NDC 904738106
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
Prochlorperazine Maleate Tab 5 MG (Base Equivalent)
Reported by 29 hospitals in the network under the percent of billed charges methodology.
Based on 488–551 billing samples across every hospital reporting.
Low
$1
Average
$5
Median
$4
High
$10
Filter by billing methodology
Reflects a negotiated percentage of total billed charges.
Showing only prices reported under the percent of billed charges methodology. Choose another in the filter above to change the chart. 29 hospitals; the 90th percentile is 1.8× 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 | Tri-City Medical Center | Oceanside, CA | $8 | $10 | $5 | 460–478 | $3 | $18 |
| 2 | The Carle Foundation Hospital | Urbana, IL | $5 | $4 | $2 | 26–53 | $0 | $8 |
| 3 | Proctor Community Hospital | Peoria, IL | $4 | $4 | $1 | 1–10 | $0 | $6 |
| 4 | Carle BroMenn Medical Center | Normal, IL | $6 | $4 | $2 | 1–10 | $0 | $7 |
| 5 | Sanford Behavioral Health Thief River Falls | Thief River Falls, MN | $5 | $5 | $1 | — | $2 | $7 |
| 6 | Sanford Medical Center Bismarck | Bismarck, ND | $3 | $3 | $1 | — | $1 | $4 |
| 7 | Sanford USD Medical Center | Sioux Falls, SD | $1 | $1 | $0 | — | $1 | $2 |
| 8 | Sanford Hillsboro Medical Center | Hillsboro, ND | $3 | $3 | $1 | — | $1 | $4 |
| 9 | Sanford Mayville Medical Center | Mayville, ND | $4 | $4 | $1 | — | $1 | $5 |
| 10 | Sanford Chamberlain Medical Center | Chamberlain, SD | $4 | $3 | $1 | — | $2 | $4 |
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