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
NM SM153 LEXIDRONAM <=150MCI
Haven, FL
See all hospitals reporting HCPCS A9604 →Price type
Winter Haven Hospital’s median price of $20.7k is 147% above the median hospital's median price ($8.4k), higher than 83% of the 1,379 hospitals reporting HCPCS A9604. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 43 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 | Humana commercial other facility · fee schedule · outpatient | $4.2k | $4.2k | — | — | — | $4.2k – $4.2k |
| 2 | Aetna medicare ppo facility · fee schedule · outpatient | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
| 3 | Blue Cross Blue Shield medicare hmo facility · fee schedule · outpatient | $4.3k | $4.3k | — | — | — | $4.3k – $4.3k |
| 4 | UnitedHealthcare medicare hmo facility · fee schedule · outpatient | $4.6k | $4.6k | — | — | — | $4.6k – $4.6k |
| 5 | Aetna medicare hmo facility · fee schedule · outpatient | $5.0k | $5.0k | — | — | — | $5.0k – $5.0k |
| 6 | Cigna medicare hmo facility · fee schedule · outpatient | $5.0k | $5.0k | — | — | — | $5.0k – $5.0k |
| 7 | Humana medicare hmo facility · fee schedule · outpatient | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 8 | WellCare medicare hmo facility · fee schedule · outpatient | $6.0k | $6.0k | — | — | — | $6.0k – $6.0k |
| 9 | Molina medicare hmo facility · percent of total billed charges · outpatientfrom % of charges | $7.6k | $7.6k | — | — | — | $7.6k – $7.6k |
| 10 | UnitedHealthcare medicaid hmo facility · case rate · outpatient | $8.7k | $8.7k | — | — | — | $8.7k – $8.7k |
| 11 | Humana medicaid hmo facility · case rate · outpatient | $8.8k | $8.8k | — | — | — | $8.8k – $8.8k |
| 12 | Molina medicaid hmo facility · case rate · outpatient | $8.9k | $8.9k | — | — | — | $8.9k – $8.9k |
| 13 | Aetna medicaid hmo facility · case rate · outpatient | $9.1k | $9.1k | — | — | — | $9.1k – $9.1k |
| 14 | Ambetter commercial select core facility · fee schedule · outpatient | $9.7k | $9.7k | — | — | — | $9.7k – $9.7k |
| 15 | Ambetter commercial value facility · fee schedule · outpatient | $11.0k | $11.0k | — | — | — | $11.0k – $11.0k |
| 16 | Blue Cross Blue Shield commercial hmo my blue facility · percent of total billed charges · outpatientfrom % of charges | $13.5k | $13.5k | — | — | — | $13.5k – $13.5k |
| 17 | Blue Cross Blue Shield commercial hmo simply blue facility · percent of total billed charges · outpatientfrom % of charges | $17.8k | $17.8k | — | — | — | $17.8k – $17.8k |
| 18 | Blue Cross Blue Shield commercial ppo blue select facility · percent of total billed charges · outpatientfrom % of charges | $18.3k | $18.3k | — | — | — | $18.3k – $18.3k |
| 19 | Aetna commercial other facility · percent of total billed charges · outpatientfrom % of charges | $19.6k | $19.6k | — | — | — | $19.6k – $19.6k |
| 20 | Aetna commercial hmo facility · percent of total billed charges · outpatientfrom % of charges | $20.5k | $20.5k | — | — | — | $20.5k – $20.5k |
| 21 | Blue Cross Blue Shield commercial hmo health options facility · percent of total billed charges · outpatientfrom % of charges | $21.6k | $21.6k | — | — | — | $21.6k – $21.6k |
| 22 | Cigna commercial hmo facility · percent of total billed charges · outpatientfrom % of charges | $22.3k | $22.3k | — | — | — | $22.3k – $22.3k |
| 23 | UnitedHealthcare commercial hmo facility · percent of total billed charges · outpatientfrom % of charges | $22.6k | $22.6k | — | — | — | $22.6k – $22.6k |
| 24 | Blue Cross Blue Shield commercial ppo network blue facility · percent of total billed charges · outpatientfrom % of charges | $22.8k | $22.8k | — | — | — | $22.8k – $22.8k |
| 25 | Molina commercial other facility · percent of total billed charges · inpatientfrom % of charges | $23.9k | $23.9k | — | — | — | $23.9k – $23.9k |
Last updated: Jan 1, 2026
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