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
PHENYTOIN SODIUM 50MG/ML 1ML
Pittsburgh, PA
See all hospitals reporting HCPCS J1165 →Price type
UPMC Mercy’s median price of $17 is 542% above the median hospital's median price ($3), higher than 82% of the 1,988 hospitals reporting HCPCS J1165. 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, 26 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 complete blue medicare advantage/freedom blue medicare advantage/security blue medicare advantage facility · fee schedule · outpatient | $12 | $12 | — | — | — | $12 – $12 |
| 3 | Highmark managed care - social mission facility · fee schedule · outpatient | $34 | $34 | — | — | — | $34 – $34 |
| 4 | Highmark commercial - social mission indemnity facility · fee schedule · outpatient | $35 | $35 | — | — | — | $35 – $35 |
| 5 | Aetna medicare facility · percent of total billed charges · outpatientfrom % of charges | $9 | $36 | $61 | 170% | — | $9 – $174 |
| 6 | Aetna neighborhood network facility · percent of total billed charges · outpatientfrom % of charges | $10 | $40 | $69 | 170% | — | $9 – $194 |
| 7 | Aetna home depot employer group facility · percent of total billed charges · outpatientfrom % of charges | $11 | $44 | $75 | 170% | — | $10 – $212 |
| 8 | Aetna neighborhood network facility · percent of total billed charges · inpatientfrom % of charges | $11 | $44 | $75 | 170% | — | $10 – $213 |
| 9 | Aetna nbr aso/fi facility · percent of total billed charges · outpatientfrom % of charges | $11 | $45 | $76 | 170% | — | $11 – $215 |
| 10 | Highmark managed care facility · fee schedule · outpatient | $46 | $46 | — | — | — | $46 – $46 |
| 11 | Highmark commercial - indemnity facility · fee schedule · outpatient | $47 | $47 | — | — | — | $47 – $47 |
| 12 | Aetna home depot employer group facility · percent of total billed charges · inpatientfrom % of charges | $12 | $48 | $82 | 170% | — | $11 – $231 |
| 13 | Aetna nbr aso/fi facility · percent of total billed charges · inpatientfrom % of charges | $12 | $49 | $84 | 170% | — | $12 – $236 |
| 14 | Cigna new business aso facility · percent of total billed charges · inpatientfrom % of charges | $12 | $49 | $84 | 170% | — | $12 – $236 |
| 15 | Aetna ebr fi facility · percent of total billed charges · inpatientfrom % of charges | $13 | $55 | $93 | 170% | — | $13 – $264 |
| 16 | Aetna ebr fi facility · percent of total billed charges · outpatientfrom % of charges | $13 | $55 | $93 | 170% | — | $13 – $264 |
| 17 | Aetna ebr aso facility · percent of total billed charges · inpatientfrom % of charges | $14 | $58 | $98 | 170% | — | $14 – $278 |
| 18 | Aetna ebr aso facility · percent of total billed charges · outpatientfrom % of charges | $14 | $58 | $98 | 170% | — | $14 – $278 |
| 19 | Cigna new business aso facility · percent of total billed charges · outpatientfrom % of charges | $14 | $59 | $101 | 170% | — | $14 – $285 |
| 20 | First Health commercial facility · percent of total billed charges · inpatientfrom % of charges | $16 | $64 | $108 | 170% | — | $15 – $306 |
| 21 | First Health commercial facility · percent of total billed charges · outpatientfrom % of charges | $16 | $64 | $108 | 170% | — | $15 – $306 |
| 22 | Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges | $21 | $73 | $126 | 174% | — | $14 – $417 |
| 23 | Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $21 | $73 | $126 | 174% | — | $14 – $417 |
| 24 | Highmark medicare facility · percent of total billed charges · outpatientfrom % of charges | $18 | $73 | $123 | 170% | — | $17 – $348 |
| 25 | MultiPlan ppo (inc. auto and worker's compensation) facility · percent of total billed charges · inpatientfrom % of charges | $32 | $131 | $221 | 170% | — | $31 – $626 |
Last updated: Mar 6, 2026
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