NDC 57074-0001-77
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.
Original text from hospital filings
CALCIUM ACETATE 952 MG-ALUMINUM SULFATE 1,347 MG TOPICAL POWDER PACKET
Reported by 16 hospitals in the network under the case rate methodology.
Low
$3
Average
$670
Median
$766
High
$900
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Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.
Showing only prices reported under the case rate methodology. Choose another in the filter above to change the chart. 16 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 | ||||||
|---|---|---|---|---|---|---|---|
| 1 | The Mercy Hospital Inc Springfield, MA | $392 | $392 | — | — | — | $0 – $392 |
| 2 | Mount Carmel Grove City Grove City, OH | $632 | $632 | — | — | — | $0 – $632 |
| 3 | Diley Ridge Medical Center Canal Winchester, OH | $632 | $632 | — | — | — | $0 – $632 |
| 4 | Mount Carmel St Ann's Westerville, OH | $632 | $632 | — | — | — | $0 – $632 |
| 5 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA | $3 | $3 | — | — | — | $1 – $3 |
| 6 | Southcoast Hospitals Group, Inc. Bedford, MA | $412 | $412 | — | — | — | $0 – $91.9k |
| 7 | Southcoast Hospitals Group, Inc. River, MA | $412 | $412 | — | — | — | $0 – $91.9k |
| 8 | Southcoast Hospitals Group, Inc. Wareham, MA | $412 | $412 | — | — | — | $0 – $91.9k |
| 9 | University Hospitals Health System Chardon, OH | $900 | $900 | — | — | — | $15 – $900 |
| 10 | University Hospitals Health System Beachwood, OH | $900 | $900 | — | — | — | $14 – $900 |
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