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NDC 00186-0654-01

UNCLASSIFIED DRUGS

Reported by 19 hospitals in the network under the fee schedule methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects negotiated fee schedule rates with commercial payers.

National pricing summary

Low

$86

Average

$225

Median

$188

High

$582

Hospitals reporting this code

#HospitalLocationApproximate 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.
1Castle Medical CenterKailua, HI$111$111$22—$22$156
2Northwest Medical Foundation Of TillamookTillamook, OR$86$86——$41$86
3Ukiah Adventist HospitalUkiah, CA$188$188——$72$188
4Adventist Health Medical Center TehachapiTehachapi, CA$210$257$89—$39$467
5Sonora Community HospitalSonora, CA$332$355$49—$146$436
6Glendale Adventist Medical CenterGlendale, CA$452$561$217—$98$992
7Adventist Health DelanoDelano, CA$93$97$13—$20$119
8Simi Valley Hospital And Health Care ServicesValley, CA$224$224——$55$224
9Adventist Health TulareTulare, CA$194$205$22—$56$231
10Rideout Memorial HospitalMarysville, CA$127$137$14—$90$158
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