Research
What U.S. hospitals charge for common injectable drugs vs. pharmacy acquisition cost
We compared the prices U.S. hospitals publish in their federally-mandated Hospital Price Transparency files for fifteen common injectable drugs against the public pharmacy acquisition cost for the same drugs (NADAC, published weekly by CMS). For each drug, reported by dozens to hundreds of hospitals, we report the median published list price, the median published cash price, and the acquisition cost, with the underlying data and sources linked. The analysis describes published prices only; it does not characterize any hospital or claim what a drug should cost.
Last reviewed June 2026 · MediBill Saver Editorial Team
At a glance
- We compared what hospitals publish for 15 common injectable drugs against the pharmacy acquisition cost (NADAC) for the same drugs. Each drug is reported by 40 to 364 hospitals in our sample.
- For normal saline (a 1-liter IV bag), the median published list price across 297 hospitals is $57.73; the pharmacy acquisition cost is $1.75 per bag.
- For ondansetron (the common anti-nausea drug, per 1 mg), the median published list price across 345 hospitals is $13.47; the acquisition cost is $0.11.
- HPT charge data is current as of May 12, 2026. The figures are what each hospital publishes in its own federally-mandated file; we do not characterize any price as appropriate or inappropriate.
Scope
This analysis covers the injectable and infusion drugs that appear most often on hospital and emergency-room bills and that have a published NADAC acquisition cost. The charge figures come from the Hospital Price Transparency files in the dataset MediBill Saver ingests, which covers a subset of U.S. hospitals. We do not extrapolate from this sample to all hospitals, and no individual hospital is named. Each figure is a median across the hospitals that publish a price for that drug.
Published hospital price vs. pharmacy acquisition cost
For each drug we report the median published list price (the chargemaster figure), the median published cash price, and the NADAC pharmacy acquisition cost for the same billable unit. The final column expresses the median list price as a multiple of the acquisition cost. Drugs are ordered by how many hospitals report a price. Each drug name links to its full benchmark page.
| Drug | Hospitals | Median list | Median cash | Acquisition (NADAC) | List ÷ NADAC |
|---|---|---|---|---|---|
| Ketorolac, non-opioid pain (per 15 mg)J1885 | 364 | $22.58 | $12.58 | $0.65 | 35× |
| Ondansetron, anti-nausea (per 1 mg)J2405 | 345 | $13.47 | $6.19 | $0.11 | 122× |
| Normal saline, 1,000 mL IV bagJ7030 | 297 | $57.73 | $33.49 | $1.75 | 33× |
| Fentanyl, opioid pain (per 0.1 mg)J3010 | 93 | $50.00 | $18.00 | $0.18 | 278× |
| Promethazine, anti-nausea (per 50 mg)J2550 | 84 | $11.25 | $4.59 | $1.30 | 9× |
| Iodinated CT contrast (per 1 mL)Q9967 | 72 | $105.36 | $37.93 | $0.65 | 162× |
| Normal saline, 500 mL IV bagJ7040 | 65 | $31.38 | $10.91 | $0.95 | 33× |
| Ringer's lactate, 1,000 mL IV bagJ7120 | 65 | $40.00 | $12.74 | $2.20 | 18× |
| Normal saline, 250 mL IV bagJ7050 | 61 | $26.76 | $9.63 | $0.60 | 45× |
| Dexamethasone, steroid (per 1 mg)J1100 | 53 | $19.49 | $6.56 | $0.12 | 162× |
| Morphine, opioid pain (per 10 mg)J2270 | 52 | $67.35 | $24.25 | $0.75 | 90× |
| Diphenhydramine, antihistamine (per 50 mg)J1200 | 52 | $10.32 | $3.37 | $0.70 | 15× |
| Ceftriaxone, antibiotic (per 250 mg)J0696 | 51 | $103.26 | $27.00 | $0.95 | 109× |
| Ciprofloxacin, antibiotic (per 200 mg)J0744 | 42 | $17.24 | $6.21 | $1.10 | 16× |
| IV acetaminophen, non-opioid pain (per 10 mg)J0131 | 40 | $175.40 | $69.19 | $0.22 | 797× |
List price is the hospital’s chargemaster figure; cash price is the self-pay rate the hospital publishes. Most patients pay neither. See the methodology note below.
List-price spread across hospitals
The same drugs, with the published list price at five points of the distribution across the hospitals that publish each one. This shows the range of prices published for the same drug.
| Drug | Min | P25 | Median | P75 | Max |
|---|---|---|---|---|---|
| Ketorolac, non-opioid pain (per 15 mg)J1885 | $0.50 | $11.53 | $22.58 | $44.25 | $10,655.06 |
| Ondansetron, anti-nausea (per 1 mg)J2405 | $0.17 | $6.38 | $13.47 | $46.00 | $10,655.06 |
| Normal saline, 1,000 mL IV bagJ7030 | $1.00 | $26.85 | $57.73 | $119.55 | $351,437.00 |
| Fentanyl, opioid pain (per 0.1 mg)J3010 | $0.71 | $12.75 | $50.00 | $111.00 | $453.03 |
| Promethazine, anti-nausea (per 50 mg)J2550 | $1.00 | $9.90 | $11.25 | $32.75 | $453.03 |
| Iodinated CT contrast (per 1 mL)Q9967 | $0.01 | $15.36 | $105.36 | $158.58 | $1,096.50 |
| Normal saline, 500 mL IV bagJ7040 | $0.64 | $30.30 | $31.38 | $99.81 | $376.00 |
| Ringer's lactate, 1,000 mL IV bagJ7120 | $1.00 | $35.40 | $40.00 | $148.00 | $379.00 |
| Normal saline, 250 mL IV bagJ7050 | $0.01 | $15.37 | $26.76 | $71.95 | $275.00 |
| Dexamethasone, steroid (per 1 mg)J1100 | $1.00 | $11.41 | $19.49 | $31.65 | $303.16 |
| Morphine, opioid pain (per 10 mg)J2270 | $2.00 | $46.18 | $67.35 | $67.35 | $275.08 |
| Diphenhydramine, antihistamine (per 50 mg)J1200 | $1.00 | $6.87 | $10.32 | $28.15 | $239.00 |
| Ceftriaxone, antibiotic (per 250 mg)J0696 | $1.00 | $54.87 | $103.26 | $131.72 | $905.52 |
| Ciprofloxacin, antibiotic (per 200 mg)J0744 | $17.24 | $17.24 | $17.24 | $55.50 | $1,068.00 |
| IV acetaminophen, non-opioid pain (per 10 mg)J0131 | $32.50 | $118.39 | $175.40 | $192.20 | $1,028.00 |
Methodology
Data sources. Hospital list and cash prices come from Hospital Price Transparency files published by U.S. hospitals under 45 CFR §180.50. Pharmacy acquisition cost comes from the CMS National Average Drug Acquisition Cost (NADAC), a weekly survey of retail pharmacy invoice prices published at data.medicaid.gov. Both are public federal data. See /data-sources and /methodology for source-by-source documentation.
Aggregation. For each drug code we read the median and percentile list (gross) charges and the median cash charge from our nightly HPT aggregate, computed with percentile_disc over the de-duplicated rates published by each hospital. Zero and negative values are excluded as data-quality artifacts. NADAC is matched to the same HCPCS billable unit so the comparison is per the same quantity.
What this is and isn’t. This report describes the prices hospitals publish for these drugs alongside the public acquisition cost of the same drugs. It is not a claim about what any hospital should charge; hospitals legally set their own prices. It is not an audit of any individual hospital, and no hospital is named. Published list and cash prices are not what most patients pay: insurance-negotiated rates, charity-care discounts under §501(r), and self-pay discounts typically apply. NADAC reflects pharmacy acquisition cost only; a hospital’s price also reflects facility overhead, pharmacy preparation, storage, waste, and other costs that an acquisition figure does not include.
How to cite
MediBill Saver Editorial Team. (2026). What U.S. hospitals charge for common injectable drugs vs. pharmacy acquisition cost. Retrieved from https://www.medibillsaver.com/research/hospital-drug-charges-vs-acquisition-cost
The underlying data is public and verifiable through the sources linked in the methodology. This report is published under CC BY 4.0.
Editorial standard
Per the editorial standard across our research, this analysis states facts, cites sources, and does not characterize any hospital, provider, or insurer. It does not claim what a charge should cost. Findings are framed as comparisons against public federal data, with the underlying sources linked so readers can verify the analysis.
If a drug like one of these is on your own bill, you can check every line against these same federal sources.