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
$1
Average
$1.4k
Median
$563
High
$9.6k
Each hospital's average Medicaid rate, under the methodology and billing class chosen below.
126 hospitals; the 90th percentile is 47.0× 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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144 hospital rates
iThe hospitals that file a Medicaid 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 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH INDIANAPOLIS INDIANAPOLIS, IN percent of total billed charges · bothfrom % of charges | 16 | $4.2k | $4.0k | $531 | 13% | 350–359 | $3.4k – $5.1k |
| 2 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY CITY, IN percent of total billed charges · bothfrom % of charges | 2 | $3.9k | $3.9k | $666 | 17% | 257–266 | $3.1k – $4.9k |
| 3 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH LAFAYETTE LAFAYETTE, IN percent of total billed charges · bothfrom % of charges | 2 | $9.5k | $10.1k | $6.3k | 63% | 165–183 | $3.5k – $17.8k |
| 4 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CROWN POINT CROWN POINT, IN percent of total billed charges · bothfrom % of charges | 14 | $3.8k | $3.7k | $1.1k | 29% | 118 | $2.5k – $5.4k |
| 5 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MUNSTER MUNSTER, IN percent of total billed charges · bothfrom % of charges | 2 | $4.9k | $4.9k | $547 | 11% | 96–114 | $4.2k – $5.7k |
| 6 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MOORESVILLE MOORESVILLE, IN percent of total billed charges · bothfrom % of charges | 2 | $4.2k | $4.2k | $590 | 14% | 75–84 | $3.4k – $5.1k |
| 7 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CRAWFORDSVILLE CRAWFORDSVILLE, IN percent of total billed charges · bothfrom % of charges | 1 | $9.6k | $9.6k | $7.8k | 82% | 65 | $1.7k – $17.4k |
| 8 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH DYER DYER, IN percent of total billed charges · bothfrom % of charges | 14 | $4.7k | $4.7k | $490 | 10% | 51–78 | $4.2k – $5.7k |
| 9 | FRANCISCAN HEALTH RENSSELAER, INC. RENSSELAER, IN percent of total billed charges · bothfrom % of charges | 2 | $8.6k | $9.4k | $8.4k | 89% | 24 | $986 – $19.3k |
| 10 | Hospital Service District #1, Parish of Terrebonne, State of Louisiana dba Terrebonne General Health System Houma, LA facility · other · outpatient | 1 | $36 | $114 | $170 | 148% | 16–25 | $3 – $698 |
| 11 | Allina Health Systems Ulm, MN facility · other · outpatient | 1 | $135 | $795 | $1.1k | 144% | 1–10 | $9 – $3.8k |
| 12 | Tufts Medical Center BOSTON, MA other · both | 1 | $0 | $0 | — | — | 1–10 | $0 – $0 |
| 13 | ADVENTIST HEALTH CLEARLAKE HOSPITAL INC Clearlake, CA fee schedule · outpatient | 1 | $331 | $715 | $798 | 112% | — | $145 – $3.2k |
| 14 | ADVENTIST HEALTH DELANO Delano, CA fee schedule · outpatient | 1 | $297 | $460 | $585 | 127% | — | $4 – $2.2k |
| 15 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA fee schedule · outpatient | 1 | $391 | $497 | $343 | 69% | — | $90 – $1.4k |
| 16 | ADVENTIST HEALTH TULARE Tulare, CA fee schedule · outpatient | 1 | $602 | $1.1k | $1.3k | 119% | — | $3 – $6.1k |
| 17 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 1 | $263 | $538 | $685 | 127% | — | $4 – $3.0k |
| 18 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 1 | $213 | $435 | $554 | 127% | — | $4 – $2.4k |
| 19 | Allina Health Systems Shakopee, MN facility · fee schedule · outpatient | 1 | $729 | $729 | $188 | 26% | — | $541 – $918 |
| 20 | Allina Health Systems MN; 1175 Nininger Road. Hastings, MN facility · fee schedule · outpatient | 1 | $541 | $541 | — | — | — | $541 – $541 |
| 21 | Allina Health Systems Owatonna, MN facility · fee schedule · outpatient | 1 | $729 | $729 | $188 | 26% | — | $541 – $918 |
| 22 | Allina Health Systems MN 55443; 550 Osborne Road NE. Fridley, MN facility · fee schedule · outpatient | 1 | $541 | $541 | — | — | — | $541 – $541 |
| 23 | Allina Health Systems Cambridge, MN facility · fee schedule · outpatient | 1 | $729 | $729 | $188 | 26% | — | $541 – $918 |
| 24 | Allina Health Systems River Falls, WI facility · fee schedule · outpatient | 1 | $729 | $729 | $188 | 26% | — | $541 – $918 |
| 25 | Allina Health Systems Minneapolis, MN facility · fee schedule · outpatient | 1 | $541 | $541 | — | — | — | $541 – $541 |
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