NDC 00574-0120-04
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
charcoal w/sorbitol 25 gm Susp 120 mL
Low
$0
Average
$13
Median
$13
High
$27
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Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | White Memorial Medical Center Angeles, CA | $28 | $27 | $1 | 5% | — | $15 – $215 |
| 2 | Allina Health Systems Rapids, MN | $0 | $0 | — | — | — | $0 – $41 |
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