NDC 904693806
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
00904-6938-06 - butalbital/acetaminophen/caffeine
Reported by 55 hospitals in the network under the percent of billed charges methodology.
Based on 460–478 billing samples across every hospital reporting.
Low
$1
Average
$48
Median
$8
High
$313
Filter by billing methodology
Reflects a negotiated percentage of total billed charges.
Showing only prices reported under the percent of billed charges methodology. Choose another in the filter above to change the chart. 55 hospitals; the 90th percentile is 88.4× 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.
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 | Tri-City Medical Center | Oceanside, CA | $9 | $12 | $5 | 460–478 | $4 | $20 |
| 2 | IOM Health System LP | Fort Wayne, IN | $8 | $9 | $3 | — | $4 | $14 |
| 3 | Bluffton Health System LLC | Bluffton, IN | $16 | $15 | $5 | — | $6 | $23 |
| 4 | Dukes Health System LLC | Peru, IN | $15 | $16 | $5 | — | $5 | $27 |
| 5 | Warsaw Health System LLC | Warsaw, IN | $21 | $20 | $7 | — | $7 | $33 |
| 6 | Lutheran Musculoskeletal Center LLC | Fort Wayne, IN | $15 | $16 | $6 | — | $7 | $31 |
| 7 | St. Joseph Health System, LLC | Wayne, IN | $10 | $11 | $4 | — | $4 | $18 |
| 8 | Dupont Hospital LLC | Wayne, IN | $7 | $7 | $3 | — | $3 | $12 |
| 9 | Durant HMA LLC | Durant, OK | $9 | $8 | $3 | — | $2 | $11 |
| 10 | Naples HMA LLC | Naples, FL | $6 | $8 | $3 | — | $4 | $21 |
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