NDC 00004-6912-06
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
UNCLASSIFIED DRUGS
Reported by 9 hospitals in the network under the fee schedule methodology.
Low
$132
Average
$597
Median
$670
High
$967
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Reflects negotiated fee schedule rates with commercial payers.
Showing only prices reported under the fee schedule methodology. Choose another in the filter above to change the chart. 9 hospitals; the 90th percentile is 2.3× 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.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | Location | Approximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price. | |||||
|---|---|---|---|---|---|---|---|---|
| 1 | Glendale Adventist Medical Center | Glendale, CA | $324 | $435 | $185 | — | $86 | $719 |
| 2 | Lodi Memorial Hospital Association Inc | Lodi, CA | $379 | $393 | $55 | — | $88 | $484 |
| 3 | White Memorial Medical Center | Angeles, CA | $101 | $132 | $64 | — | $24 | $353 |
| 4 | Dignity Community Care | Sacramento, CA | $770 | $695 | $249 | — | $100 | $951 |
| 5 | Dignity Health | Sacramento, CA | $742 | $692 | $171 | — | $238 | $951 |
| 6 | Dignity Health | Folsom, CA | $756 | $667 | $244 | — | $105 | $951 |
| 7 | Sierra Nevada Memorial-miners Hospital | Grass Valley, CA | $724 | $721 | $104 | — | $408 | $832 |
| 8 | Dignity Health | Carmichael, CA | $713 | $670 | $245 | — | $105 | $951 |
| 9 | Dignity Health | Redding, CA | $994 | $967 | $91 | — | $812 | $1.1k |
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