NDC 143929801
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
PHARMACY - EXTENSION OF 025X - DRUGS REQUIRING DETAILED CODING (A)
Low
$6
Average
$54
Median
$21
High
$262
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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. 12 hospitals; the 90th percentile is 5.4× 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.
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| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | St. Peter's Health Helena, MT | $6 | $6 | — | — | 120 | $6 – $6 |
| 2 | Sanford Fargo Medical Center Fargo, ND | $22 | $21 | $7 | 33% | — | $1 – $28 |
| 3 | Sanford Medical Center Bismarck Bismarck, ND | $27 | $27 | $7 | 27% | — | $12 – $34 |
| 4 | Sanford USD Medical Center Sioux Falls, SD | $279 | $262 | $90 | 34% | — | $1 – $357 |
| 5 | Sanford Worthington Medical Center Worthington, MN | $65 | $58 | $17 | 30% | — | $1 – $79 |
| 6 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA | $19 | $19 | $8 | 44% | — | $2 – $32 |
| 7 | Pennsylvania Hospital of the University of Pennsylvania Health System Philadelphia, PA | $18 | $19 | $8 | 44% | — | $2 – $30 |
| 8 | Presbyterian Medical Center of the University of Pennsylvania Health System D/B/A Penn Presbyterian Medical Center Philadelphia, PA | $18 | $19 | $8 | 42% | — | $2 – $30 |
| 9 | The Chester County Hospital West Chester, PA | $20 | $20 | $8 | 41% | — | $2 – $30 |
| 10 | Penn Medicine Princeton Medical Center Plainsboro, NJ | $24 | $21 | $8 | 39% | — | $2 – $30 |
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