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
$10
Average
$965
Median
$979
High
$4.8k
Each hospital's average Medicare rate, under the methodology and billing class chosen below.
176 hospitals; the 90th percentile is 4.3× 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.
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199 hospital rates
iThe hospitals that file a Medicare 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 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC other · both | 1 | $198 | $198 | $148 | 75% | 2,036 | $50 – $346 |
| 2 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC other · both | 1 | $198 | $198 | $148 | 75% | 2,036 | $50 – $346 |
| 3 | STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS other · outpatient | 1 | $831 | $1.1k | $824 | 76% | 600–609 | $50 – $3.7k |
| 4 | Mercy Hospital Oklahoma City Inc City, OK facility · other · outpatient | 1 | $839 | $1.1k | $680 | 65% | 550–577 | $49 – $2.3k |
| 5 | METHODIST UNIVERSITY HOSPITAL MEMPHIS, TN other · both | 1 | $700 | $857 | $636 | 74% | 502–529 | $23 – $2.2k |
| 6 | Reid Health Richmond, IN other · both | 3 | $831 | $1.1k | $558 | 51% | 462 | $479 – $2.0k |
| 7 | PRISMA HEALTH BAPTIST COLUMBIA HOSPITAL COLUMBIA, SC other · both | 1 | $346 | $346 | — | — | 310 | $346 – $346 |
| 8 | Boston Medical Center Boston, MA other · both | 1 | $880 | $3.7k | $12.2k | 328% | 200 | $10 – $56.8k |
| 9 | FRANCISCAN HEALTH RENSSELAER, INC. RENSSELAER, IN percent of total billed charges · bothfrom % of charges | 1 | $235 | $720 | $974 | 135% | 175–229 | $16 – $4.3k |
| 10 | Mercy Perry Perryville, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $100 | $157 | $218 | 139% | 146–191 | $13 – $1.1k |
| 11 | Aspen Valley Hospital District Aspen, CO facility · percent of total billed charges · bothfrom % of charges | 4 | $522 | $1.6k | $2.6k | 161% | 119–164 | $155 – $9.0k |
| 12 | Mercy Hospital Ardmore Inc Ardmore, OK facility · other · outpatient | 1 | $916 | $1.1k | $541 | 50% | 115–124 | $340 – $2.0k |
| 13 | Mercy Hospital Aurora Aurora, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $79 | $100 | $65 | 65% | 84–111 | $11 – $307 |
| 14 | Eskenazi Health Indianapolis, IN facility · other · outpatient | 2 | $1.4k | $1.4k | — | — | 81–90 | $1.4k – $1.4k |
| 15 | Quitman Hospital, LLC Quitman, TX facility · percent of total billed charges · bothfrom % of charges | 3 | $232 | $907 | $1.1k | 120% | 39–84 | $5 – $4.0k |
| 16 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MICHIGAN CITY CITY, IN other · both | 1 | $776 | $898 | $582 | 65% | 37 | $50 – $2.3k |
| 17 | Pittsburg Hospital, LLC Pittsburg, TX facility · percent of total billed charges · bothfrom % of charges | 3 | $213 | $965 | $1.2k | 123% | 36–72 | $6 – $4.3k |
| 18 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH MUNSTER MUNSTER, IN other · both | 1 | $776 | $938 | $553 | 59% | 32–41 | $322 – $2.3k |
| 19 | Mercy Hospital Cassville Knob, MO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $132 | $160 | $94 | 59% | 29–56 | $80 – $461 |
| 20 | Mercy Hospital Berryville Berryville, AR facility · percent of total billed charges · outpatientfrom % of charges | 1 | $111 | $382 | $500 | 131% | 28–64 | $14 – $1.9k |
| 21 | Mercy Hospital Fort Smith Smith, AR facility · other · outpatient | 1 | $863 | $979 | $558 | 57% | 27–36 | $49 – $2.3k |
| 22 | Mercy Hospital Fort Smith Smith, AR facility · other · outpatient | 1 | $863 | $979 | $558 | 57% | 27–36 | $49 – $2.3k |
| 23 | Tufts Medical Center BOSTON, MA other · both | 1 | $5.5k | $4.8k | $1.3k | 26% | 27–45 | $3.0k – $5.8k |
| 24 | COMMONSPIRIT KANSAS, INC. Garden City, KS other · inpatient | 1 | $20 | $20 | — | — | 22 | $20 – $20 |
| 25 | COMMONSPIRIT KANSAS, INC. Garden City, KS other · outpatient | 1 | $20 | $20 | — | — | 22 | $20 – $20 |
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