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
NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH
Low
$2
Average
$8
Median
$5
High
$40
Each hospital's average Blue Cross Blue Shield rate, under the methodology and billing class chosen below.
40 hospitals; the 90th percentile is 7.3× 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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48 hospital rates
iThe hospitals that file a Blue Cross Blue Shield 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 | Northfield Hospital Northfield, MN other · both | 1 | $40 | $40 | $0 | 0% | 3–30 | $39 – $40 |
| 2 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE other · outpatient | 1 | $19 | $21 | $6 | 30% | — | $16 – $34 |
| 3 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges | 1 | $11 | $12 | $4 | 30% | — | $9 – $19 |
| 4 | Benson Hospital Corporation Benson, AZ facility · fee schedule · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 5 | Covenant Medical Center Inc Saginaw, MI facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 6 | Covenant Medical Center Inc Saginaw, MI facility · fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 7 | Henry Ford Health System West Bloomfield, MI facility · fee schedule · outpatient | 3 | $4 | $4 | $0 | 11% | — | $4 – $5 |
| 8 | Henry Ford Health System Plymouth, MI facility · fee schedule · outpatient | 3 | $5 | $5 | $0 | 4% | — | $5 – $5 |
| 9 | Henry Ford Macomb Hospital Corporation Clinton Twp, MI facility · fee schedule · outpatient | 3 | $4 | $4 | $0 | 11% | — | $4 – $5 |
| 10 | Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI facility · fee schedule · outpatient | 3 | $4 | $4 | $0 | 11% | — | $4 – $5 |
| 11 | HonorHealth Florence Medical Center Florence, AZ facility · fee schedule · outpatient | 1 | $7 | $7 | $2 | 29% | — | $5 – $9 |
| 12 | Honorhealth Deer Valley Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $7 | $7 | $2 | 30% | — | $5 – $9 |
| 13 | Honorhealth Four Peaks Medical Center Mesa, AZ facility · fee schedule · outpatient | 1 | $7 | $7 | $2 | 29% | — | $5 – $9 |
| 14 | Honorhealth John C. Lincoln Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $7 | $7 | $2 | 30% | — | $5 – $9 |
| 15 | Honorhealth Scottsdale Osborn Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $7 | $7 | $2 | 30% | — | $5 – $9 |
| 16 | Honorhealth Scottsdale Shea Medical Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $7 | $7 | $2 | 30% | — | $5 – $9 |
| 17 | Honorhealth Scottsdale Thompson Peak Med Center Scottsdale, AZ facility · fee schedule · outpatient | 1 | $7 | $7 | $2 | 30% | — | $5 – $9 |
| 18 | Honorhealth Sonoran Crossing Medical Center Phoenix, AZ facility · fee schedule · outpatient | 1 | $7 | $7 | $2 | 30% | — | $5 – $9 |
| 19 | KARMANOS CANCER CENTER DETROIT, MI fee schedule | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 20 | Kalkaska Memorial Health Center Kalkaska, MI professional · fee schedule · both | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 21 | Memorial Healthcare Owosso, MI fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 22 | Morrison Community Hospital District Morrison, IL facility · fee schedule · both | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 23 | Munson Healthcare Cadillac Cadillac, MI facility · fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 24 | Munson Healthcare Cadillac Cadillac, MI professional · fee schedule · both | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 25 | Munson Healthcare Charlevoix Hospital Charlevoix, MI professional · fee schedule · both | 1 | $2 | $2 | — | — | — | $2 – $2 |
← Payers reporting HCPCS S4990 · Snapshot 20261111T120946Z-9134e7f7