RC 343
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.
Generation details were not recorded for this description.
Original text from hospital filings
KIT FOR PREPARATION OF GA-68-GOZETOTIDE 25 MCG INTRAVENOUS SOLUTION
Low
$244
Average
$1.1k
Median
$965
High
$1.7k
Each hospital's average Cigna Healthspring rate, under the methodology and billing class chosen below.
52 hospitals; the 90th percentile is 1.6× 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.
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52 hospital rates
iThe hospitals that file a Cigna Healthspring rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Northwestern Medicine Valley West Hospital Sandwich, IL percent of total billed charges · outpatientfrom % of charges | 1 | $130 | $244 | $285 | 117% | 2–20 | $0 – $1.1k |
| 2 | Atrium Health Hospitals Inc Kings Mountain, NC fee schedule · outpatient | 1 | $718 | $965 | $722 | 75% | — | $11 – $2.3k |
| 3 | Atrium Health Hospitals Inc Lincolnton, NC fee schedule · outpatient | 1 | $718 | $965 | $722 | 75% | — | $11 – $2.3k |
| 4 | Atrium Health Hospitals Inc Wadesboro, NC fee schedule · outpatient | 1 | $718 | $965 | $722 | 75% | — | $11 – $2.3k |
| 5 | CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER Houston, TX case rate · outpatient | 2 | $1.2k | $1.4k | $1.0k | 73% | — | $51 – $4.4k |
| 6 | Carolinas Medical Center Charlotte, NC fee schedule · outpatient | 1 | $718 | $965 | $722 | 75% | — | $11 – $2.3k |
| 7 | Carolinas Medical Center Charlotte, NC fee schedule · outpatient | 1 | $718 | $965 | $722 | 75% | — | $11 – $2.3k |
| 8 | Carolinas Medical Center Davidson, NC percent of total billed charges · outpatientfrom % of charges | 1 | $409 | $1.5k | $2.0k | 139% | — | $1 – $6.9k |
| 9 | Carolinas Medical Center Charlotte, NC fee schedule · outpatient | 1 | $718 | $965 | $722 | 75% | — | $11 – $2.3k |
| 10 | Columbus Regional Healthcare System, Inc Whiteville, NC fee schedule · outpatient | 1 | $842 | $842 | — | — | — | $842 – $842 |
| 11 | Conway Regional Medical Center Conway, AR facility · fee schedule · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 12 | Granbury Hospital Corporation Granbury, TX facility · fee schedule · outpatient | 1 | $928 | $928 | — | — | — | $928 – $928 |
| 13 | Holy Redeemer Health System Meadowbrook, PA facility · case rate · outpatient | 1 | $890 | $905 | $397 | 44% | — | $367 – $1.5k |
| 14 | Laird Hospital, Inc. Union, MS other · outpatient | 1 | $221 | $564 | $620 | 110% | — | $3 – $2.0k |
| 15 | Lancaster General Health Lancaster, PA facility · fee schedule · outpatient | 1 | $1.1k | $1.4k | $589 | 43% | — | $768 – $2.4k |
| 16 | Laredo Texas Hospital Company LP Laredo, TX facility · per diem · outpatient | 1 | $97 | $961 | $1.7k | 175% | — | $39 – $6.5k |
| 17 | MEMORIAL HEALTH SYSTEM OF EAST TEXAS Lufkin, TX case rate · outpatient | 2 | $683 | $918 | $452 | 49% | — | $646 – $1.8k |
| 18 | MEMORIAL HOSPITAL OF POLK COUNTY Livingston, TX case rate · outpatient | 2 | $724 | $973 | $479 | 49% | — | $685 – $1.9k |
| 19 | MedStar Franklin Square Medical Center Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $304 | $901 | $1.4k | 152% | — | $8 – $7.6k |
| 20 | MedStar Good Samaritan Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $878 | $1.7k | $1.9k | 114% | — | $24 – $10.7k |
| 21 | MedStar Harbor Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $720 | $1.2k | $1.2k | 97% | — | $19 – $6.3k |
| 22 | MedStar Montgomery Medical Center Olney, MD percent of total billed charges · outpatientfrom % of charges | 1 | $398 | $1.0k | $1.4k | 142% | — | $11 – $8.1k |
| 23 | MedStar Southern Hospital Center Clinton, MD percent of total billed charges · outpatientfrom % of charges | 1 | $570 | $1.5k | $2.2k | 145% | — | $15 – $12.3k |
| 24 | MedStar St. Mary's Hospital Leonardtown, MD percent of total billed charges · outpatientfrom % of charges | 1 | $320 | $1.0k | $1.6k | 157% | — | $10 – $8.8k |
| 25 | MedStar Union Memorial Hospital Baltimore, MD percent of total billed charges · outpatientfrom % of charges | 1 | $710 | $1.4k | $1.8k | 125% | — | $19 – $10.2k |
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