05 | MRF ↗ |