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
GONAL-F 1,050 UNIT SUBCUTANEOUS SOLUTION
Normal, IL
See all hospitals reporting HCPCS S0126 →Price type
Carle BroMenn Medical Center’s median price of $2.8k is 932% above the median hospital's median price ($275), higher than 98% of the 771 hospitals reporting HCPCS S0126. 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, 17 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 | Humana medicare-medicaid (d-snp) fee schedule · inpatient | $232 | $232 | — | — | — | $232 – $232 |
| 2 | Humana medicare-medicaid (d-snp) fee schedule · outpatient | $232 | $232 | — | — | — | $232 – $232 |
| 3 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · inpatient | $239 | $239 | — | — | — | $239 – $239 |
| 4 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · outpatient | $239 | $239 | — | — | — | $239 – $239 |
| 5 | UnitedHealthcare va ccn/optum fee schedule · inpatient | $686 | $686 | — | — | — | $686 – $686 |
| 6 | UnitedHealthcare va ccn/optum fee schedule · outpatient | $686 | $686 | — | — | — | $686 – $686 |
| 7 | Molina managed medicaid percent of total billed charges · inpatientfrom % of charges | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 8 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 9 | Molina medicare-medicaid (d-snp) percent of total billed charges · inpatientfrom % of charges | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 10 | Molina medicare-medicaid (d-snp) percent of total billed charges · outpatientfrom % of charges | $2.8k | $2.8k | — | — | — | $2.8k – $2.8k |
| 11 | Blue Cross Blue Shield blue choice/options/ppo percent of total billed charges · outpatientfrom % of charges | $8.7k | $8.7k | — | — | — | $8.7k – $8.7k |
| 12 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $8.8k | $8.8k | — | — | — | $8.8k – $8.8k |
| 13 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $8.8k | $8.8k | — | — | — | $8.8k – $8.8k |
| 14 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $8.8k | $8.8k | — | — | — | $8.8k – $8.8k |
| 15 | Aetna ppo percent of total billed charges · inpatientfrom % of charges | $9.4k | $9.4k | — | — | — | $9.4k – $9.4k |
| 16 | Aetna ppo percent of total billed charges · outpatientfrom % of charges | $9.4k | $9.4k | — | — | — | $9.4k – $9.4k |
| 17 | MultiPlan ppo percent of total billed charges · outpatientfrom % of charges | $10.7k | $10.7k | — | — | — | $10.7k – $10.7k |
Last updated: Apr 15, 2026
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