Price Transparency Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

Payer comparison · HCPCS J9316 · LEBANON, MO

J9316 — Pertuzu, Trastuzu, 10 Mg

What each payer pays MERCY HOSPITAL LEBANON (CCN 260059) for this procedure, and where each sits versus the all-payer median at this facility. Find your plan to see whether you're above or below the market here.

$16,735 All-payer median here
$20,205 Cash / self-pay here
73 payer/plan-name variants
← This hospital National rates for J9316 →
Per-payer negotiated rate at this facility. Use the column headers to sort, the filter row to narrow results.
Payer / plan Median negotiated vs all-payer median Rate rows
   
MULTIPLAN CONTRACTED [320270] $29,531 76.5% 2
PHCS (Private Healthcare Systems) $29,531 76.5% 2
USA MANAGED CARE ORG CONTRACTED [320429] $27,355 63.5% 2
AMERICAN HEALTHCARE ALLIANCE CONTRACTED [320020] $26,422 57.9% 2
WORKERS COMP [20426] $25,645 53.2% 8
POINT C / MID-AMERICAN BENEFITS $24,873 48.6% 18
IMAGINE360 ADMINISTRATORS (GPA) $24,868 48.6% 2
HEALTHLINK PPO $24,868 48.6% 8
YUZU HEALTH CONTRACTED [320521] $24,868 48.6% 4
AITHER HEALTH CONTRACTED [320449] $24,868 48.6% 4
AUXIANT CONTRACTED [320462] $24,868 48.6% 8
INSURANCE SYSTEM INC CONTRACTED [320465] $24,868 48.6% 2
BENEFIT MANAGEMENT CONTRACTED [320052] $24,868 48.6% 2
EBMS CONTRACTED [320493] $24,868 48.6% 2
EDISON HEALTH SOLUTIONS CONTRACTED [320502] $24,868 48.6% 2
REFLECT HEALTH (FORMERLY S&S HEALTHCARE) $24,868 48.6% 2
EVOLUTIONS HEALTHCARE SYSTEMS $24,868 48.6% 2
First Health Network $24,868 48.6% 2
HEALTH SYSTEMS INC CONTRACTED [320174] $24,868 48.6% 2
MERCY BENEFIT ADMIN CONTRACTED [320251] $24,863 48.6% 18
Aetna $23,314 39.3% 2
SHOW-ME HEALTH ADMINISTRATORS CONTRACTED [320483] $23,314 39.3% 4
90 DEGREE BENEFITS CONTRACTED [320436] $23,314 39.3% 2
Cigna Healthcare $22,998 37.4% 6
PREFERRED HEALTH PLAN CONTRACTED [320522] $20,205 20.7% 2
UMR (UnitedHealthcare TPA) $18,185 8.7% 4
ADMINISTRATIVE PAYOR CONTRACTED [320005] $13,988 -16.4% 4
MC ANTHEM [20455] $13,921 -16.8% 4
Humana $13,239 -20.9% 4
MEDICA [20239] $12,279 -26.6% 2
Medica $12,279 -26.6% 2
BCBS MEDICAID CONTRACTED [320046] $11,750 -29.8% 2
UnitedHealthcare $11,507 -31.2% 10
OPTUM HEALTH BEHAVIORAL SOLUTIONS [520250] $11,507 -31.2% 2
BLUE CROSS AND BLUE SHIELD [20053] $11,106 -33.6% 10
MC GENERIC ANTHEM [20456] $11,106 -33.6% 2
SUNFLOWER HEALTH PLAN CONTRACTED [320369] $9,326 -44.3% 2
AMBETTER CONTRACTED [320452] $9,326 -44.3% 2
Home State Health (Centene Missouri Medicaid) $9,326 -44.3% 2
NOVASYS CONTRACTED [320285] $9,326 -44.3% 2
KANCARE CONTRACTED [320213] $7,315 -56.3% 2
KANCARE [20213] $7,315 -56.3% 2
Medicaid (Generic) $6,942 -58.5% 4
MO MEDICAID BH CARVE OUT [320315] $6,217 -62.9% 2
UNITED HEALTHCARE MEDICAID CONTRACTED [320397] $6,217 -62.9% 2
CENTIVO CONTRACTED [320505] $102 -99.4% 2
HealthSCOPE Benefits EHC Repricing $78 -99.5% 2
NHC ADVANTAGE MEDICARE CONTRACTED [320282] $64 -99.6% 2
WELLCARE MEDICARE ADVANTAGE CONTRACTED [320421] $63 -99.6% 2
Devoted Health $62 -99.6% 2
GLOBAL HEALTH $61 -99.6% 2
ESSENCE HEALTHCARE MEDICARE CONTRACTED [320122] $61 -99.6% 2
PROMINENCE HEALTH PLAN MEDICARE ADVANTAGE CONTRACTED [320496] $61 -99.6% 2
PROVIDER PARTNERS HEALTH PLANS CONTRACTED [320450] $61 -99.6% 2
QUAL CHOICE CONTRACTED [320325] $61 -99.6% 2
ELARA CARING ASPIRE HOSPICE [20433] $61 -99.6% 2
CROSS TIMBERS HOSPICE [20098] $61 -99.6% 2
TRICARE $61 -99.6% 2
CHEROKEE NATION HEALTH SERV CONTRACTED [320066] $61 -99.6% 2
CHAMPVA [20065] $61 -99.6% 2
VA COMMUNITY CARE NETWORK $61 -99.6% 2
BCBS MEDICARE ADVANTAGE CONTRACTED [320047] $61 -99.6% 2
KINDFUL HOSPICE CONTRACTED [320434] $61 -99.6% 2
LONGEVITY HEALTH PLAN MEDICARE CONTRACTED [320225] $61 -99.6% 2
KINDFUL HOSPICE [20434] $61 -99.6% 2
Medica Holding Company $61 -99.6% 2
Medicare (Generic) $61 -99.6% 2
MERCY HOSPICE OKC [20252] $61 -99.6% 2
MERCY MGD BEHAVIORAL HEALTH CONTRACTED [320259] $61 -99.6% 2
AETNA MEDICARE ADVANTAGE CONTRACTED [320010] $61 -99.6% 2
HALO HCR INC HOSPICE CONTRACTED [320432] $61 -99.6% 2
PACE OF THE OZARKS CONTRACTED [320518] $61 -99.6% 2
HALO HCR INC HOSPICE [20432] $61 -99.6% 2

Median over current-blob negotiated rates (COALESCE of standard / median / min–max midpoint, $0.01–$5M sentinel guard). Payers are canonical-grouped where a mapping exists; unmapped regional-plan name variants may appear as separate rows.