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
AMIFOSTINE CRYSTALLINE 500 MG INTRAVENOUS SOLR [4371]
Arlington, TX
See all hospitals reporting HCPCS J0207 →Price type
AMH Cath Labs LLC’s median price of $2.2k is 51% above the median hospital's median price ($1.5k), higher than 68% of the 1,269 hospitals reporting HCPCS J0207. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 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 | Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges | $315 | $315 | — | — | — | $315 – $315 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $315 | $315 | — | — | — | $315 – $315 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $331 | $331 | — | — | — | $331 – $331 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $340 | $340 | — | — | — | $340 – $340 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $346 | $346 | — | — | — | $346 – $346 |
| 6 | Aetna whole health percent of total billed charges · inpatientfrom % of charges | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 7 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 8 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 9 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $1.8k | $1.8k | — | — | — | $1.8k – $1.8k |
| 10 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 11 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 12 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 13 | Blue Cross Blue Shield hmo fee schedule · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 14 | Blue Cross Blue Shield exchange fee schedule · outpatient | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 15 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 16 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 17 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 18 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 19 | Blue Cross Blue Shield ppo fee schedule · outpatient | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 20 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $2.6k | $2.6k | — | — | — | $2.6k – $2.6k |
| 21 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $3.1k | $3.1k | — | — | — | $3.1k – $3.1k |
| 22 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $3.1k | $3.1k | — | — | — | $3.1k – $3.1k |
| 23 | Cigna indemnity percent of total billed charges · inpatientfrom % of charges | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 24 | Cigna indemnity percent of total billed charges · outpatientfrom % of charges | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 25 | Blue Cross Blue Shield traditional fee schedule · outpatient | $10.3k | $10.3k | — | — | — | $10.3k – $10.3k |
Last updated: Apr 21, 2026
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