87696 (OTHER) by state — Price Transparency

OTHER · across United States

87696 — Antithrombin Iii (human) 500 (+/-) Unit Intravenous Solution

State-by-state median negotiated rates. Lower bars are cheaper states; the range bar shows the IQR (25th to 75th percentile within each state).

$2,633 National median

$951 – $1,567,915 IQR (p25 – p75)

5 hospitals filing

2 states

View hospital-by-hospital → Raw rate rows →

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What would you pay?

Plug in your deductible, what you've already spent against it, your OOP-max, and your coinsurance %. We'll math the rest. Math reference: methodology.

This estimate runs on the hospital’s facility charge only. The surgeon’s and anesthesiologist’s fees are billed separately and aren’t in this number — your EOB shows your complete total.

Uninsured estimates use the cash / self-pay median for this code: $520,506.

I am… Annual deductible (assumed — typical plan) Already spent this year

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Out-of-pocket max (assumed — typical plan) Coinsurance % (after deductible)

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Median negotiated rate, by state

Ranked by typical (median) negotiated price. Hover for state-level IQR.

Median negotiated rate by state for 87696 (OTHER), with interquartile range
State	Median	p25	p75
NH	$1,798	$1,341	$2,178
IN	$3,361	$634	$2,009,678

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
State	Median	p25	p75	Min	Max	Hospitals	Payers	Rates

NH	$1,798	$1,341	$2,178	$1,224	$2,895	1 ⚠ thin data	12	32
IN	$3,361	$634	$2,009,678	$317	$2,250,166	4	77	313