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
Trinity Medical Center
Reported by 4 hospitals in the network under the case rate methodology.
Low
$235
Average
$3.2k
Median
$2.1k
High
$8.5k
Filter by billing methodology
Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.
| # | Hospital | Location | Std dev as a share of this hospital’s average price: how widely its filed prices for this code vary relative to its own price level, so hospitals can be compared. The spread is across payers, plans and settings, so contract mix can drive it as well as pricing discipline. | 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 | Trinity Medical Center | Rock Island, IL | $235 | $235 | — | — | — | $1 | $235 |
| 2 | UPMC Northwest | Seneca, PA | $3.7k | $3.7k | — | — | — | $1 | $3.7k |
| 3 | OU Health - University of Oklahoma Medical Center | Oklahoma City, OK | $448 | $448 | — | — | — | $448 | $448 |
| 4 | University of New Mexico Hospital | UNM Sandoval Regional Medical Center - A Campus of UNM Hospital | Albuquerque, NM | $8.5k | $8.5k | — | — | — | $8.5k | $8.5k |
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