NDC 58160-0849-52
Reported by 4 hospitals in the network under the other methodology.
Based on 6–60 billing samples across every hospital reporting.
Low
$95
Average
$137
Median
$141
High
$169
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
| # | 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 | Carle BroMenn Medical Center | Normal, IL | $94 | $95 | $2 | 3–30 | $35 | $262 |
| 2 | The Carle Foundation Hospital | Urbana, IL | $141 | $141 | — | 2–20 | $35 | $555 |
| 3 | Methodist Medical Center of Illinois | Peoria, IL | $141 | $141 | — | 1–10 | $70 | $234 |
| 4 | Ellis Hospital | Schenectady, NY | $169 | $169 | — | — | $169 | $861 |
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