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NDC 17478050401

Methylene Blue IV Soln 1

Reported by 42 hospitals in the network under the percent of billed charges 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 a negotiated percentage of total billed charges.

National pricing summary

Low

$30

Average

$66

Median

$63

High

$174

Hospitals reporting this code

#HospitalLocation
1Foley Hospital Company LLCFoley, AL$15$124$110$154$38
2QHG of Enterprise IncEnterprise, AL$25$197$174$253$69
3Navarro Hospital LPCorsicana, TX$4$29$31$48$10
4Sanford Behavioral Health Thief River FallsThief River Falls, MN$8$38$35$47$10
5Sanford Westbrook HospitalWestbrook, MN$8$69$62$78$16
6Sanford Worthington Medical CenterWorthington, MN$6$72$64$88$19
7Sanford Mayville Medical CenterMayville, ND$10$34$30$38$7
8Sanford Chamberlain Medical CenterChamberlain, SD$28$61$57$74$16
9Sanford Thief River Falls Medical CenterThief River Falls, MN$8$38$35$47$10
10Sanford Sheldon Medical CenterSheldon, IA$25$56$56$78$19
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