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
idarucizumab per 2.5 g
San Angelo, TX
See all hospitals reporting HCPCS C9399 →Price type
Shannon River Crest Hospital’s median price of $9.6k is 513% above the median hospital's median price ($1.6k), higher than 91% of the 1,125 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: 6 payers, 15 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 ppo facility · percent of total billed charges · inpatientfrom % of charges | $8.5k | $8.5k | — | — | — | $8.5k – $8.5k |
| 2 | Aetna ppo facility · percent of total billed charges · outpatientfrom % of charges | $8.5k | $8.5k | — | — | — | $8.5k – $8.5k |
| 3 | Cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $9.3k | $9.3k | — | — | — | $9.3k – $9.3k |
| 4 | Bcbs Tx bav facility · percent of total billed charges · inpatientfrom % of charges | $9.6k | $9.6k | — | — | — | $9.6k – $9.6k |
| 5 | Bcbs Tx bav facility · percent of total billed charges · outpatientfrom % of charges | $9.6k | $9.6k | — | — | — | $9.6k – $9.6k |
| 6 | Bcbs Tx hmo facility · percent of total billed charges · inpatientfrom % of charges | $9.6k | $9.6k | — | — | — | $9.6k – $9.6k |
| 7 | Bcbs Tx hmo facility · percent of total billed charges · outpatientfrom % of charges | $9.6k | $9.6k | — | — | — | $9.6k – $9.6k |
| 8 | Bcbs Tx ppo facility · percent of total billed charges · inpatientfrom % of charges | $9.6k | $9.6k | — | — | — | $9.6k – $9.6k |
| 9 | Bcbs Tx ppo facility · percent of total billed charges · outpatientfrom % of charges | $9.6k | $9.6k | — | — | — | $9.6k – $9.6k |
| 10 | First Health ppo facility · percent of total billed charges · inpatientfrom % of charges | $9.6k | $9.6k | — | — | — | $9.6k – $9.6k |
| 11 | First Health ppo facility · percent of total billed charges · outpatientfrom % of charges | $9.6k | $9.6k | — | — | — | $9.6k – $9.6k |
| 12 | UnitedHealthcare ppo facility · percent of total billed charges · inpatientfrom % of charges | $10.0k | $10.0k | — | — | — | $10.0k – $10.0k |
| 13 | UnitedHealthcare ppo facility · percent of total billed charges · outpatientfrom % of charges | $10.0k | $10.0k | — | — | — | $10.0k – $10.0k |
| 14 | Humana ppo facility · percent of total billed charges · inpatientfrom % of charges | $10.3k | $10.3k | — | — | — | $10.3k – $10.3k |
| 15 | Humana ppo facility · percent of total billed charges · outpatientfrom % of charges | $10.3k | $10.3k | — | — | — | $10.3k – $10.3k |
Last updated: Dec 8, 2025
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