Signature Cross-Insurance Cost Matrix • NDC 00904682207Peripheral COMT (Catechol-O-Methyltransferase) Inhibitor

Entacapone (Comtan / Carbidopa-Levodopa-Entacapone Stalevo): Cost Across Insurances

Complete cell-by-cell comparison across Self-Pay Cash, Original Medicare, 6 Major California Commercial Payers (Anthem, Blue Shield, UnitedHealthcare, Aetna, Cigna, Kaiser Permanente), and Medi-Cal — with every cell labeled with its official data source and effective date.

1. Published Prices(Cash & Medicare)2. Plan-Adjusted(Payer MRF Rate)3. Verified Price(Real-Time 270/271 Check)

Accuracy Level — Tier 1 Published Prices: You are currently viewing general published hospital cash prices, Medicare baselines, and multi-payer ranges. Add your insurance card to unlock Tier 2 plan pricing and Tier 3 verified benefit checks.

Tier 1: General Published Rates Across 9 InsurancesEvery cell labeled with official Source + Date • “Not published” shown honestly where proprietary

Hospital procedure cells are extracted from 14 Bay Area hospital MRFs (45 CFR § 180.50, Oct 2026); medication cells use CMS NADAC (as of 2026-10-28) & CY 2026 Medicare Part D / Medi-Cal Rx rules.

Parkinson's Service / Medication
Self-Pay / Cash Price
Hospital MRF / Retail Cash
Medicare Rate
2026 CMS / NADAC / Part D
Anthem Blue Cross
MRF Negotiated / Formulary
Blue Shield of CA
MRF Negotiated / Formulary
UnitedHealthcare
MRF Negotiated / Formulary
Aetna
MRF Negotiated / Formulary
Cigna
MRF Negotiated / Formulary
Kaiser Permanente
MRF Negotiated / Formulary
Medi-Cal (CA Medicaid)
CA DHCS / Medi-Cal Rx
MedicationNDC 00904682207
Entacapone (Comtan / Carbidopa-Levodopa-Entacapone Stalevo)
$28 – $95 / 30 days (120 generic entacapone tablets)

$28 – $95 / 30 days (120 generic entacapone tablets); $75 – $185 / 30 days (120 generic Stalevo combination tablets)

Source: CMS NADAC 2026 & Retail Pharmacy Cash Benchmarks (Oct 2026)
Date: Oct 2026
NADAC: $39.81 / 120 tablets (Entacapone)

ENTACAPONE 200 MG TABLET ($0.33178/EA) & CARBIDOPA-LEVODOPA-ENTACAPONE 25-100-200 MG TAB ($0.69423/EA) • Medicare Part D patient cost: $5 – $42 copay / 30 days

Source: CMS NADAC 2026 (data.medicaid.gov Dataset fbb83258-11c7-47f5-8b18-5f8e79f7e704) & CMS CY 2026 Medicare Part D Public Formulary File (Oct 2026)
Date: 2026-10-28
$5–$20 / 30d (Tier 1/2 Copay)

Tier 2 Generic; no PA. (Covered CA 2026 standard generic copay design; plan-specific PBM net rebate price not publicly published)

Source: Covered CA 2026 Standard Benefit Design & Anthem Blue Cross CA Commercial Formulary
Date: Oct 2026
$5–$20 / 30d (Tier 1/2 Copay)

Tier 2 Generic; no PA. (Covered CA 2026 standard generic copay design; plan-specific PBM net rebate price not publicly published)

Source: Covered CA 2026 Standard Benefit Design & Blue Shield of CA CA Commercial Formulary
Date: Oct 2026
$5–$20 / 30d (Tier 1/2 Copay)

Tier 2 Generic; no PA. (Covered CA 2026 standard generic copay design; plan-specific PBM net rebate price not publicly published)

Source: Covered CA 2026 Standard Benefit Design & UnitedHealthcare CA Commercial Formulary
Date: Oct 2026
$5–$20 / 30d (Tier 1/2 Copay)

Tier 2 Generic; no PA. (Covered CA 2026 standard generic copay design; plan-specific PBM net rebate price not publicly published)

Source: Covered CA 2026 Standard Benefit Design & Aetna CA Commercial Formulary
Date: Oct 2026
$5–$20 / 30d (Tier 1/2 Copay)

Tier 2 Generic; no PA. (Covered CA 2026 standard generic copay design; plan-specific PBM net rebate price not publicly published)

Source: Covered CA 2026 Standard Benefit Design & Cigna CA Commercial Formulary
Date: Oct 2026
$5–$20 / 30d (Tier 1/2 Copay)

Formulary Generic; no PA. (Covered CA 2026 standard generic copay design; plan-specific PBM net rebate price not publicly published)

Source: Covered CA 2026 Standard Benefit Design & Kaiser Permanente CA Commercial Formulary
Date: Oct 2026
$0 patient copay

$0 copay on Medi-Cal Rx Contract Drug List.

Source: CA DHCS Medi-Cal Rx Contract Drug List (CDL) & PA Policy
Date: Oct 2026
Audit-Grade Cell Verification (9/9 Insurance Columns Sourced)

Every Insurance Cell for Entacapone — With Source & Date Citations

Tier 1 Cash Baseline Published Rate

Self-Pay / Discounted Cash Price

$28 – $95 / 30 days (120 generic entacapone tablets)

$28 – $95 / 30 days (120 generic entacapone tablets); $75 – $185 / 30 days (120 generic Stalevo combination tablets)

Official Source: CMS NADAC 2026 & Retail Pharmacy Cash Benchmarks (Oct 2026)
Effective / Verified Date: Oct 2026
Federal Benchmark Published Rate

Original Medicare (CMS 2026 / NADAC / Part D)

NADAC: $39.81 / 120 tablets (Entacapone)

ENTACAPONE 200 MG TABLET ($0.33178/EA) & CARBIDOPA-LEVODOPA-ENTACAPONE 25-100-200 MG TAB ($0.69423/EA) • Medicare Part D patient cost: $5 – $42 copay / 30 days

Official Source: CMS NADAC 2026 (data.medicaid.gov Dataset fbb83258-11c7-47f5-8b18-5f8e79f7e704) & CMS CY 2026 Medicare Part D Public Formulary File (Oct 2026)
Effective / Verified Date: 2026-10-28
Commercial & MA MRF Published Rate

Anthem Blue Cross (California)

$5–$20 / 30d (Tier 1/2 Copay)

Tier 2 Generic; no PA. (Covered CA 2026 standard generic copay design; plan-specific PBM net rebate price not publicly published)

Official Source: Covered CA 2026 Standard Benefit Design & Anthem Blue Cross CA Commercial Formulary
Effective / Verified Date: Oct 2026
Commercial & MA MRF Published Rate

Blue Shield of California

$5–$20 / 30d (Tier 1/2 Copay)

Tier 2 Generic; no PA. (Covered CA 2026 standard generic copay design; plan-specific PBM net rebate price not publicly published)

Official Source: Covered CA 2026 Standard Benefit Design & Blue Shield of CA CA Commercial Formulary
Effective / Verified Date: Oct 2026
Commercial & MA MRF Published Rate

UnitedHealthcare (UHC)

$5–$20 / 30d (Tier 1/2 Copay)

Tier 2 Generic; no PA. (Covered CA 2026 standard generic copay design; plan-specific PBM net rebate price not publicly published)

Official Source: Covered CA 2026 Standard Benefit Design & UnitedHealthcare CA Commercial Formulary
Effective / Verified Date: Oct 2026
Commercial & MA MRF Published Rate

Aetna

$5–$20 / 30d (Tier 1/2 Copay)

Tier 2 Generic; no PA. (Covered CA 2026 standard generic copay design; plan-specific PBM net rebate price not publicly published)

Official Source: Covered CA 2026 Standard Benefit Design & Aetna CA Commercial Formulary
Effective / Verified Date: Oct 2026
Commercial MRF Published Rate

Cigna

$5–$20 / 30d (Tier 1/2 Copay)

Tier 2 Generic; no PA. (Covered CA 2026 standard generic copay design; plan-specific PBM net rebate price not publicly published)

Official Source: Covered CA 2026 Standard Benefit Design & Cigna CA Commercial Formulary
Effective / Verified Date: Oct 2026
Integrated HMO / MRF Published Rate

Kaiser Permanente (Northern CA)

$5–$20 / 30d (Tier 1/2 Copay)

Formulary Generic; no PA. (Covered CA 2026 standard generic copay design; plan-specific PBM net rebate price not publicly published)

Official Source: Covered CA 2026 Standard Benefit Design & Kaiser Permanente CA Commercial Formulary
Effective / Verified Date: Oct 2026
$0 Safety-Net Published Rate

Medi-Cal (California Medicaid / Medi-Cal Rx)

$0 patient copay

$0 copay on Medi-Cal Rx Contract Drug List.

Official Source: CA DHCS Medi-Cal Rx Contract Drug List (CDL) & PA Policy
Effective / Verified Date: Oct 2026
CMS NADAC & Medicare Part D Formulary Details

Entacapone (Comtan / Carbidopa-Levodopa-Entacapone Stalevo) — Clinical & Formulary Summary

Open Full Medication Page

What it's for: Taken with each dose of levodopa/carbidopa to block peripheral COMT breakdown of levodopa, extending the duration of each levodopa dose ('ON' time). (Source: NINDS & FDA Prescribing Information)

CMS NADAC Baseline (2026-10-28)
ENTACAPONE 200 MG TABLET ($0.33178/EA) & CARBIDOPA-LEVODOPA-ENTACAPONE 25-100-200 MG TAB ($0.69423/EA)
30-Day Baseline: $39.81 / 120 tablets (Entacapone) • $83.31 / 120 tablets (Combo)
Source: CMS NADAC 2026 (data.medicaid.gov Dataset fbb83258-11c7-47f5-8b18-5f8e79f7e704)
2026 Medicare Part D Formulary Status
Tier: Tier 2 or Tier 3 (Generic)
Prior Auth: No
2026 Patient Cost: $5 – $42 copay / 30 days