NDC 904649035
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
00904-6490-35 - sodium chloride hypertonic ophth
Low
$14
Average
$15
Median
$15
High
$15
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Reflects negotiated fee schedule rates with commercial payers.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Dukes Health System LLC Peru, IN | $11 | $14 | $6 | 40% | — | $10 – $53 |
| 2 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania Philadelphia, PA | $15 | $15 | — | — | — | $2 – $15 |
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