Hydroxychloroquine 200 mg oral tablet at St. David's Georgetown Hospital

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.

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Provider: anthropic
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Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

CIPROFLXN 250/5 PO100ML

Georgetown, TX

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How this price compares nationally

St. David's Georgetown Hospital’s median price of $200 is 989% above the median hospital's median price ($18), higher than 86% of the 981 hospitals reporting HCPCS J8499. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J8499 at St. David's Georgetown Hospital

Negotiated rates from the hospital’s own file: 10 payers, 38 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	Oscar hix percent of total billed charges · outpatientfrom % of charges	$12	$12	—	—	—	$12 – $12
2	Oscar hmo percent of total billed charges · outpatientfrom % of charges	$12	$12	—	—	—	$12 – $12
3	Oscar epo percent of total billed charges · outpatientfrom % of charges	$14	$14	—	—	—	$14 – $14
4	Oscar pos percent of total billed charges · outpatientfrom % of charges	$14	$14	—	—	—	$14 – $14
5	Oscar ppo percent of total billed charges · outpatientfrom % of charges	$14	$14	—	—	—	$14 – $14
6	Healthcare Highways epo percent of total billed charges · outpatientfrom % of charges	$19	$19	—	—	—	$19 – $19
7	Healthcare Highways ppo percent of total billed charges · outpatientfrom % of charges	$19	$19	—	—	—	$19 – $19
8	Cigna newbusinessnetwork percent of total billed charges · outpatientfrom % of charges	$21	$21	—	—	—	$21 – $21
9	Cigna hmo percent of total billed charges · outpatientfrom % of charges	$22	$22	—	—	—	$22 – $22
10	Cigna openaccess percent of total billed charges · outpatientfrom % of charges	$22	$22	—	—	—	$22 – $22
11	Cigna openaccessplus percent of total billed charges · outpatientfrom % of charges	$22	$22	—	—	—	$22 – $22
12	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$26	$26	—	—	—	$26 – $26
13	Aetna narrownetwork percent of total billed charges · outpatientfrom % of charges	$29	$29	—	—	—	$29 – $29
14	Aetna comm percent of total billed charges · outpatientfrom % of charges	$29	$29	—	—	—	$29 – $29
15	Aetna meritain percent of total billed charges · outpatientfrom % of charges	$29	$29	—	—	—	$29 – $29
16	Aetna asa percent of total billed charges · outpatientfrom % of charges	$34	$34	—	—	—	$34 – $34
17	Aetna oon percent of total billed charges · outpatientfrom % of charges	$34	$34	—	—	—	$34 – $34
18	Superior Healthplan chip percent of total billed charges · outpatientfrom % of charges	$36	$78	$133	170%	—	$1 – $760
19	Superior Healthplan chpfc percent of total billed charges · outpatientfrom % of charges	$36	$78	$133	170%	—	$1 – $760
20	Superior Healthplan star percent of total billed charges · outpatientfrom % of charges	$36	$78	$133	170%	—	$1 – $760
21	Superior Healthplan starplus percent of total billed charges · outpatientfrom % of charges	$36	$78	$133	170%	—	$1 – $760
22	Blue Cross Blue Shield mybluehealth percent of total billed charges · outpatientfrom % of charges	$107	$233	$395	170%	—	$2 – $2.3k
23	Superior Healthplan ambetterepo percent of total billed charges · outpatientfrom % of charges	$122	$265	$451	170%	—	$2 – $2.6k
24	Superior Healthplan ambetterhmo percent of total billed charges · outpatientfrom % of charges	$122	$265	$451	170%	—	$2 – $2.6k
25	Superior Healthplan valuehmo percent of total billed charges · outpatientfrom % of charges	$122	$265	$451	170%	—	$2 – $2.6k

Page 1 of 2 · 38 rates

Last updated: Sep 1, 2026

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