NDC 62559-0157-10
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 17 GRAM ORAL POWDER PACKET
Reported by 16 hospitals in the network under the fee schedule methodology.
Low
$1
Average
$183
Median
$228
High
$365
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Reflects negotiated fee schedule rates with commercial payers.
Showing only prices reported under the fee schedule methodology. Choose another in the filter above to change the chart. 16 hospitals; the 90th percentile is 50.3× 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 | 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 | Chi Memorial Hospital - Georgia | Ringgold, GA | $58 | $47 | $23 | — | $12 | $67 |
| 2 | Memorial Health Care System Inc. | Hixson, TN | $82 | $67 | $20 | — | $16 | $82 |
| 3 | Memorial Health Care System Inc. | Chattanooga, TN | $82 | $66 | $20 | — | $17 | $82 |
| 4 | Alegent Creighton Health | Omaha, NE | $234 | $227 | $86 | — | $62 | $332 |
| 5 | Alegent Health Memorial Hospital, Schuyler | Schuyler, NE | $374 | $329 | $84 | — | $84 | $442 |
| 6 | Alegent Creighton Health | Plainview, NE | $374 | $345 | $60 | — | $238 | $528 |
| 7 | Alegent Creighton Health | Papillion, NE | $234 | $228 | $84 | — | $70 | $332 |
| 8 | Alegent Health Bergan Mercy Health System | Omaha, NE | $283 | $236 | $92 | — | $66 | $332 |
| 9 | Alegent Health Community Memorial Hospital Of Missouri Valley, Iowa | Missouri Valley, IA | $374 | $318 | $92 | — | $137 | $382 |
| 10 | Alegent Health Immanuel Medical Center | Omaha, NE | $234 | $229 | $85 | — | $55 | $332 |
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