NDC 63739-0694-57
Reported by 2 hospitals in the network under the fee schedule methodology.
Low
$1
Average
$13
Median
$13
High
$25
Filter by billing methodology
Reflects negotiated fee schedule rates with commercial payers.
| # | 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 | Dukes Health System LLC | Peru, IN | $19 | $25 | $10 | — | $17 | $93 |
| 2 | Laredo Texas Hospital Company LP | Laredo, TX | $1 | $1 | $0 | — | $1 | $19 |
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