APC 1458
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Phentolaine mesylate inj
Low
$289
Average
$525
Median
$421
High
$2.1k
Each hospital's average Optum rate, under the methodology and billing class chosen below.
26 hospitals; the 90th percentile is 1.6× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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26 hospital rates
iThe hospitals that file a Optum rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Affinity Hospital LLC Birmingham, AL facility · fee schedule · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 2 | Campbell County HMA, LLC LaFollette, TN facility · fee schedule · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 3 | East Georgia Regional Medical Center LLC Statesboro, GA facility · per diem · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 4 | Foley Hospital Company LLC Foley, AL facility · fee schedule · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 5 | Gadsden Regional Medical Center LLC Gadsden, AL facility · fee schedule · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 6 | HENRICO DOCTORS HOSPITAL - FOREST MECHANICSVILLE, VA fee schedule · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 7 | Jefferson County HMA LLC Jefferson City, TN facility · per diem · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 8 | Key West HMA LLC FL 33040; 1200 Kennedy Dr. Key West, FL facility · fee schedule · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 9 | Kirksville Missouri Hospital Co LLC PO Box C8502 Kirksville, MO facility · per diem · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 10 | METHODIST HOSPITAL HELOTES, TX fee schedule · outpatient | 1 | $644 | $644 | — | — | — | $644 – $644 |
| 11 | METHODIST SPECIALTY AND TRANSPLANT SAN ANTONIO, TX fee schedule · outpatient | 1 | $644 | $644 | — | — | — | $644 – $644 |
| 12 | Metro Knoxville HMA LLC Powell, TN facility · per diem · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 13 | Metro Knoxville HMA LLC Knoxville, TN facility · per diem · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 14 | Moberly Hospital Company LLC Moberly, MO facility · fee schedule · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 15 | Naples HMA LLC Naples, FL facility · per diem · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 16 | Naples HMA LLC Naples, FL facility · per diem · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 17 | Naples HMA LLC Naples, FL facility · per diem · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 18 | PARHAM DOCTORS HOSPITAL Richmond, VA fee schedule · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 19 | Presbyterian Medical Center of the University of Pennsylvania Health System D/B/A Penn Presbyterian Medical Center Philadelphia, PA facility · other · outpatient | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 20 | RESEARCH MEDICAL CENTER KANSAS CITY, MO fee schedule · outpatient | 2 | $426 | $426 | $6 | 1% | — | $421 – $432 |
| 21 | RETREAT DOCTORS HOSPITAL RICHMOND, VA fee schedule · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
| 22 | ST. DAVID'S NORTH AUSTIN MEDICAL CENTER AUSTIN, TX fee schedule · outpatient | 1 | $289 | $289 | — | — | — | $289 – $289 |
| 23 | ST. DAVID'S SOUTH AUSTIN MEDICAL CENTER AUSTIN, TX fee schedule · outpatient | 1 | $722 | $722 | — | — | — | $722 – $722 |
| 24 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA facility · other · outpatient | 3 | $818 | $833 | $448 | 54% | — | $370 – $1.4k |
| 25 | Triad of Alabama LLC Dothan, AL facility · fee schedule · outpatient | 1 | $421 | $421 | — | — | — | $421 – $421 |
← Payers reporting APC 1458 · Snapshot 20261111T120946Z-9134e7f7