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
Prescription drug,brand name
Low
$3
Average
$361
Median
$361
High
$1.4k
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
115 hospitals; the 90th percentile is 47.3× 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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120 hospital rates
iThe hospitals that file a UnitedHealthcare 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 | "Savoy Medical Management Group, Inc." Mamou, LA facility · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 2 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 3 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 2 | $16 | $16 | — | — | — | $16 – $16 |
| 4 | ANGEL MEDICAL CENTER Franklin, NC percent of total billed charges · outpatientfrom % of charges | 4 | $406 | $380 | $111 | 29% | — | $203 – $504 |
| 5 | BLUE RIDGE REGIONAL HOSPITAL Spruce Pine, NC percent of total billed charges · outpatientfrom % of charges | 4 | $477 | $419 | $135 | 32% | — | $191 – $529 |
| 6 | CANONSBURG GENERAL HOSPITAL CANONSBURG, PA fee schedule · outpatient | 2 | $16 | $16 | — | — | — | $16 – $16 |
| 7 | CENTENNIAL HOSPITAL A CAMPUS OF TMCA ENGLEWOOD, CO percent of total billed charges · outpatientfrom % of charges | 2 | $880 | $880 | $326 | 37% | — | $555 – $1.2k |
| 8 | CENTERPOINT MEDICAL CENTER Independence, MO percent of total billed charges · outpatientfrom % of charges | 2 | $76 | $76 | $22 | 28% | — | $54 – $98 |
| 9 | CHIPPENHAM HOSPITAL RICHMOND, VA percent of total billed charges · outpatientfrom % of charges | 2 | $1.4k | $1.4k | $501 | 37% | — | $861 – $1.9k |
| 10 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 11 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $27 | $27 | — | — | — | $27 – $27 |
| 12 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 13 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 14 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 15 | Carle BroMenn Medical Center Normal, IL fee schedule · inpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 16 | Carle BroMenn Medical Center Normal, IL fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 17 | Carle Eureka Hospital Eureka, IL fee schedule · inpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 18 | Carle Eureka Hospital Eureka, IL fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 19 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 20 | Fairview Hospital Cleveland, OH facility · case rate · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 21 | Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient | 1 | $11 | $11 | — | — | — | $11 – $11 |
| 22 | GROVE CITY MEDICAL CENTER GROVE CITY, PA fee schedule · outpatient | 2 | $16 | $16 | — | — | — | $16 – $16 |
| 23 | HCA FLORIDA FORT WALTON-DESTIN HOSPITAL FT WALTON BEACH, FL percent of total billed charges · outpatientfrom % of charges | 2 | $489 | $489 | $182 | 37% | — | $307 – $671 |
| 24 | HCA FLORIDA GULF COAST HOSPITAL PANAMA CITY BEACH, FL percent of total billed charges · outpatientfrom % of charges | 2 | $517 | $517 | $154 | 30% | — | $362 – $671 |
| 25 | HCA FLORIDA KENDALL HOSPITAL MIAMI, FL percent of total billed charges · outpatientfrom % of charges | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
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