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
VANCOMYCIN-(PEG) 1.25 GRAM/250 ML IV PGBK [179221]
Low
$19
Average
$95
Median
$125
High
$179
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
20 hospitals; the 90th percentile is 5.8× 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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20 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 | ACADIA GENERAL HOSPITAL, INC 1305 CROWLEY RAYNE HWY other · outpatient | 1 | $179 | $179 | $32 | 18% | — | $147 – $211 |
| 2 | Baptist Medical Center-Attala Kosciusko, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $26 | $26 | $6 | 22% | — | $16 – $34 |
| 3 | Baptist Medical Center-Yazoo Yazoo City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $25 | $25 | $6 | 22% | — | $15 – $33 |
| 4 | Baptist Memorial Hospital - Leake Carthage, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $25 | $25 | $6 | 22% | — | $15 – $33 |
| 5 | Baptist Memorial Hospital-Calhoun Calhoun City, MS facility · percent of total billed charges · outpatientfrom % of charges | 1 | $32 | $32 | $7 | 22% | — | $19 – $42 |
| 6 | Hospital Authority of Colquitt County Moultrie, GA fee schedule · both | 1 | $150 | $150 | — | — | — | $150 – $150 |
| 7 | LAFAYETTE GENERAL MEDICAL CENTER INC Lafayette, LA other · outpatient | 1 | $147 | $147 | — | — | — | $147 – $147 |
| 8 | MACON COMMUNITY HOSPITAL LAFAYETTE, TN percent of total billed charges · bothfrom % of charges | 1 | $19 | $19 | $3 | 18% | — | $16 – $22 |
| 9 | McLeod Health Dillon, SC percent of total billed charges · bothfrom % of charges | 1 | $152 | $146 | $43 | 30% | — | $107 – $255 |
| 10 | McLeod Health Cheraw, SC percent of total billed charges · bothfrom % of charges | 1 | $143 | $139 | $38 | 28% | — | $107 – $255 |
| 11 | McLeod Health Manning, SC percent of total billed charges · bothfrom % of charges | 1 | $152 | $146 | $43 | 30% | — | $107 – $255 |
| 12 | McLeod Health Florence, SC percent of total billed charges · bothfrom % of charges | 1 | $152 | $146 | $43 | 30% | — | $107 – $255 |
| 13 | McLeod Health Beach, SC percent of total billed charges · bothfrom % of charges | 1 | $152 | $144 | $41 | 29% | — | $107 – $255 |
| 14 | McLeod Health Loris, SC percent of total billed charges · bothfrom % of charges | 1 | $152 | $144 | $41 | 29% | — | $107 – $255 |
| 15 | McLeod Health River, SC percent of total billed charges · bothfrom % of charges | 1 | $152 | $144 | $41 | 29% | — | $107 – $255 |
| 16 | Orange County Global Medical Center Santa Ana, CA facility · fee schedule · outpatient | 1 | $110 | $110 | — | — | — | $110 – $110 |
| 17 | Penn Medicine Princeton Medical Center Princeton, NJ facility · fee schedule · outpatient | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 18 | Pennsylvania Hospital of the University of Pennsylvania Health System Philadelphia, PA facility · fee schedule · outpatient | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 19 | Presbyterian Medical Center of the University of Pennsylvania Health System D/B/A Penn Presbyterian Medical Center Philadelphia, PA facility · fee schedule · outpatient | 1 | $44 | $44 | — | — | — | $44 – $44 |
| 20 | The Chester County Hospital West Chester, PA facility · fee schedule · outpatient | 1 | $44 | $44 | — | — | — | $44 – $44 |
← Payers reporting HCPCS J3372 · Snapshot 20261111T120946Z-9134e7f7