Injection of pantoprazole sodium

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

PANTOPRAZOLE SODIUM 40 MG IV SOLR

Payers reporting HCPCS C9113

Payer pricing summary

Low

Average

$69

Median

$38

High

$550

Payer rate distribution

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#
1	Aetna facility · fee schedule · outpatient · +19 other terms	34	$13	$12	$4	33%	—	$5 – $32
2	Blue Cross Blue Shield fee schedule · outpatient · +11 other terms	26	$50	$16	$26	165%	—	$1 – $136
3	Cigna fee schedule · outpatient · +12 other terms	26	$8	$29	$16	56%	—	$1 – $46
4	UnitedHealthcare fee schedule · outpatient · +15 other terms	24	$20	$26	$45	174%	—	$1 – $390
5	Humana fee schedule · outpatient · +11 other terms	20	$18	$25	$12	49%	—	$1 – $45
6	Anthem facility · case rate · outpatient · +11 other terms	15	$9	$10	$2	23%	—	$6 – $15
7	Caresource facility · case rate · outpatient · +3 other terms	15	$9	$10	$2	23%	—	$6 – $15
8	Molina facility · case rate · outpatient · +11 other terms	15	$9	$10	$2	23%	—	$6 – $15
9	MultiPlan fee schedule · outpatient · +10 other terms	15	$46	$48	$11	23%	—	$1 – $55
10	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$19	$19	$7	36%	—	$1 – $24
11	Optum facility · case rate · outpatient · +7 other terms	11	$8	$9	$2	22%	—	$7 – $13
12	Ucare percent of total billed charges · outpatientfrom % of charges · +3 other terms	9	$20	$20	$4	22%	—	$11 – $27
13	Medica percent of total billed charges · outpatientfrom % of charges · +4 other terms	8	$25	$25	$10	41%	—	$7 – $43
14	Aetna Better Health fee schedule · inpatient · +4 other terms	7	$5	$5	—	—	—	$5 – $5
15	First Health fee schedule · inpatient · +7 other terms	6	$40	$40	$0	1%	—	$40 – $40
16	Phcs fee schedule · inpatient · +5 other terms	6	$43	$43	$0	1%	—	$43 – $43
17	Superior Healthplan percent of total billed charges · outpatientfrom % of charges	6	$23	$20	$13	64%	—	$6 – $38
18	WellCare fee schedule · outpatient · +3 other terms	6	$14	$14	$2	17%	—	$10 – $17
19	Regence percent of total billed charges · inpatientfrom % of charges · +1 other terms	5	$51	$51	$15	29%	—	$33 – $90
20	Medicaid fee schedule · outpatient · +3 other terms	4	$1	$1	$0	10%	—	$1 – $1
21	Bcbs Ks percent of total billed charges · outpatientfrom % of charges	3	$88	$88	$20	23%	—	$77 – $128
22	Devoted facility · fee schedule · outpatient · +2 other terms	3	$80	$72	$40	56%	—	$20 – $117
23	Healthcare Highways percent of total billed charges · outpatientfrom % of charges	3	$28	$67	$68	101%	—	$28 – $185
24	Highmark facility · fee schedule · outpatient · +2 other terms	3	$5	$5	$0	4%	—	$5 – $5
25	Kaiser fee schedule · outpatient · +4 other terms	3	$1	$1	$0	12%	—	$1 – $1

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