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
RIBOFLAV5 & RIBOFLAV5-DEXTRAN 0.146 &0.146-20 % OPHTH SOSY
Low
$0
Average
$2.4k
Median
$2.0k
High
$7.8k
Each hospital's average WellCare rate, under the methodology and billing class chosen below.
18 hospitals; the 90th percentile is 368853.0× 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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19 hospital rates
iThe hospitals that file a WellCare 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 | North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges | 1 | $7.8k | $7.8k | — | — | 1–10 | $7.8k – $7.8k |
| 2 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges | 1 | $2.4k | $2.4k | — | — | — | $2.4k – $2.4k |
| 3 | Atrium Health Hospitals Inc Lincolnton, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1.9k | $1.9k | — | — | — | $1.9k – $1.9k |
| 4 | Atrium Health Hospitals Inc Wadesboro, NC percent of total billed charges · outpatientfrom % of charges | 1 | $2.5k | $2.5k | — | — | — | $2.5k – $2.5k |
| 5 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 6 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 7 | Carolinas Medical Center Davidson, NC percent of total billed charges · outpatientfrom % of charges | 1 | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 8 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 9 | Penn Medicine Princeton Medical Center Princeton, NJ facility · other · outpatient | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 10 | The Charlotte Mecklenburg Hospital Authority Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 11 | The Charlotte Mecklenburg Hospital Authority Kannapolis, NC percent of total billed charges · outpatientfrom % of charges | 1 | $2.1k | $2.1k | — | — | — | $2.1k – $2.1k |
| 12 | The Charlotte Mecklenburg Hospital Authority Waxhaw, NC percent of total billed charges · outpatientfrom % of charges | 1 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 13 | The Charlotte Mecklenburg Hospital Authority Huntersville, NC percent of total billed charges · outpatientfrom % of charges | 1 | $1.7k | $1.7k | — | — | — | $1.7k – $1.7k |
| 14 | The Charlotte Mecklenburg Hospital Authority Albemarle, NC percent of total billed charges · outpatientfrom % of charges | 1 | $2.0k | $2.0k | — | — | — | $2.0k – $2.0k |
| 15 | Vanderbilt Bedford Hospital Shelbyville, TN fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 16 | Vanderbilt Tullahoma-Harton Hospital Tullahoma, TN fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 17 | Vanderbilt University Medical Center Nashville, TN fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 18 | Vanderbilt University Medical Center Nashville, TN percent of total billed charges · bothfrom % of charges | 1 | $3.0k | $3.0k | — | — | — | $3.0k – $3.0k |
| 19 | Vanderbilt Wilson County Hospital Lebanon, TN fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
← Payers reporting HCPCS J2787 · Snapshot 20261111T120946Z-9134e7f7