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NDC 55390025101

mitoMYcin 5 mg Powder-Inj at Laredo Texas Hospital Company LP

Laredo, TX

Pricing by billing methodology

Price type

All methodologies

$219

Aggregated across all available billing methodologies for this code.

Case rate

Not reported

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

Fee schedule

$44

Reflects negotiated fee schedule rates with commercial payers.

Per diem

$45

Reflects a negotiated per diem rate paid per day of care.

Percent of billed charges

$604

Reflects a negotiated percentage of total billed charges.

Other

$84

Reflects a payer-specific billing methodology not covered by the standard categories.

Last updated: Apr 1, 2026

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