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
AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION
York, PA
Negotiated rates from the hospital’s own file: 7 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 | Amerihealth Caritas community healthchoices (chc)/medicaid facility · fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 2 | Aetna medicare facility · fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 3 | Highmark medicaid facility · fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 4 | Blue Cross Blue Shield chip facility · fee schedule · outpatient | $2 | $2 | — | — | — | $2 – $2 |
| 5 | Blue Cross Blue Shield commercial facility · fee schedule · outpatient | $2 | $2 | — | — | — | $2 – $2 |
| 6 | Blue Cross Blue Shield medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $1 | $2 | $3 | 151% | — | $0 – $14 |
| 7 | Cigna commercial facility · fee schedule · outpatient | $3 | $3 | — | — | — | $3 – $3 |
| 8 | Aetna aco facility · percent of total billed charges · outpatientfrom % of charges | $2 | $4 | $7 | 151% | — | $0 – $30 |
| 9 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $2 | $5 | $8 | 151% | — | $0 – $35 |
| 10 | Aetna aco facility · percent of total billed charges · inpatientfrom % of charges | $2 | $5 | $8 | 152% | — | $0 – $35 |
| 11 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $3 | $6 | $9 | 151% | — | $1 – $41 |
| 12 | UnitedHealthcare commercial facility · percent of total billed charges · inpatientfrom % of charges | $3 | $7 | $10 | 152% | — | $1 – $44 |
| 13 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · inpatientfrom % of charges | $4 | $9 | $14 | 151% | — | $1 – $61 |
| 14 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · outpatientfrom % of charges | $4 | $9 | $14 | 151% | — | $1 – $61 |
| 15 | Highmark medicare facility · fee schedule · outpatient | $12 | $12 | — | — | — | $12 – $12 |