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
POLIDOCANOL 1 % INTRAVENOUS FOAM
Utica, NY
See all hospitals reporting HCPCS C9399 →Price type
MVHS, Inc.’s median price of $9.5k is 504% above the median hospital's median price ($1.6k), higher than 91% of the 1,126 hospitals reporting HCPCS C9399. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 10 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 | Excellus excellus bcbs medicaid percent of total billed charges · bothfrom % of charges | $4.6k | $4.6k | — | — | — | $4.6k – $4.6k |
| 2 | Cigna mvp and cigna commercial percent of total billed charges · bothfrom % of charges | $6.3k | $6.3k | $6.0k | 95% | — | $298 – $12.2k |
| 3 | UnitedHealthcare uhc empire plan percent of total billed charges · bothfrom % of charges | $6.9k | $6.9k | — | — | — | $6.9k – $6.9k |
| 4 | UnitedHealthcare uhc commercial percent of total billed charges · bothfrom % of charges | $8.6k | $8.6k | — | — | — | $8.6k – $8.6k |
| 5 | Aetna aetna commercial percent of total billed charges · bothfrom % of charges | $10.3k | $10.3k | — | — | — | $10.3k – $10.3k |
| 6 | Bcbs Ny excellus bcbs indemnity percent of total billed charges · bothfrom % of charges | $11.8k | $11.8k | — | — | — | $11.8k – $11.8k |
| 7 | Blue Cross Blue Shield excellus bcbs hmo/ppo percent of total billed charges · bothfrom % of charges | $11.8k | $11.8k | — | — | — | $11.8k – $11.8k |
| 8 | Excellus excellus bcbs hmo/ppo percent of total billed charges · bothfrom % of charges | $11.8k | $11.8k | — | — | — | $11.8k – $11.8k |
| 9 | Excellus excellus bcbs indemnity percent of total billed charges · bothfrom % of charges | $11.8k | $11.8k | — | — | — | $11.8k – $11.8k |
| 10 | Humana humana hmo/pos percent of total billed charges · bothfrom % of charges | $13.0k | $13.0k | — | — | — | $13.0k – $13.0k |
Last updated: Aug 7, 2026
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