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
FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE|RX AMT DISCARD/NOT ADMIN TO PT
Perryville, MO
See all hospitals reporting HCPCS J9395 →Price type
Mercy Perry’s median price of $4.0k is 12685% above the median hospital's median price ($32), higher than 99% of the 1,878 hospitals reporting HCPCS J9395. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 16 payers, 29 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 | Optum hb pcmh uhc all payer exchange facility · fee schedule · outpatient | $153 | $153 | — | — | — | $153 – $153 |
| 2 | UnitedHealthcare hb pcmh uhc all payer exchange facility · fee schedule · outpatient | $153 | $153 | — | — | — | $153 – $153 |
| 3 | UnitedHealthcare hb pcmh uhc core facility · fee schedule · outpatient | $153 | $153 | — | — | — | $153 – $153 |
| 4 | Medicaid hb wash jefn linc samc pcmh stod il medicaid facility · percent of total billed charges · outpatientfrom % of charges | $975 | $975 | $1 | 0% | — | $974 – $976 |
| 5 | Blue Cross Blue Shield hb pcmh missouri care health plan/healthy blue facility · percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | $1 | 0% | — | $1.3k – $1.3k |
| 6 | Medicaid hb pcmh mo medicaid facility · percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | $1 | 0% | — | $1.3k – $1.3k |
| 7 | UnitedHealthcare hb pcmh uhc managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $1.3k | $1.3k | $1 | 0% | — | $1.3k – $1.3k |
| 8 | Blue Cross Blue Shield hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | $2 | 0% | — | $2.0k – $2.0k |
| 9 | Humana hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | $2 | 0% | — | $2.0k – $2.0k |
| 10 | Medica hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | $2 | 0% | — | $2.0k – $2.0k |
| 11 | Medicare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | $2 | 0% | 30 | $2.0k – $2.0k |
| 12 | UnitedHealthcare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | $2 | 0% | — | $2.0k – $2.0k |
| 13 | WellCare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | $2 | 0% | — | $2.0k – $2.0k |
| 14 | UnitedHealthcare hb pcmh uhc medicare w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $2.0k | $2.0k | $2 | 0% | — | $2.0k – $2.0k |
| 15 | Aetna hb pcmh aetna/coventry medicare 102% w/o seq facility · percent of total billed charges · outpatientfrom % of charges | $2.1k | $2.1k | $2 | 0% | — | $2.1k – $2.1k |
| 16 | Devoted hb pcmh devoted health medicare advantage 104% w/seq facility · percent of total billed charges · outpatientfrom % of charges | $2.1k | $2.1k | $2 | 0% | — | $2.1k – $2.1k |
| 17 | Tricare hb pcmh tricare facility · percent of total billed charges · outpatientfrom % of charges | $2.4k | $2.4k | $2 | 0% | — | $2.4k – $2.4k |
| 18 | Medica hb linc pcmh medica exchange new 010122 facility · percent of total billed charges · outpatientfrom % of charges | $2.7k | $2.7k | $3 | 0% | — | $2.7k – $2.7k |
| 19 | Ambetter hb pcmh ambetter exchange facility · percent of total billed charges · outpatientfrom % of charges | $3.1k | $3.1k | $3 | 0% | — | $3.1k – $3.1k |
| 20 | Blue Cross Blue Shield hb stlo wash jefn linc samc cape stod pcmh bcbs ascension facility · percent of total billed charges · outpatientfrom % of charges | $3.1k | $3.1k | $3 | 0% | — | $3.1k – $3.1k |
| 21 | Blue Cross Blue Shield hb pcmh anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges | $4.0k | $4.0k | $4 | 0% | — | $4.0k – $4.0k |
| 22 | Blue Cross Blue Shield hb pcmh anthem pathway/exchange facility · percent of total billed charges · outpatientfrom % of charges | $4.0k | $4.0k | $4 | 0% | — | $4.0k – $4.0k |
| 23 | Aetna hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $4.3k | $4.3k | $4 | 0% | — | $4.3k – $4.3k |
| 24 | First Health hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges | $4.3k | $4.3k | $4 | 0% | — | $4.3k – $4.3k |
| 25 | Anthem hb pcmh anthem blue access facility · percent of total billed charges · outpatientfrom % of charges | $4.6k | $4.6k | $4 | 0% | — | $4.5k – $4.6k |
Last updated: Mar 12, 2026
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