NDC 52536-0104-05
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
Reported by 57 hospitals in the network.
Based on 341–575 billing samples across every hospital reporting.
Low
$2
Average
$563
Median
$176
High
$5.0k
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Showing prices across every billing methodology. Pick one in the filter above to narrow the chart. 57 hospitals; the 90th percentile is 44.0× 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 | Lodi Memorial Hospital Association Inc | Lodi, CA | $40 | $41 | $19 | 255–336 | $15 | $85 |
| 2 | Sonora Community Hospital | Sonora, CA | $20 | $20 | $5 | 45–117 | $11 | $33 |
| 3 | Adventist Health Delano | Delano, CA | $18 | $20 | $6 | 34–52 | $5 | $32 |
| 4 | San Joaquin Community Hospital | Bakersfield, CA | $13 | $18 | $11 | 7–70 | $8 | $69 |
| 5 | Sanford Westbrook Hospital | Westbrook, MN | $151 | $136 | $35 | — | $44 | $171 |
| 6 | Alegent Creighton Health | Omaha, NE | $167 | $162 | $62 | — | $45 | $237 |
| 7 | Alegent Creighton Health | Papillion, NE | $167 | $163 | $60 | — | $50 | $237 |
| 8 | Alegent Health Bergan Mercy Health System | Omaha, NE | $202 | $169 | $66 | — | $47 | $237 |
| 9 | Alegent Health Immanuel Medical Center | Omaha, NE | $167 | $163 | $61 | — | $39 | $237 |
| 10 | Alegent Health - Mercy Hospital, Corning Iowa | Corning, IA | $267 | $261 | $68 | — | $120 | $618 |
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