NDC 57896-0489-14
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
POLYETHYLENE GLYCOL 3350 PO POWD
Reported by 4 hospitals in the network under the case rate methodology.
Low
$235
Average
$662
Median
$716
High
$983
Filter by billing methodology
Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.
| # | Hospital | Location | 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 | The Finley Hospital | Dubuque, IA | $235 | $235 | — | — | $6 | $235 |
| 2 | OU Health - University of Oklahoma Medical Center | Oklahoma City, OK | $448 | $448 | — | — | $448 | $448 |
| 3 | Southern Baptist Hospital of Florida, INC | Jacksonville, FL | $983 | $983 | — | — | $983 | $983 |
| 4 | Southern Baptist Hospital of Florida, INC | Jacksonville, FL | $983 | $983 | — | — | $983 | $983 |
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