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
VANCOMYCIN 1.25 GRAM/250 ML IN DEXTROSE 5 % INFUSION *DH WRAPPED*
Lebanon, NH
See all hospitals reporting HCPCS J3373 →Price type
Mary Hitchcock Memorial Hospital’s median price of $79 is 316% above the median hospital's median price ($19), higher than 87% of the 1,717 hospitals reporting HCPCS J3373. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 60 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 | Aetna aetna medicare advantage - dhp professional · fee schedule · outpatient | $0.03 | $0.03 | $0.03 – $0.03 |
| 2 | Ambetter ambetter commercial - exchange behavioral health - dhp professional · fee schedule · outpatient | $0.03 | $0.03 | $0.03 – $0.03 |
| 3 | Anthem anthem - medicare advantage - dhp professional · fee schedule · outpatient | $0.03 | $0.03 | $0.03 – $0.03 |
| 4 | Bcbs Vt bcbs of vermont - medicare advantage - dhp professional · fee schedule · outpatient | $0.03 | $0.03 | $0.03 – $0.03 |
| 5 | Bcbs Vt bcbs of vermont - the vermont health plan professional · fee schedule · outpatient | $0.03 | $0.03 | $0.03 – $0.03 |
| 6 | Cigna cigna medicare advantage - dhp professional · fee schedule · outpatient | $0.03 | $0.03 | $0.03 – $0.03 |
| 7 | UnitedHealthcare uhc - medicare advantage - dhp professional · fee schedule · outpatient | $0.03 | $0.03 | $0.03 – $0.03 |
| 8 | UnitedHealthcare uhc - va community care network - dhpn professional · fee schedule · outpatient | $0.03 | $0.03 | $0.03 – $0.03 |
| 9 | UnitedHealthcare uhc - va community care network - dhps professional · fee schedule · outpatient | $0.03 | $0.03 | $0.03 – $0.03 |
| 10 | WellCare wellcare - medicare advantage - dhp professional · fee schedule · outpatient | $0.03 | $0.03 | $0.03 – $0.03 |
| 11 | Anthem anthem indiv qhp - exchange facility · fee schedule · outpatient | $0.05 | $0.05 | $0.05 – $0.05 |
| 12 | Ambetter ambetter commercial - exchange - dhps professional · fee schedule · outpatient | $0.07 | $0.07 | $0.07 – $0.07 |
| 13 | Ambetter ambetter commercial - exchange - dhpn professional · fee schedule · outpatient | $0.09 | $0.09 | $0.09 – $0.09 |
| 14 | Anthem anthem shop - exchange facility · fee schedule · outpatient | $0.09 | $0.09 | $0.09 – $0.09 |
| 15 | Anthem anthem - indemnity facility · fee schedule · outpatient | $0.11 | $0.11 | $0.11 – $0.11 |
| 16 | Anthem anthem hmo/pos; individual non qhp on or off exch; shop off exch facility · fee schedule · outpatient | $0.11 | $0.11 | $0.11 – $0.11 |
| 17 | Anthem anthem ppo facility · fee schedule · outpatient | $0.11 | $0.11 | $0.11 – $0.11 |
| 18 | Amerihealth Caritas amerihealth caritas - nh managed medicaid - dhp professional · fee schedule · outpatient | $0.13 | $0.13 | $0.13 – $0.13 |
| 19 | Amerihealth Caritas amerihealth caritas - nh managed medicaid professional · percent of total billed charges · outpatientfrom % of charges | $0.23 | $0.23 | $0.23 – $0.23 |
| 20 | UnitedHealthcare uhc - freedom plan professional · percent of total billed charges · outpatientfrom % of charges | $0.98 | $0.98 | $0.98 – $0.98 |
| 21 | UnitedHealthcare uhc - freedom plan professional · percent of total billed charges · inpatientfrom % of charges | $1.02 | $1.02 | $1.02 – $1.02 |
| 22 | Bcbs Vt bcbs of vermont - the vermont health plan professional · percent of total billed charges · outpatientfrom % of charges | $1.10 | $1.10 | $1.10 – $1.10 |
| 23 | Bcbs Vt bcbs of vermont - vermont health partnership professional · percent of total billed charges · outpatientfrom % of charges | $1.10 | $1.10 | $1.10 – $1.10 |
| 24 | Cigna cigna hmo-pos professional · percent of total billed charges · outpatientfrom % of charges | $1.21 | $1.21 | $1.21 – $1.21 |
| 25 | Aetna aetna hmo/pos/ppo - arnb professional · percent of total billed charges · inpatientfrom % of charges | $1.23 | $1.23 | $1.23 – $1.23 |
Last updated: Jan 1, 2026
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