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  5. /Percent of billed charges

NDC 11523723402

POLYETHYLENE GLYCOL 3350 PO POWD

Reported by 37 hospitals in the network under the percent of billed charges methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects a negotiated percentage of total billed charges.

National pricing summary

Low

$1

Average

$20

Median

$8

High

$359

Hospitals reporting this code

#HospitalLocation
1St Luke'sJones Regional Medical CenterAnamosa, IA$4$6$7$12$3
2Northwest Sahurita Hospital LLCAZ 85748, AZ$1$1$1$6$1
3Northwest Sahurita Hospital LLCAZ 85629, AZ$1$1$1$6$1
4Oro Valley Hospital LLCTucson, AZ$1$2$3$6$2
5Northwest Hospital LLCAZ 85741, AZ$1$2$2$6$2
6Laredo Texas Hospital Company LPLaredo, TX$29$394$359$539$139
7Saint Joseph Hospital, Inc. Dba Intermountain Nhealth Saint Joseph HospitalDENVER, CO$19$58$58$102$25
8Intermountain Front Range Inc. Dba Intermountain Health Lutheran HospitalWHEAT RIDGE, CO$19$58$57$102$24
9Baylor Scott & White Medical Center - TempleTemple, TX$2$8$8$12$2
10Baylor Scott & White Medical Center - BrenhamBrenham, TX$2$7$6$12$3
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