NDC 51672-1340-03
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
UNCLASSIFIED DRUGS
Low
$156
Average
$202
Median
$170
High
$427
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. 19 hospitals; the 90th percentile is 1.9× 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 | FHN Memorial Hospital Freeport, IL | $160 | $156 | $25 | 16% | 110–128 | $111 – $199 |
| 2 | IOM Health System LP Fort Wayne, IN | $380 | $427 | $157 | 37% | — | $195 – $712 |
| 3 | Lutheran Musculoskeletal Center LLC Fort Wayne, IN | $350 | $378 | $133 | 35% | — | $171 – $715 |
| 4 | St. Joseph Health System, LLC Wayne, IN | $258 | $288 | $106 | 37% | — | $113 – $470 |
| 5 | Gadsden Regional Medical Center LLC Gadsden, AL | $258 | $231 | $91 | 39% | — | $49 – $1.5k |
| 6 | Essentia Health Northern Pines 5211 Highway 110 Aurora, MN | $183 | $174 | $34 | 20% | — | $97 – $241 |
| 7 | Essentia Health St Marys Hospital-Superior 3500 Tower Ave Superior, WI | $185 | $172 | $32 | 19% | — | $97 – $218 |
| 8 | Essentia Health Sandstone 705 Lundorff Dr Sandstone, MN | $182 | $173 | $35 | 20% | — | $97 – $241 |
| 9 | Essentia Health Ada 201 9th St W Ada, MN | $168 | $170 | $36 | 21% | — | $94 – $218 |
| 10 | Essentia Health Fosston 900 Hilligoss Blvd SE Fosston, MN | $168 | $170 | $36 | 21% | — | $94 – $218 |
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