Rx68382039601_J3490_102000_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_102000_000) negotiated rates. PPMan price-transparency data, derived from CMS-required hospital MRFs. Retrieved , from http://ppman.hank.ai/transparency/code/Rx68382039601_J3490_102000_000?code_type=OTHER
“SODIUM BENZOATE 10 -SODIUM PHENYLACETATE 10 INTRA (OTHER Rx68382039601_J3490_102000_000) negotiated rates.” HANK Price Transparency, http://ppman.hank.ai/transparency/code/Rx68382039601_J3490_102000_000?code_type=OTHER. Accessed .
“SODIUM BENZOATE 10 -SODIUM PHENYLACETATE 10 INTRA (OTHER Rx68382039601_J3490_102000_000) negotiated rates,” HANK Price Transparency, accessed , http://ppman.hank.ai/transparency/code/Rx68382039601_J3490_102000_000?code_type=OTHER.
Source: PPMan price-transparency data, derived from CMS-required hospital machine-readable files (45 CFR 180). See methodology.
Usually $18,625–$219,504 (25th–75th percentile) across 1 hospital · 18 payers.
“Negotiated” is the hospital’s negotiated facility rate for this OTHER Rx68382039601_J3490_102000_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 OCONEE MEMORIAL HOSPITAL | Blue Choice Medicaid (Greenville County Only) | — | $833.37 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Bluechoice Medicaid | — | $886.55 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Medicaid Other | — | $907.98 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Medicaid | — | $907.98 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Select Health Medicaid | — | $913.16 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Molina Medicaid | — | $913.16 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Absolute Total Care Medicaid | — | $930.88 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Humana Healthy Horizons Medicaid | — | $971.54 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Tricare | — | $36,278.33 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Tricare Humana Military | — | $36,278.33 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Bcbs Exchange | — | $41,850.90 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Medicare | — | $68,833.80 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Bcbs Exchange | — | $95,943.90 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Aetna Prisma Health | — | $99,645.00 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Select Health First Choice Vip | — | $99,645.00 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Aetna Whole Health Of Sc | — | $145,197.00 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Cigna Local Plus | — | $150,606.30 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Aetna Sc Preferred | — | $170,820.00 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Cigna Hmo Ppo | — | $184,200.90 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Aetna | — | $190,749.00 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Bcbs Preferred Ppc | — | $200,713.50 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Aetna Medicare | — | $210,678.00 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | United Healthcare | — | $211,247.40 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Tricare Humana Military | — | $227,760.00 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Tricare | — | $227,760.00 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Cigna Behavioral Health | — | $227,760.00 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | First Health-Aetna Rental Network | — | $227,760.00 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Multiplan | — | $241,995.00 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Humana Choicecare Ppo | — | $241,995.00 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Cigna Hmo Ppo | — | $284,700.00 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |
| PRISMA HEALTH OCONEE MEMORIAL HOSPITAL | Cigna Local Plus | — | $284,700.00 | $284,700.00 | $185,055.00 | 2026-05-28 | MRF ↗ |