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
FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION
Smith, AR
See all hospitals reporting HCPCS Q2009 →Price type
Mercy Hospital Fort Smith’s median price of $6 is 62% below the median hospital's median price ($15), higher than 34% of the 2,109 hospitals reporting HCPCS Q2009. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 17 payers, 28 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 | Aetna hb ftsm managed medicare facility · other · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 2 | Blue Cross Blue Shield hb ftsm managed medicare facility · other · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 3 | First Health hb ftsm managed medicare facility · other · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 4 | Humana hb ftsm humana mcr facility · other · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 5 | Medica hb ftsm managed medicare facility · other · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 6 | Medicare hb ftsm medicare facility · other · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 7 | Tricare hb ftsm tricare facility · other · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 8 | UnitedHealthcare hb ftsm managed medicare facility · other · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 9 | UnitedHealthcare hb ftsm uhc mcr 100% facility · other · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 10 | WellCare hb ftsm novasys mcr 103% facility · other · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 11 | Devoted hb ftsm devoted health mcr facility · other · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 12 | Cigna hb ftsm healthspring cigna mcr 105% facility · other · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 13 | Ambetter hb ftsm novasys ambetter exchange facility · other · outpatient | $2 | $2 | — | — | — | $2 – $2 |
| 14 | Optum hb ftsm,wldar,ozkar,prsar,bnvr uhc facility · fee schedule · outpatient | $8 | $8 | $5 | 67% | — | $3 – $13 |
| 15 | UnitedHealthcare hb ftsm,wldar,ozkar,prsar,bnvr uhc facility · fee schedule · outpatient | $8 | $8 | $5 | 67% | — | $3 – $13 |
| 16 | Anthem hb ftsm blue cross facility · fee schedule · outpatient | $18 | $18 | $12 | 67% | — | $6 – $29 |
| 17 | Blue Cross Blue Shield hb ftsm bcbs exchange facility · fee schedule · outpatient | $18 | $18 | $12 | 67% | — | $6 – $29 |
| 18 | Blue Cross Blue Shield hb ftsm blue cross facility · fee schedule · outpatient | $18 | $18 | $12 | 67% | — | $6 – $29 |
| 19 | Medicaid hb ftsm ark medicaid facility · fee schedule · outpatient | $33 | $33 | $22 | 67% | — | $11 – $54 |
| 20 | Caresource hb ftsm caresource medicaid facility · fee schedule · outpatient | $33 | $33 | $22 | 67% | — | $11 – $55 |
| 21 | Aetna hb ftsm coventry/aetna facility · fee schedule · outpatient | $41 | $41 | $27 | 67% | — | $14 – $68 |
| 22 | First Health hb ftsm first health_ccn facility · fee schedule · outpatient | $47 | $47 | $31 | 67% | — | $16 – $78 |
| 23 | Medicaid hb ftsm mo medicaid facility · percent of total billed charges · outpatientfrom % of charges | $60 | $60 | $55 | 92% | — | $5 – $115 |
| 24 | Aetna hb ftsm ok managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $75 | $75 | $69 | 92% | — | $6 – $144 |
| 25 | Humana hb ftsm ok managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $75 | $75 | $69 | 92% | — | $6 – $144 |
Last updated: Jun 8, 2026
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