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
RRX PENTETATE DX/0-25MCI DOSE
Wheatland, WY
See all hospitals reporting HCPCS A9539 →Price type
Platte County Hospital’s median price of $320 is 165% above the median hospital's median price ($121), higher than 81% of the 1,794 hospitals reporting HCPCS A9539. 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, 14 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 | UnitedHealthcare nebraska medicaid/chip facility · percent of total billed charges · outpatientfrom % of charges | $160 | $160 | — | — | — | $160 – $160 |
| 2 | Humana medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $190 | $190 | — | — | — | $190 – $190 |
| 3 | Medica medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $190 | $190 | — | — | — | $190 – $190 |
| 4 | UnitedHealthcare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $190 | $190 | — | — | — | $190 – $190 |
| 5 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $315 | $315 | — | — | — | $315 – $315 |
| 6 | Medica commercial facility · percent of total billed charges · outpatientfrom % of charges | $316 | $316 | — | — | — | $316 – $316 |
| 7 | Bcbs Wy institutional facility · percent of total billed charges · inpatientfrom % of charges | $316 | $316 | — | — | — | $316 – $316 |
| 8 | Bcbs Wy institutional facility · percent of total billed charges · outpatientfrom % of charges | $316 | $316 | — | — | — | $316 – $316 |
| 9 | First Health medical rental facility · percent of total billed charges · inpatientfrom % of charges | $320 | $320 | — | — | — | $320 – $320 |
| 10 | First Health medical rental facility · percent of total billed charges · outpatientfrom % of charges | $320 | $320 | — | — | — | $320 – $320 |
| 11 | Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges | $323 | $323 | — | — | — | $323 – $323 |
| 12 | Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $323 | $323 | — | — | — | $323 – $323 |
| 13 | MultiPlan commercial facility · percent of total billed charges · inpatientfrom % of charges | $323 | $323 | — | — | — | $323 – $323 |
| 14 | MultiPlan commercial facility · percent of total billed charges · outpatientfrom % of charges | $323 | $323 | — | — | — | $323 – $323 |
Last updated: Feb 12, 2026
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