Dornase alfa inhalation solution, 2.5 mg

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

DORNASE ALFA 2.5 MG/2.5ML INH SOLN

Medicaid pricing summary

Low

Average

$171

Median

$126

High

$700

Medicaid rate distribution

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26 hospital rates

#		Plans
1	ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges	1	$148	$148	—	—	—	$148 – $148
2	ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges	1	$120	$120	—	—	—	$120 – $120
3	Berkshire Medical Center Great Barrington, MA facility · fee schedule · outpatient	2	$126	$126	—	—	—	$126 – $126
4	Childrens Hospital of Los Angeles Angeles, CA facility · other · outpatient	2	$55	$55	—	—	—	$55 – $55
5	Childrens Hospital of Los Angeles Angeles, CA professional · fee schedule · outpatient	2	$14	$14	—	—	—	$14 – $14
6	Cleveland Clinic Weston Hospital Nonprofit Corporation Weston, FL facility · case rate · outpatient	1	$65	$65	—	—	—	$65 – $65
7	Fairview Hospital Great Barrington, MA facility · fee schedule · outpatient	2	$254	$254	—	—	—	$254 – $254
8	Fairview Maple Grove Surgery Center Maple Grove, MN fee schedule · both	1	$59	$59	—	—	—	$59 – $59
9	Grossmont Hospital Corporation La Mesa, CA percent of total billed charges · inpatientfrom % of charges	1	$166	$166	$57	34%	—	$109 – $223
10	Grossmont Hospital Corporation La Mesa, CA percent of total billed charges · outpatientfrom % of charges	1	$109	$109	—	—	—	$109 – $109
11	Hospital Service District #1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System Houma, LA facility · other · outpatient	1	$173	$173	—	—	—	$173 – $173
12	INDIAN RIVER MEMORIAL HOSPITAL INC Vero Beach, FL facility · case rate · outpatient	1	$65	$65	—	—	—	$65 – $65
13	NYU Langone Mineola, NY case rate · outpatient	15	$112	$112	—	—	—	$112 – $112
14	NYU Langone Brooklyn, NY case rate · outpatient	15	$153	$153	—	—	—	$153 – $153
15	NYU Langone New York, NY case rate · outpatient	15	$156	$156	—	—	—	$156 – $156
16	NYU Langone Hospital?Suffolk Patchogue, NY case rate · outpatient	15	$106	$106	—	—	—	$106 – $106
17	North Adams Regional Hospital North Adams, MA facility · fee schedule · outpatient	1	$254	$254	—	—	—	$254 – $254
18	Ohio State University Hospitals Columbus, OH fee schedule · outpatient	1	$1	$1	—	—	—	$1 – $1
19	Sharp Chula Vista Medical Center Chula Vista, CA percent of total billed charges · inpatientfrom % of charges	1	$119	$119	$51	43%	—	$68 – $170
20	Sharp Chula Vista Medical Center Chula Vista, CA percent of total billed charges · outpatientfrom % of charges	1	$67	$67	—	—	—	$67 – $67
21	Sharp Coronado Hospital and Healthcare Center Coronado, CA percent of total billed charges · inpatientfrom % of charges	1	$142	$142	—	—	—	$142 – $142
22	Sharp Coronado Hospital and Healthcare Center Coronado, CA percent of total billed charges · outpatientfrom % of charges	1	$89	$89	—	—	—	$89 – $89
23	Sharp Memorial Hospital San Diego, CA percent of total billed charges · inpatientfrom % of charges	1	$95	$95	—	—	—	$95 – $95
24	Sharp Mesa Vista Hospital San Diego, CA percent of total billed charges · inpatientfrom % of charges	1	$139	$139	$43	31%	—	$95 – $182
25	Tufts Medical Center BOSTON, MA percent of total billed charges · bothfrom % of charges	1	$600	$600	—	—	—	$600 – $600

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← Payers reporting HCPCS J7639 · Snapshot 20261111T120946Z-9134e7f7

HCPCS J7639