HCPCS S0126
Injection, follitropin alfa, 75 iu
Current code15 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Island Hospital | — | — | — |
| Kadlec Regional Medical Center | $306 | — | — |
| Olympic Medical Center | — | — | — |
| Overlake Hospital Medical Center & Clinics | $458 – $2,463 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $266 – $493 | — | — |
| Providence Centralia Hospital | $621 | — | — |
| Providence Holy Family Hospital | $266 – $493 | — | — |
| Providence Regional Medical Center Everett | $266 – $493 | — | — |
| Providence St Mary Medical Center | $493 | — | — |
| Providence St Peter Hospital | $512 | — | — |
| Swedish Edmonds Hospital | $266 | — | — |
| Swedish Issaquah | $266 | — | — |
| Swedish Medical Center | $266 | — | — |
| Swedish Medical Center / Cherry Hill | $266 | — | — |
| Virginia Mason Medical Center | $770 – $874 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.