00641149535 (OTHER) by state — Price Transparency

OTHER · across United States

00641149535 — 25 Ampule In 1 Carton (0641-1495-35) / 1 Ml In 1 Ampule (0641-1495-31)

State-by-state median negotiated rates. Lower bars are cheaper states; the range bar shows the IQR (25th to 75th percentile within each state).

$2,878 National median

$2,878 – $2,878 IQR (p25 – p75)

1 hospitals filing

1 states

View hospital-by-hospital → Raw rate rows →

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Out-of-pocket max (assumed — typical plan) Coinsurance % (after deductible)

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Median negotiated rate, by state

Ranked by typical (median) negotiated price. Hover for state-level IQR.

Median negotiated rate by state for 00641149535 (OTHER), with interquartile range
State	Median	p25	p75
GA	$2,878	$2,878	$2,878

Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
State	Median	p25	p75	Min	Max	Hospitals	Payers	Rates

GA	$2,878	$2,878	$2,878	$2,878	$2,878	1 ⚠ thin data	10	13