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
Phenytoin 250 MG/5 ML Vial
Aberdeen, SD
See all hospitals reporting HCPCS J1165 →Price type
Avera St. Luke's’s median price of $1 is 59% below the median hospital's median price ($3), higher than 33% of the 1,968 hospitals reporting HCPCS J1165. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 4 payers, 8 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Medica com fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 2 | Medica ind fee schedule · outpatient | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Wellmark ppo fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 4 | UnitedHealthcare com fee schedule · outpatient | $1 | $1 | — | — | — | $1 – $1 |
| 5 | Healthpartners com percent of total billed charges · outpatientfrom % of charges | $25 | $25 | — | — | — | $25 – $25 |
| 6 | Medica ind percent of total billed charges · inpatientfrom % of charges | $29 | $29 | — | — | — | $29 – $29 |
| 7 | Medica com percent of total billed charges · inpatientfrom % of charges | $34 | $34 | — | — | — | $34 – $34 |
| 8 | UnitedHealthcare com percent of total billed charges · inpatientfrom % of charges | $35 | $35 | — | — | — | $35 – $35 |
Last updated: Apr 1, 2026
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