NDC 59353-0404-09
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
PHARMACY - EXTENSION OF 025X - DRUGS REQUIRING DETAILED CODING (A)
Based on 154–190 billing samples across every hospital reporting.
Low
$3
Average
$417
Median
$6
High
$6.1k
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Showing prices across every billing methodology. Pick one in the filter above to narrow the chart. 41 hospitals; the 90th percentile is 171.3× 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 | ||||||
|---|---|---|---|---|---|---|---|
| 1 | St. Peter's Health Helena, MT | $3 | $3 | — | — | 150 | $3 – $3 |
| 2 | Monument Health Rapid City Hospital Inc City, SD | $10 | $9 | $3 | 34% | 3–30 | $1 – $12 |
| 3 | Sanford Fargo Medical Center Fargo, ND | $715 | $659 | $508 | 77% | 1–10 | $1 – $1.2k |
| 4 | University of Iowa Health Care Medical Center Downtown Iowa City, IA | $900 | $786 | $492 | 63% | — | $1 – $1.4k |
| 5 | University of Iowa Health Care Medical Center Iowa City, IA | $909 | $781 | $491 | 63% | — | $1 – $1.4k |
| 6 | Sanford Medical Center Bismarck Bismarck, ND | $698 | $534 | $338 | 63% | — | $1 – $870 |
| 7 | Sanford USD Medical Center Sioux Falls, SD | $804 | $652 | $531 | 81% | — | $1 – $1.3k |
| 8 | Sanford Worthington Medical Center Worthington, MN | $452 | $450 | $277 | 61% | — | $1 – $784 |
| 9 | Sanford Canby Medical Center Canby, MN | $777 | $711 | $170 | 24% | — | $228 – $890 |
| 10 | Brfhh Monroe, Llc Monroe, LA | $126 | $325 | $408 | 126% | — | $1 – $1.2k |
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