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NDC 1747871130

LIDOCAINE HCL 2 % MUCOSAL JELLY

Reported by 14 hospitals in the network under the other 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 payer-specific billing methodology not covered by the standard categories.

National pricing summary

Low

$16

Average

$65

Median

$41

High

$180

Hospitals reporting this code

#HospitalLocation
1Catholic Health Initiatives ColoradoColorado Springs, CO$107$31$31$400—
2Catholic Health Initiatives ColoradoColorado Springs, CO$123$180$180$400—
3St Francis HospitalColorado Springs, CO$107$180$180$386—
4Longmont United HospitalLongmont, CO$107$33$33$409—
5Catholic Health Initiatives ColoradoFrisco, CO$123$24$37$418$18
6Commonspirit Kansas, Inc.Ulysses, KS$364$77$77$432—
7Commonspirit Kansas, Inc.Dodge City, KS$159$77$77$409—
8Catholic Health Initiatives ColoradoPueblo, CO$125$44$44$400—
9Catholic Health Initiatives ColoradoFort Morgan, CO$145$70$70$441—
10Catholic Health Initiatives ColoradoDurango, CO$134$5$16$409$19
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