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
fosphenytoin pediatric 50 mg PE/mL Soln 10 mL VIAL
Ulm, MN
See all hospitals reporting HCPCS Q2009 →Price type
Allina Health Systems’s median price of $40 is 162% above the median hospital's median price ($15), higher than 67% of the 2,109 hospitals reporting HCPCS Q2009. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 25 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna allina aetna medicare (n) facility · fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 2 | Medicare medicare (n) facility · fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 3 | Bcbs Mn bc pmap (n) facility · other · outpatient | $8 | $8 | — | — | — | $8 – $8 |
| 4 | Bcbs Mn bc premier(n) facility · other · outpatient | $9 | $9 | — | — | — | $9 – $9 |
| 5 | Blue Cross Blue Shield bc aehp (n) facility · other · outpatient | $10 | $10 | — | — | — | $10 – $10 |
| 6 | Bcbs Mn bc high value/performance network (n) facility · other · outpatient | $11 | $11 | — | — | — | $11 – $11 |
| 7 | Bcbs Mn bc state health plan (n) facility · other · outpatient | $12 | $12 | — | — | — | $12 – $12 |
| 8 | Ucare ucare pmap (abdmnorsuv) facility · percent of total billed charges · outpatientfrom % of charges | $18 | $17 | $7 | 41% | — | $10 – $25 |
| 9 | Medica medica pmap (n) facility · percent of total billed charges · outpatientfrom % of charges | $28 | $28 | $11 | 41% | — | $15 – $39 |
| 10 | Medicaid medicaid ma (n) facility · other · outpatient | $38 | $38 | $15 | 41% | — | $21 – $54 |
| 11 | Medica medica medicare (r) facility · fee schedule · outpatient | $39 | $39 | $16 | 41% | — | $21 – $55 |
| 12 | Medica medica dual solutions (r) facility · percent of total billed charges · outpatientfrom % of charges | $39 | $39 | $16 | 41% | — | $21 – $56 |
| 13 | Blue Cross Blue Shield bc medicare (n) facility · fee schedule · outpatient | $41 | $40 | $16 | 41% | — | $22 – $58 |
| 14 | Aetna aetna elevate (n r) facility · percent of total billed charges · inpatientfrom % of charges | $54 | $53 | $22 | 41% | — | $29 – $76 |
| 15 | Aetna aetna elevate (n r) facility · percent of total billed charges · outpatientfrom % of charges | $54 | $54 | $22 | 41% | — | $29 – $77 |
| 16 | Aetna aetna performance (n r) facility · percent of total billed charges · inpatientfrom % of charges | $58 | $57 | $23 | 41% | — | $31 – $82 |
| 17 | Aetna aetna performance (n r) facility · percent of total billed charges · outpatientfrom % of charges | $59 | $58 | $24 | 41% | — | $32 – $83 |
| 18 | Medica medica ubh (n) facility · percent of total billed charges · inpatientfrom % of charges | $61 | $61 | $25 | 41% | — | $33 – $87 |
| 19 | Medica medica ubh pmap (n) facility · percent of total billed charges · outpatientfrom % of charges | $70 | $69 | $28 | 41% | — | $38 – $99 |
| 20 | Cigna hpi cigna (n) facility · other · outpatient | $72 | $71 | $29 | 41% | — | $39 – $101 |
| 21 | First Health first health (abdmnosurv) facility · percent of total billed charges · inpatientfrom % of charges | $74 | $73 | $30 | 41% | — | $40 – $104 |
| 22 | First Health first health (abdmnosurv) facility · percent of total billed charges · outpatientfrom % of charges | $74 | $73 | $30 | 41% | — | $40 – $104 |
| 23 | Medica medica ubh (n) facility · percent of total billed charges · outpatientfrom % of charges | $74 | $73 | $30 | 41% | — | $40 – $104 |
| 24 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · inpatientfrom % of charges | $74 | $73 | $30 | 41% | — | $40 – $105 |
| 25 | Aetna aetna direct/indirect network (n r) facility · percent of total billed charges · outpatientfrom % of charges | $75 | $74 | $30 | 41% | — | $41 – $106 |
Last updated: Jun 16, 2026
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