NDC 904655161
Reported by 17 hospitals in the network under the other methodology.
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
Based on 448–475 billing samples across every hospital reporting.
Low
$0
Average
$57
Median
$6
High
$574
| # | 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 | Bexar County Hospital District | San Antonio, TX | $32 | $32 | $17 | 404–413 | $2 | $49 |
| 2 | Carle BroMenn Medical Center | Normal, IL | $59 | $59 | — | 42 | $0 | $59 |
| 3 | Crestview Hospital Corporation | Crestview, FL | $152 | $574 | $1.1k | 2–20 | $27 | $3.5k |
| 4 | St. Joseph Health System, LLC | Wayne, IN | $12 | $12 | $7 | — | $1 | $18 |
| 5 | Victoria of Texas LP | Victoria, TX | $35 | $58 | $53 | — | $13 | $198 |
| 6 | Victoria of Texas LP | Victoria, TX | $35 | $58 | $53 | — | $13 | $198 |
| 7 | Affinity Hospital LLC | Birmingham, AL | $38 | $38 | $10 | — | $7 | $48 |
| 8 | Gadsden Regional Medical Center LLC | Gadsden, AL | $122 | $122 | — | — | $122 | $122 |
| 9 | Laredo Texas Hospital Company LP | Laredo, TX | $6 | $6 | $0 | — | $3 | $60 |
| 10 | Poplar Bluff Regional Medical Center LLC | Poplar Bluff, MO | $3 | $3 | — | — | $1 | $4 |
Ask Claude or any MCP client for NDC 904655161 pricing at a specific hospital — see how to connect.