62991108704 (NDC) by state — Price Transparency

NDC · across United States

62991108704 — Hchg Rx 250 Pharmacy

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

$13,837 National median

$13,837 – $16,473 IQR (p25 – p75)

1 hospitals filing

1 states

View hospital-by-hospital → Raw rate rows →

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This estimate runs on the hospital’s facility charge only. The surgeon’s and anesthesiologist’s fees are billed separately and aren’t in this number — your EOB shows your complete total.

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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 62991108704 (NDC), with interquartile range
State	Median	p25	p75
MI	$13,837	$13,837	$16,473

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

MI	$13,837	$13,837	$16,473	$11,558	$17,516	1 ⚠ thin data	8	26