NDC 904692361
Reported by 16 hospitals in the network under the other methodology.
Based on 13–22 billing samples across every hospital reporting.
Low
$0
Average
$5
Median
$1
High
$74
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. 16 hospitals; the 90th percentile is 134.0× 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 | Carle BroMenn Medical Center | Normal, IL | $3 | $3 | — | 12 | $0 | $84 |
| 2 | North Adams Regional Hospital | North Adams, MA | $1 | $0 | $0 | 1–10 | $0 | $1 |
| 3 | USC Arcadia Hospital | Arcadia, CA | $1 | $1 | $0 | — | $0 | $2 |
| 4 | The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania | Philadelphia, PA | $1 | $1 | $0 | — | $0 | $1 |
| 5 | Pennsylvania Hospital of the University of Pennsylvania Health System | Philadelphia, PA | $1 | $1 | $0 | — | $0 | $1 |
| 6 | Presbyterian Medical Center of the University of Pennsylvania Health System D/B/A Penn Presbyterian Medical Center | Philadelphia, PA | $1 | $1 | $0 | — | $0 | $1 |
| 7 | The Chester County Hospital | West Chester, PA | $1 | $1 | $0 | — | $0 | $1 |
| 8 | Penn Medicine Princeton Medical Center | Plainsboro, NJ | $1 | $1 | $0 | — | $0 | $1 |
| 9 | Allina Health Systems | Paul, MN | $0 | $0 | — | — | $0 | $3 |
| 10 | Allina Health Systems | Minneapolis, MN | $0 | $0 | — | — | $0 | $3 |
Ask Claude or any MCP client for NDC 904692361 pricing at a specific hospital — see how to connect.