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
Injection, pantoprazole sodium, 40 mg
Low
$2
Average
$41
Median
$11
High
$762
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
73 hospitals; the 90th percentile is 10.8× 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.
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84 hospital rates
iThe hospitals that file a Aetna rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · fee schedule · outpatient | 2 | $11 | $11 | $1 | 12% | — | $10 – $12 |
| 2 | Adena Fayette Medical Center Washington Court House, OH facility · fee schedule · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 3 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 1 | $13 | $13 | — | — | — | $13 – $13 |
| 4 | Bethesda Hospital Inc. Lebanon, OH facility · fee schedule · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 5 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · fee schedule · outpatient | 3 | $12 | $11 | $1 | 10% | — | $10 – $12 |
| 6 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · fee schedule · outpatient | 2 | $11 | $11 | $1 | 12% | — | $10 – $12 |
| 7 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · fee schedule · outpatient | 3 | $12 | $11 | $1 | 10% | — | $10 – $12 |
| 8 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · fee schedule · outpatient | 3 | $12 | $11 | $1 | 10% | — | $10 – $12 |
| 9 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $6 | $6 | $1 | 12% | — | $5 – $7 |
| 10 | Children's Mercy Hospital Kansas City, MO facility · percent of total billed charges · inpatientfrom % of charges | 2 | $56 | $56 | $4 | 6% | — | $53 – $60 |
| 11 | Children's Mercy Hospital Kansas City, MO facility · percent of total billed charges · outpatientfrom % of charges | 2 | $56 | $56 | $4 | 6% | — | $53 – $60 |
| 12 | Children's Mercy Hospital Kansas Overland Park, KS facility · percent of total billed charges · inpatientfrom % of charges | 2 | $56 | $56 | $4 | 6% | — | $53 – $60 |
| 13 | Children's Mercy Hospital Kansas Overland Park, KS facility · percent of total billed charges · outpatientfrom % of charges | 2 | $56 | $56 | $4 | 6% | — | $53 – $60 |
| 14 | Cleveland Clinic Mercy Hospital Canton, OH facility · fee schedule · outpatient | 1 | $12 | $12 | — | — | — | $12 – $12 |
| 15 | Clifton Springs Hospital And Clinic Clifton Springs, NY facility · fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 16 | Clinton Memorial Hospital Wilmington, OH fee schedule · outpatient | 1 | $14 | $14 | — | — | — | $14 – $14 |
| 17 | Conway Hospital, Inc. Conway, SC professional · fee schedule · outpatient | 1 | $762 | $762 | — | — | — | $762 – $762 |
| 18 | Covenant Medical Center Lubbock, TX fee schedule · outpatient | 1 | $16 | $16 | — | — | — | $16 – $16 |
| 19 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 20 | Covenant Medical Center Inc Saginaw, MI professional · fee schedule · both | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 21 | Craig Hospital Englewood, CO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $23 | $23 | $1 | 4% | — | $22 – $24 |
| 22 | Denver Health and Hospital Authority Denver, CO facility · fee schedule · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 23 | Doctors’ Hospital of Williamsburg Williamsburg, VA fee schedule · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 24 | East Valley Glendora Hospital, LLC Glendora, CA facility · percent of total billed charges · bothfrom % of charges | 1 | $96 | $96 | — | — | — | $96 – $96 |
| 25 | Fairview Health Services Minneapolis, MN percent of total billed charges · outpatientfrom % of charges | 1 | $34 | $34 | — | — | — | $34 – $34 |
← Payers reporting HCPCS S0164 · Snapshot 20261112T181611Z-3fa9fb76