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  4. /25021-0612-81

NDC 25021-0612-81

MAGNESIUM SULFATE IN WATER 2 GRAM/50 ML (4 %) IV PGBK

Reported by 44 hospitals in the network.

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.

National pricing summary

Based on 11,917–12,682 billing samples across every hospital reporting.

Low

$1

Average

$34

Median

$32

High

$92

Hospitals reporting this code

#HospitalLocationApproximate 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.
1Mercy Health Saint MarysGrand Rapids, MI$35$38$99,600$26$59
2Johnson Memorial HospitalStafford Springs, CT$59$55$6800$34$59
3Chi St. Luke's Health Baylor College Of Medicine Medical CenterHouston, TX$35$34$21336–444$0$108
4Dignity HealthCarmichael, CA$1$16$25248–320$1$67
5St. Luke's Community Health ServicesSpring, TX$34$33$21228$0$108
6St. Luke's Community Health ServicesThe Woodlands, TX$34$33$21228$0$108
7Dignity Community CareSacramento, CA$2$18$26131–194$1$67
8St. Lukes Hospital At The VintageHouston, TX$35$34$22132$0$108
9CHI St. Vincent Hospital Hot SpringsHot Springs, AR$30$35$2886–140$1$68
10St Lukes Community Development Corporation - Sugar LandSugar Land, TX$35$34$2212–120$0$108
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Look up this code directly

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