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
Phytonadione 1 MG/0.5 ML Ampul
Low
$2
Average
$50
Median
$14
High
$763
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
103 hospitals; the 90th percentile is 49.4× 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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166 hospital rates
iThe hospitals that file a Wellmark 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 | Lakes Regional Hospital Spirit Lake, IA fee schedule · outpatient | 2 | $2 | $2 | — | — | 4–40 | $2 – $2 |
| 2 | Osceola Regional Health Center Sibley, IA fee schedule · outpatient | 2 | $2 | $2 | — | — | 4–40 | $2 – $2 |
| 3 | Avera St. Luke's Aberdeen, SD outpatient | 1 | $25 | $25 | — | — | 3–30 | $25 – $25 |
| 4 | Avera St. Luke's Aberdeen, SD fee schedule · outpatient | 1 | $2 | $2 | — | — | 3–30 | $2 – $2 |
| 5 | Platte Healthcare Platte, SD outpatient | 1 | $81 | $81 | — | — | 1–10 | $81 – $81 |
| 6 | Platte Healthcare Platte, SD percent of total billed charges · outpatientfrom % of charges | 1 | $81 | $81 | — | — | 1–10 | $81 – $81 |
| 7 | Spencer Municipal Hospital Spencer, IA fee schedule · inpatient | 1 | $3 | $3 | — | — | 1–10 | $3 – $3 |
| 8 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · inpatient | 2 | $63 | $63 | $6 | 9% | — | $57 – $71 |
| 9 | ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA Corning, IA fee schedule · outpatient | 2 | $3 | $3 | — | — | — | $3 – $3 |
| 10 | ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM Council Bluffs, IA fee schedule · outpatient | 2 | $3 | $3 | — | — | — | $3 – $3 |
| 11 | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · inpatient | 2 | $60 | $60 | $5 | 9% | — | $54 – $68 |
| 12 | ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA Missouri Valley, IA fee schedule · outpatient | 2 | $3 | $3 | — | — | — | $3 – $3 |
| 13 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 3 | $2 | $2 | — | — | — | $2 – $2 |
| 14 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · outpatient | 3 | $2 | $2 | — | — | — | $2 – $2 |
| 15 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · inpatientfrom % of charges | 1 | $63 | $75 | $24 | 33% | — | $51 – $112 |
| 16 | Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, IL percent of total billed charges · outpatientfrom % of charges | 1 | $63 | $75 | $24 | 33% | — | $51 – $112 |
| 17 | Avera Behavioral Health Hospital Sioux Falls, SD fee schedule · outpatient | 2 | $2 | $2 | — | — | — | $2 – $2 |
| 18 | Avera DeSmet De Smet, SD percent of total billed charges · inpatientfrom % of charges | 1 | $172 | $172 | — | — | — | $172 – $172 |
| 19 | Avera DeSmet De Smet, SD percent of total billed charges · outpatientfrom % of charges | 1 | $172 | $172 | — | — | — | $172 – $172 |
| 20 | Avera Dell Rapids Hospital Dell Rapids, SD percent of total billed charges · inpatientfrom % of charges | 1 | $183 | $183 | — | — | — | $183 – $183 |
| 21 | Avera Dell Rapids Hospital Dell Rapids, SD percent of total billed charges · outpatientfrom % of charges | 1 | $183 | $183 | — | — | — | $183 – $183 |
| 22 | Avera Flandreau Hospital Flandreau, SD percent of total billed charges · inpatientfrom % of charges | 1 | $158 | $158 | — | — | — | $158 – $158 |
| 23 | Avera Flandreau Hospital Flandreau, SD percent of total billed charges · outpatientfrom % of charges | 1 | $158 | $158 | — | — | — | $158 – $158 |
| 24 | Avera Heart Hospital Sioux Falls, SD fee schedule · outpatient | 2 | $2 | $2 | — | — | — | $2 – $2 |
| 25 | Avera Holy Family Hospital Estherville, IA fee schedule · outpatient | 2 | $2 | $2 | — | — | — | $2 – $2 |
← Payers reporting HCPCS J3430 · Snapshot 20261111T120946Z-9134e7f7