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NDC 55390025101

55390-0251-01 - mitomycin 5. mg REC Injection

Reported by 48 hospitals in the network.

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.

National pricing summary

Low

$58

Average

$246

Median

$130

High

$894

Hospitals reporting this code

#HospitalLocation
1IOM Health System LPFort Wayne, IN$409$796$894$1.5k$328
2Bluffton Health System LLCBluffton, IN$160$414$406$602$140
3Dukes Health System LLCPeru, IN$178$433$464$962$210
4Warsaw Health System LLCWarsaw, IN$299$838$835$1.3k$285
5Lutheran Musculoskeletal Center LLCFort Wayne, IN$398$814$879$1.7k$310
6St. Joseph Health System, LLCIN 46802, IN$328$786$847$1.4k$313
7Dupont Hospital LLCIN 46825, IN$191$405$438$708$162
8Northwest Sahurita Hospital LLCAZ 85748, AZ$16$27$59$236$56
9Northwest Sahurita Hospital LLCAZ 85629, AZ$16$27$58$236$55
10Oro Valley Hospital LLCTucson, AZ$16$73$115$353$110
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