NDC 09991-2621-00
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
METHOTREXATE OPHTHALMIC INJ 400 MCG/0.04 ML
Low
$195
Average
$242
Median
$242
High
$319
Filter by billing methodology
Reflects a negotiated percentage of total billed charges.
Showing only prices reported under the percent of billed charges methodology. Choose another in the filter above to change the chart. 23 hospitals; the 90th percentile is 1.4× 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 | ||||||
|---|---|---|---|---|---|---|---|
| 1 | North Carolina Baptist Hospital Winston Salem, NC | $149 | $195 | $100 | 51% | 9–90 | $85 – $405 |
| 2 | North Carolina Baptist Hospital Bermuda Run, NC | $148 | $197 | $102 | 52% | 9–90 | $5 – $405 |
| 3 | The Charlotte Mecklenburg Hospital Authority Charlotte, NC | $225 | $234 | $116 | 50% | 2–20 | $45 – $437 |
| 4 | The Charlotte Mecklenburg Hospital Authority Charlotte, NC | $218 | $228 | $115 | 51% | 1–10 | $45 – $414 |
| 5 | Floyd Healthcare Management Inc Rome, GA | $270 | $248 | $88 | 35% | 1–10 | $3 – $383 |
| 6 | The Medical Center of Central Georgia Inc Macon, GA | $293 | $293 | $80 | 27% | 1–10 | $3 – $419 |
| 7 | Navicent Health Baldwin Inc Milledgeville, GA | $347 | $319 | $79 | 25% | 1–10 | $3 – $383 |
| 8 | Carolinas Medical Center Charlotte, NC | $228 | $242 | $98 | 41% | — | $3 – $405 |
| 9 | Carolinas Medical Center Charlotte, NC | $239 | $251 | $98 | 39% | — | $3 – $405 |
| 10 | Carolinas Medical Center Charlotte, NC | $225 | $242 | $100 | 41% | — | $3 – $414 |
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