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 HCl (Premix)
Low
$0
Average
$37
Median
$1
High
$219
Each hospital's average Tricare rate, under the methodology and billing class chosen below.
33 hospitals; the 90th percentile is 774.2× 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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35 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 | Aspen Valley Hospital District Aspen, CO facility · percent of total billed charges · bothfrom % of charges | 4 | $68 | $70 | $27 | 38% | — | $37 – $129 |
| 2 | CORNING HOSPITAL Corning, NY facility · other · outpatient | 1 | $163 | $163 | $65 | 40% | — | $65 – $261 |
| 3 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · inpatientfrom % of charges | 1 | $0 | $0 | $0 | 35% | — | $0 – $0 |
| 4 | Fisher-Titus Medical Center Norwalk, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | $0 | 31% | — | $0 – $0 |
| 5 | HOULTON REGIONAL HOSPITAL HOULTON, ME percent of total billed charges · bothfrom % of charges | 1 | $21 | $21 | — | — | — | $21 – $21 |
| 6 | Kaweah Health Medical Center Visalia, CA facility · fee schedule · outpatient | 1 | $100 | $93 | $62 | 67% | — | $1 – $176 |
| 7 | Kaweah Health Mental Health Hospital Visalia, CA facility · fee schedule · outpatient | 1 | $100 | $93 | $62 | 67% | — | $1 – $176 |
| 8 | Kaweah Health Rehabilitation Hospital Visalia, CA facility · fee schedule · outpatient | 1 | $100 | $93 | $62 | 67% | — | $1 – $176 |
| 9 | MCLAREN CARO REGION CARO, MI fee schedule | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 10 | MCLAREN THUMB REGION AXE, MI fee schedule | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 11 | McLeod Health Dillon, SC fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 12 | McLeod Health Cheraw, SC fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 13 | McLeod Health Manning, SC fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 14 | McLeod Health Florence, SC fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 15 | McLeod Health Beach, SC fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 16 | McLeod Health Loris, SC fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 17 | McLeod Health River, SC fee schedule · both | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 18 | MedStar Franklin Square Medical Center Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | $0 | 4% | — | $0 – $0 |
| 19 | MedStar Good Samaritan Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $1 | $1 | $0 | 7% | — | $1 – $1 |
| 20 | MedStar Harbor Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $1 | $1 | $0 | 7% | — | $0 – $1 |
| 21 | MedStar Montgomery Medical Center Olney, MD percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | $0 | 6% | — | $0 – $0 |
| 22 | MedStar Southern Hospital Center Clinton, MD percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | $0 | 7% | — | $0 – $1 |
| 23 | MedStar St. Mary's Hospital Leonardtown, MD percent of total billed charges · outpatientfrom % of charges | 1 | $0 | $0 | $0 | 8% | — | $0 – $0 |
| 24 | MedStar Union Memorial Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $1 | $1 | $0 | 7% | — | $1 – $1 |
| 25 | Mercy Hospital Berryville Berryville, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $27 | $27 | $11 | 40% | — | $11 – $44 |
← Payers reporting HCPCS J3375 · Snapshot 20261111T120946Z-9134e7f7