NDC 338012503
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
D5LR UP TO 1000ML
Reported by 17 hospitals in the network under the other methodology.
Based on 30–48 billing samples across every hospital reporting.
Low
$7
Average
$195
Median
$59
High
$1.7k
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 17 hospitals; the 90th percentile is 41.8× 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 | Location | Approximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price. | |||||
|---|---|---|---|---|---|---|---|---|
| 1 | Carle BroMenn Medical Center | Normal, IL | $58 | $58 | — | 28 | $2 | $80 |
| 2 | Carle Eureka Hospital | Eureka, IL | $44 | $44 | $19 | 2–20 | $2 | $90 |
| 3 | Vicksburg Healthcare LLC | Vicksburg, MS | $158 | $331 | $275 | — | $21 | $791 |
| 4 | Northwest Sahurita Hospital LLC | Tucson, AZ | $8 | $7 | $1 | — | $3 | $21 |
| 5 | Victoria of Texas LP | Victoria, TX | $43 | $71 | $64 | — | $15 | $241 |
| 6 | Victoria of Texas LP | Victoria, TX | $43 | $71 | $64 | — | $15 | $241 |
| 7 | Northwest Sahurita Hospital LLC | Sahuarita, AZ | $8 | $7 | $1 | — | $3 | $21 |
| 8 | Northwest Hospital LLC | Tucson, AZ | $8 | $8 | $2 | — | $3 | $21 |
| 9 | Triad of Alabama LLC | Dothan, AL | $277 | $277 | $269 | — | $3 | $545 |
| 10 | Affinity Hospital LLC | Birmingham, AL | $215 | $215 | $54 | — | $3 | $269 |
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