NDC 00078-0897-78
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
TRIAMC ACEPF40MG/MLOPJWTB
Reported by 19 hospitals in the network under the case rate methodology.
Based on 110 billing samples across every hospital reporting.
Low
$10
Average
$462
Median
$431
High
$900
Filter by billing methodology
Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.
Showing only prices reported under the case rate methodology. Choose another in the filter above to change the chart. 19 hospitals; the 90th percentile is 30.2× 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 | Boston Children's Hospital | Boston, MA | $10 | $10 | — | 110 | $10 | $4.0k |
| 2 | Dignity Community Care | Northridge, CA | $31 | $32 | $2 | — | $4 | $4.4k |
| 3 | Dignity Community Care | Los Angeles, CA | $31 | $31 | — | — | $8 | $4.9k |
| 4 | Dignity Community Care | San Luis Obispo, CA | $31 | $31 | — | — | $6 | $11.1k |
| 5 | Dignity Community Care | Redwood City, CA | $36 | $36 | — | — | $4 | $7.4k |
| 6 | Dignity Community Care | Glendale, CA | $31 | $31 | — | — | $6 | $9.4k |
| 7 | Advocate Condell Medical Center | Libertyville, IL | $36 | $39 | $5 | — | $36 | $943 |
| 8 | University of Arkansas for Medical Sciences | Little Rock, AR | $887 | $887 | — | — | $46 | $887 |
| 9 | Froedtert Memorial Lutheran Hospital Inc | Milwaukee, WI | $25 | $25 | $0 | — | $24 | $4.4k |
| 10 | Boston Medical Center | Boston, MA | $431 | $431 | — | — | $28 | $513 |
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