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
DRUG SCRN QUAN LEVETIRACETAM
Low
$4
Average
$1.6k
Median
$22
High
$3284.7k
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
2196 hospitals; the 90th percentile is 11.0× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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3,626 hospital rates
iThe hospitals that file a UnitedHealthcare rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS other · outpatient | 1 | $14 | $14 | — | — | 60 | $14 – $14 |
| 2 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS fee schedule · outpatient | 1 | $22 | $22 | — | — | 58 | $22 – $22 |
| 3 | Public Hospital Dis No 1 Skagit dba Skagit Valley Hospital Vernon, WA fee schedule · both | 2 | $15 | $15 | $1 | 7% | 42 | $14 – $16 |
| 4 | METHODIST LEBONHEUR CHILDRENS HOSP TN 38301; 7691 POPLAR AVE. MEMPHIS, TN fee schedule · both | 5 | $13 | $20 | $15 | 73% | 36–45 | $12 – $50 |
| 5 | Missouri Baptist Medical Center Saint Louis, MO fee schedule · both | 2 | $15 | $15 | $1 | 8% | 31 | $14 – $16 |
| 6 | Appalachian Regional Healthcare, Inc. Hazard, KY other · outpatient | 1 | $13 | $13 | — | — | 26 | $13 – $13 |
| 7 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Omaha, NE fee schedule · outpatient | 3 | $37 | $35 | $17 | 49% | 25 | $13 – $56 |
| 8 | Christian Hospital St. Louis, MO fee schedule · both | 2 | $15 | $15 | $1 | 8% | 23–32 | $14 – $16 |
| 9 | ST JOSEPH REGIONAL HEALTH CENTER Bryan, TX fee schedule · outpatient | 6 | $13 | $17 | $6 | 38% | 23–32 | $11 – $26 |
| 10 | Fairview Health Services Minneapolis, MN other · inpatient | 3 | $23 | $22 | $7 | 31% | 22–76 | $13 – $30 |
| 11 | Weeks Medical Center Lancaster, NH facility · fee schedule · both | 1 | $52 | $52 | — | — | 22–31 | $52 – $52 |
| 12 | CHI St. Vincent Hospital Hot Springs Hot Springs, AR fee schedule · outpatient | 3 | $13 | $13 | $0 | 1% | 21 | $13 – $14 |
| 13 | Holy Cross Hospital-Silver Spring Silver Spring, MD facility · percent of total billed charges · bothfrom % of charges | 3 | $41 | $41 | $1 | 3% | 15–150 | $40 – $43 |
| 14 | Appalachian Regional Healthcare, Inc. Liberty, KY percent of total billed charges · outpatientfrom % of charges | 2 | $230 | $180 | $71 | 39% | 14–23 | $80 – $230 |
| 15 | Brigham and Women's Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 2 | $183 | $183 | — | — | 14–23 | $183 – $183 |
| 16 | Sturdy Memorial Hospital Attleboro, MA percent of total billed charges · outpatientfrom % of charges | 1 | $13 | $13 | — | — | 14 | $13 – $13 |
| 17 | TRINITY HOSPITAL HOLDING COMPANY St.Clairsville, OH fee schedule · outpatient | 3 | $166 | $115 | $72 | 63% | 14 | $13 – $166 |
| 18 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 1 | $13 | $13 | — | — | 13 | $13 – $13 |
| 19 | ALEGENT HEALTH IMMANUEL MEDICAL CENTER Omaha, NE fee schedule · outpatient | 3 | $30 | $33 | $17 | 53% | 12 | $13 – $56 |
| 20 | Appalachian Regional Healthcare, Inc. Williamson, KY other · outpatient | 1 | $13 | $13 | — | — | 12 | $13 – $13 |
| 21 | GRMC, Inc. Oakland, MD percent of total billed charges · bothfrom % of charges | 2 | $30 | $30 | $2 | 8% | 12–120 | $27 – $34 |
| 22 | Spencer Municipal Hospital Spencer, IA percent of total billed charges · outpatientfrom % of charges | 1 | $135 | $135 | — | — | 12 | $135 – $135 |
| 23 | Parkland Health Dallas, TX facility · percent of total billed charges · bothfrom % of charges | 2 | $27 | $27 | — | — | 11 | $27 – $27 |
| 24 | ROBERT PACKER HOSPITAL Doing Business As: ROBERT PACKER HOSPITAL, TOWANDA CAMPUS Towanda, PA facility · other · outpatient | 1 | $13 | $13 | — | — | 11 | $13 – $13 |
| 25 | UKIAH ADVENTIST HOSPITAL Ukiah, CA percent of total billed charges · outpatientfrom % of charges | 2 | $118 | $84 | $53 | 63% | 6–60 | $9 – $127 |
← Payers reporting CPT 80177 · Snapshot 20261112T181611Z-3fa9fb76