ELAP Other Groups: disclosed hospital rates

iDirect answer

Based on the published hospital price files, ELAP Other Groups appears in disclosed negotiated rates across 1 hospital and 27 services. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.

27 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
ABATACEPT 250 MG IV SOLR Outpatient	Penn Medicine Lancaster General Health	J0129 HCPCS	$4,483	$4,483	$44.11 – $163	—
BELATACEPT 250 MG IV SOLR Outpatient	Penn Medicine Lancaster General Health	J0485 HCPCS	$2,775	$2,775	$3.85 – $14.17	—
BEZLOTOXUMAB 1000 MG/40ML IV SOLN Outpatient	Penn Medicine Lancaster General Health	J0565 HCPCS	$11,411	$11,411	$39.43 – $145	—
CAPECITABINE 150 MG ORAL TABS Outpatient	Penn Medicine Lancaster General Health	J8522 HCPCS	$105	$105	$0.04 – $0.14	—
CAPECITABINE 500 MG ORAL TABS Outpatient	Penn Medicine Lancaster General Health	J8522 HCPCS	$194	$194	$0.04 – $0.14	—
DONANEMAB-AZBT 350 MG/20ML IV SOLN Outpatient	Penn Medicine Lancaster General Health	J0175 HCPCS	$2,147	$2,147	$4.12 – $15.16	—
ELOTUZUMAB 300 MG IV SOLR Outpatient	Penn Medicine Lancaster General Health	J9176 HCPCS	$6,500	$6,500	$7.89 – $29.25	—
ELOTUZUMAB 400 MG IV SOLR Outpatient	Penn Medicine Lancaster General Health	J9176 HCPCS	$9,169	$9,169	$7.89 – $29.25	—
GEMTUZUMAB OZOGAMICIN 4.5 MG IV SOLR Outpatient	Penn Medicine Lancaster General Health	J9203 HCPCS	$25,936	$25,936	$237 – $874	—
IBUTILIDE FUMARATE 1 MG/10ML IV SOLN Outpatient	Penn Medicine Lancaster General Health	J1742 HCPCS	$254	$254	$197 – $723	—
INFLIXIMAB-ABDA 100 MG IV SOLR Outpatient	Penn Medicine Lancaster General Health	Q5104 HCPCS	$1,663	$1,663	$27.00 – $101	—
IPILIMUMAB 50 MG/10ML IV SOLN Outpatient	Penn Medicine Lancaster General Health	J9228 HCPCS	$24,479	$24,479	$183 – $680	—
LYMPHOCYTEANTI-THYMO IMM GLOB 50 MG/ML IV SOLN Outpatient	Penn Medicine Lancaster General Health	J7504 HCPCS	$12,958	$12,958	$5,135 – $19,321	—
NECITUMUMAB 800 MG/50ML IV SOLN Outpatient	Penn Medicine Lancaster General Health	J9295 HCPCS	$11,973	$11,973	$5.67 – $20.86	—
NIVOLUMAB 100 MG/10ML IV SOLN Outpatient	Penn Medicine Lancaster General Health	J9299 HCPCS	$9,801	$9,801	$32.96 – $122	—
NIVOLUMAB 40 MG/4ML IV SOLN Outpatient	Penn Medicine Lancaster General Health	J9299 HCPCS	$3,960	$3,960	$32.96 – $122	—
NIVOLUMAB-RELATLIMAB-RMBW 240-80 MG/20ML IV SOLN Outpatient	Penn Medicine Lancaster General Health	J9298 HCPCS	$41,645	$41,645	$198 – $734	—
ONABOTULINUMTOXINA 100 UNITS IJ SOLR Outpatient	Penn Medicine Lancaster General Health	J0585 HCPCS	$1,949	$1,949	$6.44 – $23.70	—
PEMBROLIZUMAB 100 MG/4ML IV SOLN Outpatient	Penn Medicine Lancaster General Health	J9271 HCPCS	$15,912	$15,912	$59.13 – $217	—
PEMETREXED DISODIUM 100 MG IV SOLR Outpatient	Penn Medicine Lancaster General Health	J9305 HCPCS	$2,426	$2,426	$3.56 – $13.08	—
PEMETREXED DISODIUM 500 MG IV SOLR Outpatient	Penn Medicine Lancaster General Health	J9305 HCPCS	$11,862	$11,862	$3.56 – $13.08	—
RAMUCIRUMAB 100 MG/10ML IV SOLN Outpatient	Penn Medicine Lancaster General Health	J9308 HCPCS	$4,481	$4,481	$74.36 – $275	—
RAMUCIRUMAB 500 MG/50ML IV SOLN Outpatient	Penn Medicine Lancaster General Health	J9308 HCPCS	$20,298	$20,298	$74.36 – $275	—
TEMSIROLIMUS 25 MG/ML IV SOLN Outpatient	Penn Medicine Lancaster General Health	J9330 HCPCS	$5,903	$5,903	$20.11 – $73.95	—
TRASTUZUMAB-DTTB 150 MG IV SOLR Outpatient	Penn Medicine Lancaster General Health	Q5112 HCPCS	$3,506	$3,506	$19.00 – $99.27	—