NDC 904630521
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
00904-6305-21 - phenol topical 1.4 Spray
Reported by 13 hospitals in the network under the per diem methodology.
Low
$0
Average
$2.2k
Median
$1.5k
High
$5.0k
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Reflects a negotiated per diem rate paid per day of care.
Showing only prices reported under the per diem methodology. Choose another in the filter above to change the chart. 13 hospitals; the 90th percentile is 1692.4× 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.
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| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Dukes Health System LLC Peru, IN | $4 | $4 | — | — | — | $3 – $18 |
| 2 | Affinity Hospital LLC Birmingham, AL | $4 | $4 | — | — | — | $2 – $12 |
| 3 | Gadsden Regional Medical Center LLC Gadsden, AL | $1.5k | $1.5k | — | — | — | $3 – $1.5k |
| 4 | Key West HMA LLC Key West, FL | $64 | $64 | $2 | 2% | — | $4 – $65 |
| 5 | East Georgia Regional Medical Center LLC Statesboro, GA | $900 | $900 | — | — | — | $9 – $900 |
| 6 | Laredo Texas Hospital Company LP Laredo, TX | $2 | $3 | $1 | 33% | — | $2 – $35 |
| 7 | Longview Medical Center LP Longview, TX | $0 | $0 | $0 | 40% | — | $0 – $6 |
| 8 | Hoopeston Community Memorial Hospital Hoopeston, IL | $4.0k | $4.0k | — | — | — | $2 – $4.0k |
| 9 | The Queens Medical Center Honolulu, HI | $4.9k | $5.0k | $229 | 5% | — | $4.8k – $5.3k |
| 10 | The Queens Medical Center Ewa Beach, HI | $4.8k | $4.8k | $356 | 7% | — | $4.5k – $5.3k |
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