ALLERGAN JUVEDERM ULTRA PLUS XC 1.0 ML at Blessing Hospital

Quincy, IL

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Pricing by billing methodology

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Payers reporting HCPCS C0104 at Blessing Hospital

Negotiated rates from the hospital’s own file: 7 payers, 16 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	UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges	$352	$352	—	—	—	$352 – $352
2	UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges	$359	$359	—	—	—	$359 – $359
3	Bcbs Il commercial facility · percent of total billed charges · inpatientfrom % of charges	$359	$359	—	—	—	$359 – $359
4	Bcbs Il commercial facility · percent of total billed charges · outpatientfrom % of charges	$359	$359	—	—	—	$359 – $359
5	Bcbs Mo commercial facility · percent of total billed charges · inpatientfrom % of charges	$419	$419	—	—	—	$419 – $419
6	Bcbs Mo commercial facility · percent of total billed charges · outpatientfrom % of charges	$419	$419	—	—	—	$419 – $419
7	Blue Cross Blue Shield commercial facility · percent of total billed charges · inpatientfrom % of charges	$419	$419	—	—	—	$419 – $419
8	Blue Cross Blue Shield commercial facility · percent of total billed charges · outpatientfrom % of charges	$419	$419	—	—	—	$419 – $419
9	Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges	$447	$447	—	—	—	$447 – $447
10	Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges	$447	$447	—	—	—	$447 – $447
11	Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges	$447	$447	—	—	—	$447 – $447
12	Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges	$447	$447	—	—	—	$447 – $447
13	Humana commercial facility · percent of total billed charges · inpatientfrom % of charges	$447	$447	—	—	—	$447 – $447
14	Humana commercial facility · percent of total billed charges · outpatientfrom % of charges	$447	$447	—	—	—	$447 – $447
15	Humana commercial professional · percent of total billed charges · bothfrom % of charges	$524	$524	—	—	—	$524 – $524
16	Cigna commercial professional · percent of total billed charges · bothfrom % of charges	$558	$558	—	—	—	$558 – $558

Last updated: Jun 8, 2026

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