NDC 00904-6422-81
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.
Generation details were not recorded for this description.
Original text from hospital filings
Miralax-Polyethylene Glycol 3350 PWPK 17 GRAM EA [CRHS]
Reported by 71 hospitals in the network.
Based on 482–527 billing samples across every hospital reporting.
Low
$0
Average
$188
Median
$9
High
$8.5k
Filter by billing methodology
Showing prices across every billing methodology. Pick one in the filter above to narrow the chart. 71 hospitals; the 90th percentile is 612.6× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | Location | Std dev | Approximate number of payer billing records behind this hospital’s price. CMS privacy rules cap small counts as a range (e.g. “1–10”) rather than an exact number — more samples means a more reliable price. | ||||
|---|---|---|---|---|---|---|---|---|
| 1 | Columbus Regional Healthcare System, Inc | Whiteville, NC | $1 | $1 | $0 | 481–517 | $0 | $1 |
| 2 | Centinela Hospital Medical Center | Inglewood, CA | $1 | $1 | — | 1–10 | $1 | $2.9k |
| 3 | Trinity Medical Center | Rock Island, IL | $1 | $71 | $107 | — | $1 | $235 |
| 4 | Trinity Medical Center | Bettendorf, IA | $1 | $1 | $0 | — | $1 | $2 |
| 5 | Central Iowa Hospital Corporation | Des Moines, IA | $1 | $1 | $0 | — | $0 | $1 |
| 6 | Central Iowa Hospital Corporation | Des Moines, IA | $1 | $1 | $0 | — | $0 | $1 |
| 7 | Alegent Creighton Health | Omaha, NE | $152 | $147 | $56 | — | $40 | $215 |
| 8 | Alegent Health Memorial Hospital, Schuyler | Schuyler, NE | $243 | $213 | $54 | — | $54 | $286 |
| 9 | Alegent Creighton Health | Plainview, NE | $243 | $224 | $39 | — | $154 | $342 |
| 10 | Alegent Creighton Health | Papillion, NE | $152 | $148 | $55 | — | $46 | $215 |
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