Phenytoin 100 mg injection at UPMC East

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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Generated: October 20, 2026

Original text from hospital filings

PHENYTOIN SOD 50MG/ML ML VIAL

Monroeville, PA

See all hospitals reporting HCPCS J1165 →

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How this price compares nationally

UPMC East’s median price of $36 is 1258% above the median hospital's median price ($3), higher than 91% of the 1,988 hospitals reporting HCPCS J1165. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS J1165 at UPMC East

Negotiated rates from the hospital’s own file: 6 payers, 34 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	Amerihealth Caritas community healthchoices (chc)/medicaid facility · fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
2	Highmark medicaid facility · fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
3	UnitedHealthcare all business facility · fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
4	UnitedHealthcare compass exchange facility · fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
5	Highmark complete blue medicare advantage/freedom blue medicare advantage/security blue medicare advantage facility · fee schedule · outpatient	$12	$12	—	—	—	$12 – $12
6	Highmark managed care - social mission facility · fee schedule · outpatient	$35	$35	—	—	—	$35 – $35
7	Highmark commercial - social mission indemnity facility · fee schedule · outpatient	$35	$35	—	—	—	$35 – $35
8	Highmark managed care facility · fee schedule · outpatient	$47	$47	—	—	—	$47 – $47
9	Highmark commercial - indemnity facility · fee schedule · outpatient	$47	$47	—	—	—	$47 – $47
10	Aetna medicare facility · percent of total billed charges · outpatientfrom % of charges	$23	$82	$120	145%	—	$23 – $322
11	Highmark upmc emergent facility · fee schedule · outpatient	$94	$94	—	—	—	$94 – $94
12	UnitedHealthcare compass exchange facility · percent of total billed charges · inpatientfrom % of charges	$31	$112	$163	145%	—	$31 – $437
13	Aetna neighborhood network facility · percent of total billed charges · outpatientfrom % of charges	$32	$116	$168	145%	—	$32 – $451
14	Aetna neighborhood network facility · percent of total billed charges · inpatientfrom % of charges	$32	$119	$172	145%	—	$32 – $463
15	Aetna ebr fi facility · percent of total billed charges · inpatientfrom % of charges	$34	$125	$182	145%	—	$34 – $489
16	Aetna ebr fi facility · percent of total billed charges · outpatientfrom % of charges	$34	$125	$182	145%	—	$34 – $489
17	Aetna home depot employer group facility · percent of total billed charges · outpatientfrom % of charges	$34	$126	$183	145%	—	$34 – $491
18	Aetna nbr aso/fi facility · percent of total billed charges · outpatientfrom % of charges	$35	$128	$187	145%	—	$35 – $502
19	Cigna nbr aso/fi facility · percent of total billed charges · outpatientfrom % of charges	$35	$128	$187	145%	—	$35 – $502
20	Cigna new business aso facility · percent of total billed charges · outpatientfrom % of charges	$35	$128	$187	145%	—	$35 – $502
21	Aetna home depot employer group facility · percent of total billed charges · inpatientfrom % of charges	$35	$129	$188	145%	—	$35 – $504
22	Aetna ebr aso facility · percent of total billed charges · inpatientfrom % of charges	$36	$132	$191	145%	—	$36 – $514
23	Aetna ebr aso facility · percent of total billed charges · outpatientfrom % of charges	$36	$132	$191	145%	—	$36 – $514
24	Aetna nbr aso/fi facility · percent of total billed charges · inpatientfrom % of charges	$36	$132	$191	145%	—	$36 – $514
25	Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges	$36	$132	$191	145%	—	$36 – $514

Page 1 of 2 · 34 rates

Last updated: Mar 6, 2026

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