NDC 70121-1699-01
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
GLYCOPYRROLATE (PF) IN WATER 0.4 MG/2 ML (0.2 MG/ML) IV SYRG
Reported by 28 hospitals in the network under the other methodology.
Based on 9–90 billing samples across every hospital reporting.
Low
$1
Average
$1
Median
$1
High
$8
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 28 hospitals; the 90th percentile is 1.7× 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 | North Carolina Baptist Hospital | Winston Salem, NC | $1 | $1 | $0 | 4–40 | $1 | $53 |
| 2 | Northwestern Medicine Delnor Hospital | Geneva, IL | $1 | $1 | — | 1–10 | $1 | $125 |
| 3 | North Carolina Baptist Hospital | Bermuda Run, NC | $1 | $1 | — | 1–10 | $0 | $53 |
| 4 | The Charlotte Mecklenburg Hospital Authority | Albermarle, NC | $8 | $8 | — | 1–10 | $0 | $40 |
| 5 | High Point Regional Health | High Point, NC | $2 | $2 | — | 1–10 | $2 | $55 |
| 6 | WRMC Hospital Operating Corporation | North Wilkesboro, NC | $1 | $1 | — | 1–10 | $0 | $54 |
| 7 | Kaiser Foundation Hospital - Roseville | ROSEVILLE, CA | $0 | $1 | $0 | — | $0 | $1 |
| 8 | Kaiser Foundation Hospital - Santa Clara | SANTA CLARA, CA | $0 | $1 | $0 | — | $0 | $1 |
| 9 | Kaiser Foundation Hospital - Oakland/richmond | Oakland, CA | $0 | $1 | $0 | — | $0 | $1 |
| 10 | Kaiser Foundation Hospital - Modesto | 95356, CA | $0 | $1 | $0 | — | $0 | $1 |
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