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 45 hospitals in the network under the percent of billed charges methodology.
Based on 341–575 billing samples across every hospital reporting.
Low
$2
Average
$200
Median
$182
High
$948
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. 45 hospitals; the 90th percentile is 28.6× 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 | $29 | $34 | $14 | 255–336 | $15 | $85 |
| 2 | Sonora Community Hospital | Sonora, CA | $19 | $18 | $3 | 45–117 | $11 | $33 |
| 3 | Adventist Health Delano | Delano, CA | $17 | $17 | $3 | 34–52 | $5 | $32 |
| 4 | San Joaquin Community Hospital | Bakersfield, CA | $13 | $15 | $4 | 7–70 | $8 | $69 |
| 5 | Sanford Westbrook Hospital | Westbrook, MN | $151 | $136 | $35 | — | $44 | $171 |
| 6 | Mercy Fitzgerald Hospital | Darby, PA | $92 | $80 | $23 | — | $20 | $92 |
| 7 | UPMC Magee-Womens Hospital | Pittsburgh, PA | $238 | $269 | $107 | — | $1 | $547 |
| 8 | UPMC St Margaret | Pittsburgh, PA | $49 | $91 | $104 | — | $1 | $399 |
| 9 | UPMC Presbyterian | Pittsburgh, PA | $357 | $311 | $95 | — | $0 | $486 |
| 10 | UPMC Passavant - McCandless | Pittsburgh, PA | $220 | $272 | $106 | — | $0 | $443 |
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