Goserelin acetate implant, 3.6 mg at Mercy Hospital Fort Smith

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

GOSERELIN 10.8 MG SUBCUTANEOUS IMPLANT|RX AMT DISCARD/NOT ADMIN TO PT

Smith, AR

See all hospitals reporting HCPCS J9202 →

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Pricing by billing methodology

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How this price compares nationally

Mercy Hospital Fort Smith’s median price of $956 is 19% below the median hospital's median price ($1.2k), higher than 38% of the 1,845 hospitals reporting HCPCS J9202. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J9202 at Mercy Hospital Fort Smith

Negotiated rates from the hospital’s own file: 17 payers, 27 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	Medicaid hb ftsm ark medicaid facility · fee schedule · outpatient	$638	$638	$319	50%	—	$319 – $956
2	Caresource hb ftsm caresource medicaid facility · fee schedule · outpatient	$650	$650	$325	50%	—	$325 – $975
3	Aetna hb ftsm managed medicare facility · other · outpatient	$763	$763	—	—	1–10	$763 – $763
4	Blue Cross Blue Shield hb ftsm managed medicare facility · other · outpatient	$763	$763	—	—	—	$763 – $763
5	First Health hb ftsm managed medicare facility · other · outpatient	$763	$763	—	—	—	$763 – $763
6	Humana hb ftsm humana mcr facility · other · outpatient	$763	$763	—	—	—	$763 – $763
7	Medica hb ftsm managed medicare facility · other · outpatient	$763	$763	—	—	—	$763 – $763
8	Medicare hb ftsm medicare facility · other · outpatient	$763	$763	—	—	—	$763 – $763
9	Tricare hb ftsm tricare facility · other · outpatient	$763	$763	—	—	—	$763 – $763
10	UnitedHealthcare hb ftsm managed medicare facility · other · outpatient	$763	$763	—	—	—	$763 – $763
11	UnitedHealthcare hb ftsm uhc mcr 100% facility · other · outpatient	$763	$763	—	—	—	$763 – $763
12	WellCare hb ftsm novasys mcr 103% facility · other · outpatient	$786	$786	—	—	—	$786 – $786
13	Devoted hb ftsm devoted health mcr facility · other · outpatient	$794	$794	—	—	—	$794 – $794
14	Cigna hb ftsm healthspring cigna mcr 105% facility · other · outpatient	$802	$802	—	—	—	$802 – $802
15	Ambetter hb ftsm novasys ambetter exchange facility · other · outpatient	$1.1k	$1.1k	—	—	—	$1.1k – $1.1k
16	Medicaid hb ftsm mo medicaid facility · percent of total billed charges · outpatientfrom % of charges	$1.5k	$1.5k	$712	46%	—	$825 – $2.3k
17	Optum hb ftsm,wldar,ozkar,prsar,bnvr uhc facility · fee schedule · outpatient	$1.6k	$1.6k	$778	50%	—	$778 – $2.3k
18	UnitedHealthcare hb ftsm,wldar,ozkar,prsar,bnvr uhc facility · fee schedule · outpatient	$1.6k	$1.6k	$778	50%	—	$778 – $2.3k
19	Anthem hb ftsm blue cross facility · fee schedule · outpatient	$1.6k	$1.6k	$805	50%	—	$805 – $2.4k
20	Blue Cross Blue Shield hb ftsm bcbs exchange facility · fee schedule · outpatient	$1.6k	$1.6k	$805	50%	—	$805 – $2.4k
21	Blue Cross Blue Shield hb ftsm blue cross facility · fee schedule · outpatient	$1.6k	$1.6k	$805	50%	—	$805 – $2.4k
22	Aetna hb ftsm ok managed medicaid facility · percent of total billed charges · outpatientfrom % of charges	$1.9k	$1.9k	$890	46%	—	$1.0k – $2.8k
23	Humana hb ftsm ok managed medicaid facility · percent of total billed charges · outpatientfrom % of charges	$1.9k	$1.9k	$890	46%	—	$1.0k – $2.8k
24	Aetna hb ftsm coventry/aetna facility · fee schedule · outpatient	$3.0k	$3.0k	$1.5k	50%	—	$1.5k – $4.6k
25	Cigna hb ftsm cigna facility · percent of total billed charges · outpatientfrom % of charges	$3.8k	$3.8k	$1.8k	46%	—	$2.1k – $5.6k

Page 1 of 2 · 27 rates

Last updated: Jun 8, 2026

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