NDC 121479905
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
levETIRAcetam (500 mg/5 mL) 100 mg/mL Oral Sol [CITY]
Reported by 43 hospitals in the network under the percent of billed charges methodology.
Low
$3
Average
$23
Median
$23
High
$96
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. 43 hospitals; the 90th percentile is 7.3× 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 | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Tri-City Medical Center Oceanside, CA | $18 | $24 | $11 | 45% | 460–478 | $8 – $42 |
| 2 | IOM Health System LP Fort Wayne, IN | $15 | $17 | $6 | 37% | — | $8 – $28 |
| 3 | Bluffton Health System LLC Bluffton, IN | $33 | $33 | $11 | 34% | — | $13 – $48 |
| 4 | Dukes Health System LLC Peru, IN | $39 | $42 | $12 | 30% | — | $13 – $70 |
| 5 | Warsaw Health System LLC Warsaw, IN | $53 | $53 | $18 | 34% | — | $19 – $84 |
| 6 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN | $39 | $42 | $15 | 35% | — | $19 – $79 |
| 7 | St. Joseph Health System, LLC Wayne, IN | $21 | $23 | $9 | 37% | — | $9 – $38 |
| 8 | Dupont Hospital LLC Wayne, IN | $11 | $12 | $4 | 37% | — | $5 – $19 |
| 9 | Durant HMA LLC Durant, OK | $19 | $16 | $7 | 42% | — | $4 – $23 |
| 10 | Wesley Health System LLC Hattiesburg, MS | $73 | $96 | $54 | 56% | — | $27 – $242 |
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