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
EMICIZUMAB-KXWH 30 MG/ML SUBCU SOLN
Low
$43
Average
$578
Median
$54
High
$15.0k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
46 hospitals; the 90th percentile is 1.2× 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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47 hospital rates
iThe hospitals that file a Tricare 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 | Beaufort Memorial Hospital Beaufort, SC facility · fee schedule · outpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 2 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 3 | CLAIBORNE MEDICAL CENTER Tazewell, TN fee schedule · outpatient | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 4 | CUMBERLAND MEDICAL CENTER, INC. Crossville, TN fee schedule · outpatient | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 5 | Charleston Area Medical Center Charleston, WV percent of total billed charges · bothfrom % of charges | 1 | $14.3k | $15.0k | $7.9k | 53% | — | $5.2k – $26.1k |
| 6 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 7 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 1 | $57 | $57 | — | — | — | $57 – $57 |
| 8 | EAST BATON ROUGE MEDICAL CENTER, LLC Baton Rouge, LA other · outpatient | 1 | $57 | $57 | — | — | — | $57 – $57 |
| 9 | Ellis Hospital NY 12308; 2210 Troy Schenectady Road Niskayuna, NY facility · fee schedule · outpatient | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 10 | FORT LOUDOUN MEDICAL CENTER Lenoir City, TN fee schedule · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 11 | FORT SANDERS REGIONAL MEDICAL CENTER Knoxville, TN fee schedule · outpatient | 1 | $50 | $50 | — | — | — | $50 – $50 |
| 12 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital City, UT facility · fee schedule · outpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 13 | IHC Health Services Inc., DBA Intermountain Primary Children's Hospital Lehi, UT facility · fee schedule · outpatient | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 14 | Kaleida Health Buffalo, NY fee schedule · outpatient | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 15 | LECONTE MEDICAL CENTER Sevierville, TN fee schedule · outpatient | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 16 | Little Company of Mary Hospital of Indiana Inc Jasper, IN facility · case rate · outpatient | 1 | $48 | $48 | — | — | — | $48 – $48 |
| 17 | MCLAREN BAY REGION CITY, MI fee schedule | 1 | $55 | $55 | — | — | — | $55 – $55 |
| 18 | MCLAREN CARO REGION CARO, MI fee schedule | 1 | $62 | $62 | — | — | — | $62 – $62 |
| 19 | MCLAREN CENTRAL MICHIGAN PLEASANT, MI fee schedule | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 20 | MCLAREN FLINT FLINT, MI fee schedule | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 21 | MCLAREN GREATER LANSING LANSING, MI fee schedule | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 22 | MCLAREN LAPEER REGION LAPEER, MI fee schedule | 1 | $52 | $52 | — | — | — | $52 – $52 |
| 23 | MCLAREN MACOMB CLEMENS, MI fee schedule | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 24 | MCLAREN NORTHERN MICHIGAN PETOSKEY, MI fee schedule | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 25 | MCLAREN OAKLAND PONTIAC, MI fee schedule | 1 | $49 | $49 | — | — | — | $49 – $49 |
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