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
DIPYRIDAMOLE 5 MG/ML INTRAVENOUS SOLUTION
Low
$1
Average
$73
Median
$17
High
$1.3k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
30 hospitals; the 90th percentile is 20.5× 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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37 hospital rates
iThe hospitals that file a Medicaid 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 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 1 | $22 | $22 | — | — | — | $22 – $22 |
| 2 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 3 | CentraState Medical Center Freehold Township, NJ percent of total billed charges · bothfrom % of charges | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 4 | Chilton Medical Center Pompton Plains, NJ percent of total billed charges · bothfrom % of charges | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 5 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $4 | $4 | — | — | — | $4 – $4 |
| 6 | Grossmont Hospital Corporation La Mesa, CA percent of total billed charges · outpatientfrom % of charges | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 7 | HealthAlliance - Clinton Hospital MA 01453; 201 Highland St Clinton, MA percent of total billed charges · bothfrom % of charges | 1 | $75 | $75 | — | — | — | $75 – $75 |
| 8 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $96 | $96 | $3 | 3% | — | $93 – $99 |
| 9 | Laredo Texas Hospital Company LP Laredo, TX facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 10 | Longview Medical Center LP Longview, TX facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 11 | Lowell General Hospital Lowell, MA percent of total billed charges · bothfrom % of charges | 1 | $63 | $63 | — | — | — | $63 – $63 |
| 12 | Mercy Hospital Ardmore Inc Ardmore, OK facility · fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 13 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 2 | $72 | $72 | $52 | 73% | — | $19 – $124 |
| 14 | Mercy Hospital Fort Smith Smith, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 15 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 2 | $72 | $72 | $52 | 73% | — | $19 – $124 |
| 16 | Mercy Hospital Fort Smith Smith, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $19 | $19 | — | — | — | $19 – $19 |
| 17 | Mercy Hospital Ozark Ozark, AR facility · fee schedule · outpatient | 2 | $72 | $72 | $52 | 73% | — | $19 – $124 |
| 18 | Mercy Hospital Paris Paris, AR facility · fee schedule · outpatient | 2 | $72 | $72 | $52 | 73% | — | $19 – $124 |
| 19 | Mercy Hospital Springfield Ozark, MO facility · fee schedule · outpatient | 2 | $72 | $72 | $52 | 73% | — | $19 – $124 |
| 20 | Mercy Hospital Springfield Ozark, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 21 | Mercy Hospital Springfield Springfield, MO facility · fee schedule · outpatient | 2 | $72 | $72 | $52 | 73% | — | $19 – $124 |
| 22 | Mercy Hospital Springfield Springfield, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 23 | Mercy Perry Perryville, MO facility · percent of total billed charges · outpatientfrom % of charges | 2 | $16 | $16 | $2 | 14% | — | $14 – $18 |
| 24 | Morristown Medical Center Morristown, NJ percent of total billed charges · bothfrom % of charges | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 25 | Newton Medical Center Newton, NJ percent of total billed charges · bothfrom % of charges | 1 | $20 | $20 | — | — | — | $20 – $20 |
← Payers reporting HCPCS J1245 · Snapshot 20261111T120946Z-9134e7f7