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
ULTOMIRIS 100 MG/ML INTRAVENOUS SOLUTION
Eureka, IL
See all hospitals reporting HCPCS J1303 →Price type
Carle Eureka Hospital’s median price of $20.4k is 5532% above the median hospital's median price ($362), higher than 92% of the 1,645 hospitals reporting HCPCS J1303. 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, 20 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 | $222 | $222 | — | — | — | $222 – $222 |
| 2 | Humana medicare-medicaid (d-snp) fee schedule · outpatient | $222 | $222 | — | — | — | $222 – $222 |
| 3 | WellCare medicare advantage hmo case rate · outpatient | $225 | $225 | — | — | — | $225 – $225 |
| 4 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · inpatient | $228 | $228 | — | — | — | $228 – $228 |
| 5 | Aetna Better Health medicare-medicaid (d-snp) fee schedule · outpatient | $228 | $228 | — | — | — | $228 – $228 |
| 6 | Molina managed medicaid percent of total billed charges · inpatientfrom % of charges | $14.6k | $14.6k | $8.4k | 57% | — | $6.3k – $23.0k |
| 7 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $14.6k | $14.6k | $8.4k | 57% | — | $6.3k – $23.0k |
| 8 | Molina medicare-medicaid (d-snp) percent of total billed charges · inpatientfrom % of charges | $14.6k | $14.6k | $8.4k | 57% | — | $6.3k – $23.0k |
| 9 | Aetna medicare advantage percent of total billed charges · outpatientfrom % of charges | $32.9k | $32.9k | $18.8k | 57% | — | $14.1k – $51.7k |
| 10 | Humana medicare advantage percent of total billed charges · outpatientfrom % of charges | $32.9k | $32.9k | $18.8k | 57% | — | $14.1k – $51.7k |
| 11 | UnitedHealthcare medicare advantage percent of total billed charges · outpatientfrom % of charges | $32.9k | $32.9k | $18.8k | 57% | — | $14.1k – $51.7k |
| 12 | UnitedHealthcare va ccn/optum percent of total billed charges · outpatientfrom % of charges | $32.9k | $32.9k | $18.8k | 57% | — | $14.1k – $51.7k |
| 13 | Molina medicare-medicaid (d-snp) percent of total billed charges · outpatientfrom % of charges | $35.1k | $35.1k | $20.1k | 57% | — | $15.0k – $55.1k |
| 14 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $45.1k | $45.1k | $25.8k | 57% | — | $19.3k – $70.9k |
| 15 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $45.3k | $45.3k | $25.9k | 57% | — | $19.4k – $71.2k |
| 16 | Aetna ppo percent of total billed charges · inpatientfrom % of charges | $48.3k | $48.3k | $27.6k | 57% | — | $20.7k – $75.9k |
| 17 | Aetna ppo percent of total billed charges · outpatientfrom % of charges | $48.3k | $48.3k | $27.6k | 57% | — | $20.7k – $75.9k |
| 18 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $49.0k | $49.0k | $28.0k | 57% | — | $21.0k – $77.0k |
| 19 | MultiPlan ppo percent of total billed charges · outpatientfrom % of charges | $54.8k | $54.8k | $31.3k | 57% | — | $23.5k – $86.2k |
| 20 | Blue Cross Blue Shield blue choice/options/ppo percent of total billed charges · outpatientfrom % of charges | $61.4k | $61.4k | $35.1k | 57% | — | $26.3k – $96.5k |
Last updated: Apr 15, 2026
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