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NDC 55390025101

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

Reported by 48 hospitals in the network under the percent of billed charges methodology.

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.

Reflects a negotiated percentage of total billed charges.

National pricing summary

Low

$125

Average

$302

Median

$181

High

$974

Hospitals reporting this code

#HospitalLocation
1IOM Health System LPFort Wayne, IN$409$796$894$1.5k$328
2Bluffton Health System LLCBluffton, IN$160$414$410$602$138
3Dukes Health System LLCPeru, IN$178$533$573$962$172
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$752$839$1.4k$309
7Dupont Hospital LLCIN 46825, IN$191$405$438$708$162
8Northwest Sahurita Hospital LLCAZ 85748, AZ$16$113$125$236$67
9Northwest Sahurita Hospital LLCAZ 85629, AZ$16$113$125$236$67
10Oro Valley Hospital LLCTucson, AZ$16$206$211$353$98
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