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
PHARMACY - EXTENSION OF 025X - DRUGS REQUIRING DETAILED CODING (A)
Low
$1
Average
$465
Median
$30
High
$2.4k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
23 hospitals; the 90th percentile is 91.4× 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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26 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 | $54 | $54 | — | — | — | $54 – $54 |
| 2 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 3 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · fee schedule · outpatient | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 4 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · fee schedule · outpatient | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 5 | Allina Health Systems Minneapolis, MN facility · fee schedule · outpatient | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 6 | CATHOLIC HEALTH INITIATIVES COLORADO Salt Lake City, UT fee schedule · outpatient | 1 | $28 | $28 | — | — | — | $28 – $28 |
| 7 | Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient | 1 | $786 | $786 | — | — | — | $786 – $786 |
| 8 | Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both | 1 | $30 | $30 | — | — | — | $30 – $30 |
| 9 | Geisinger Medical Center Muncy, PA fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 10 | HANFORD COMMUNITY HOSPITAL Selma, CA fee schedule · outpatient | 1 | $41 | $41 | — | — | — | $41 – $41 |
| 11 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $2.4k | $2.4k | $71 | 3% | — | $2.3k – $2.4k |
| 12 | Hospital Service District #1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System Houma, LA facility · other · outpatient | 1 | $1.3k | $1.3k | — | — | — | $1.3k – $1.3k |
| 13 | INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient | 1 | $786 | $786 | — | — | — | $786 – $786 |
| 14 | Laredo Texas Hospital Company LP Laredo, TX facility · fee schedule · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 15 | Mercy Hospital Ada Inc Ada, OK facility · fee schedule · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 16 | Mercy Hospital Ardmore Inc Ardmore, OK facility · fee schedule · outpatient | 1 | $1.1k | $1.1k | — | — | — | $1.1k – $1.1k |
| 17 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 2 | $1.1k | $1.1k | $58 | 5% | — | $1.0k – $1.1k |
| 18 | Mercy Hospital Fort Smith Smith, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $741 | $741 | — | — | — | $741 – $741 |
| 19 | Mercy Hospital Fort Smith Smith, AR facility · fee schedule · outpatient | 2 | $1.1k | $1.1k | $58 | 5% | — | $1.0k – $1.1k |
| 20 | Mercy Hospital Fort Smith Smith, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $741 | $741 | — | — | — | $741 – $741 |
| 21 | Mercy Hospital South Louis, MO facility · percent of total billed charges · outpatientfrom % of charges | 2 | $923 | $923 | $132 | 14% | — | $791 – $1.1k |
| 22 | Northwest Hospital LLC Tucson, AZ facility · other · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 23 | Ohio State University Hospitals Columbus, OH fee schedule · outpatient | 1 | $1 | $1 | — | — | — | $1 – $1 |
| 24 | Oro Valley Hospital LLC Tucson, AZ facility · other · outpatient | 1 | $23 | $23 | — | — | — | $23 – $23 |
| 25 | Victoria of Texas LP Victoria, TX facility · fee schedule · outpatient | 1 | $19 | $19 | — | — | — | $19 – $19 |
← Payers reporting HCPCS J2407 · Snapshot 20261111T120946Z-9134e7f7