HC ED UNLISTED THERAPEUTIC PROPH/DX IV/IA NJX/NFS CDM - as described in hospitals' own price files.
| Hospital | Location | Cash price | Typical insurance | List price | Negotiated range |
|---|
| Swedish Medical Center / Cherry Hill | Seattle, WA | $45.12 | - | $94.00 | - |
| Swedish Issaquah | Issaquah, WA | $45.12 | - | $94.00 | - |
| Covenant Hospital Plainview | Plainview, TX | $49.14 | - | $117 | - |
| Covenant Medical Center | Lubbock, TX | $53.76 | - | $128 | - |
| Providence Redwood Memorial Hospital | Fortuna, CA | $54.06 | - | $106 | - |
| St. Patrick Hospital | Missoula, MT | $60.00 | - | $75.00 | - |
| Providence St. Jude Medical Center | Fullerton, CA | $62.40 | - | $130 | - |
| Covenant Health Hobbs Hospital | Hobbs, NM | $63.00 | - | $150 | - |
| Covenant Hospital Levelland | Levelland, TX | $65.10 | - | $155 | - |
| Providence Regional Medical Center Everett | Everett, WA | $70.20 | - | $135 | - |
| Providence Mount Carmel Hospital | Colville, WA | $74.20 | - | $106 | - |
| Providence St. Joseph Hospital | Chewelah, WA | $74.20 | - | $106 | - |
| Providence Queen Of The Valley Medical Center | Napa, CA | $82.62 | - | $162 | - |
| Petaluma Valley Hospital | Petaluma, CA | $86.19 | - | $169 | - |
| Providence Newberg Medical Center | Newberg, OR | $86.25 | - | $115 | - |
| Providence Milwaukie Hospital | Milwaukie, OR | $86.25 | - | $115 | - |
| Providence St. Vincent Medical Center | Portland, OR | $86.25 | - | $115 | - |
| Providence Portland Medical Center | Portland, OR | $86.25 | - | $115 | - |
| Providence Willamette Falls Medical Center | Oregon City, OR | $86.25 | - | $115 | - |
| Providence Hood River Memorial Hospital | Hood River, OR | $93.75 | - | $125 | - |
| Providence Medford Medical Center | Medford, OR | $93.75 | - | $125 | - |
| Providence St. Joseph Hospital | Eureka, CA | $94.56 | - | $197 | - |
| Providence Seward Hospital | Seward, AK | $95.16 | - | $122 | - |
| Providence Valdez Medical Center | Valdez, AK | $95.16 | - | $122 | - |
| Providence Holy Family Hospital | Spokane, WA | $100 | - | $143 | - |
| Providence Centralia Hospital | Centralia, WA | $100 | - | $193 | - |
| Providence St. Peter Hospital | Olympia, WA | $100 | - | $193 | - |
| Providence Seaside Hospital | Seaside, OR | $105 | - | $140 | - |
| Providence Kodiak Island Medical Ctr | Kodiak, AK | $109 | - | $140 | - |
| Providence Santa Rosa Memorial Hospital | Santa Rosa, CA | $113 | - | $222 | - |
| Kadlec Regional Medical Center | Richland, WA | $116 | - | $166 | - |
| Providence St. Mary Medical Center | Walla Walla, WA | $127 | - | $181 | - |
| St. Mary Medical Center | Long Beach, CA | $147 | - | $307 | - |
Prices are from each hospital's own machine-readable price file. Cash price is the published discounted cash price; typical insurance price is the median of the per-plan negotiated rates in the file; list price is the gross charge.