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
TREOSULFAN 50 MG/ML CHEMO INFUSION IN NS (WRAPPED)
Low
$27
Average
$349
Median
$31
High
$1.9k
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
6 hospitals; the 90th percentile is 34.5× 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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6 hospital rates
iThe hospitals that file a Tricare 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 | Butler Healthcare Providers_ DBA Butler Memorial Hospital Butler, PA facility · fee schedule · outpatient | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 2 | Clarion Hospital Clarion, PA facility · fee schedule · outpatient | 1 | $32 | $32 | — | — | — | $32 – $32 |
| 3 | Little Company of Mary Hospital of Indiana Inc Jasper, IN facility · case rate · outpatient | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 4 | Mayo Clinic Health System Cannon Falls 55009-5003 facility · fee schedule · both | 1 | $1.9k | $1.9k | $1.3k | 67% | — | $647 – $3.2k |
| 5 | NATIONWIDE CHILDREN'S HOSPITAL TOLEDO, LLC Toledo, OH facility · fee schedule · outpatient | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 6 | Nationwide Children's Hospital Columbus, OH facility · fee schedule · outpatient | 1 | $30 | $30 | — | — | — | $30 – $30 |
← Payers reporting HCPCS J0614 · Snapshot 20261111T120946Z-9134e7f7