NDC 58468-0090-01
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
58468-0090-01 - hylan G-F 20 8 mg/mL 16. Soln
Reported by 98 hospitals in the network under the other methodology.
Based on 327–354 billing samples across every hospital reporting.
Low
$3
Average
$214
Median
$11
High
$3.4k
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 98 hospitals; the 90th percentile is 84.1× 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 | Saint Alphonsus Medical Center - Nampa | Nampa, ID | $8 | $10 | $4 | 210 | $7 | $1.9k |
| 2 | Saint Alphonsus Regional Medical Center - Boise | Boise, ID | $8 | $10 | $4 | 54–72 | $7 | $2.1k |
| 3 | Tufts Medical Center | BOSTON, MA | $599 | $599 | — | 44 | $121 | $599 |
| 4 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH DYER | DYER, IN | $8 | $8 | $2 | 18 | $8 | $1.5k |
| 5 | Boston Medical Center | Boston, MA | $8 | $8 | $1 | 1–10 | $8 | $639 |
| 6 | Bluffton Health System LLC | Bluffton, IN | $578 | $578 | — | — | $533 | $2.0k |
| 7 | Dukes Health System LLC | Peru, IN | $1.1k | $1.1k | $189 | — | $628 | $3.4k |
| 8 | St. Joseph Health System, LLC | Wayne, IN | $3.4k | $3.4k | — | — | $815 | $3.4k |
| 9 | Metro Knoxville HMA LLC | Knoxville, TN | $58 | $58 | — | — | $5 | $94 |
| 10 | Metro Knoxville HMA LLC | Powell, TN | $58 | $58 | — | — | $5 | $133 |
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