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
Polyethylene Glycol 3350 Powder
Reported by 5 hospitals in the network under the per diem methodology.
Low
$142
Average
$1.4k
Median
$1.7k
High
$1.7k
Filter by billing methodology
Reflects a negotiated per diem rate paid per day of care.
Showing only prices reported under the per diem methodology. Choose another in the filter above to change the chart. 5 hospitals; the 90th percentile is 2.2× 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 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 | Indiana University Health Bloomington Inc. | Bloomington, IN | $142 | $142 | — | — | — | $3 | $142 |
| 2 | Memorial Hospital West | Pembroke Pines, FL | $1.7k | $1.7k | $1.0k | 58% | — | $4 | $2.7k |
| 3 | Memorial Regional Hospital | Hollywood, FL | $1.7k | $1.7k | $1.0k | 58% | — | $4 | $2.7k |
| 4 | Memorial Hospital Pembroke | Pembroke Pines, FL | $1.7k | $1.7k | $1.0k | 58% | — | $4 | $2.7k |
| 5 | Memorial Hospital Miramar | Miramar, FL | $1.7k | $1.7k | $1.0k | 58% | — | $4 | $2.7k |
Ask Claude or any MCP client for NDC 00904-6422-81 pricing at a specific hospital — see how to connect.