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
$35
Median
$15
High
$462
Each hospital's average UnitedHealthcare rate, under the methodology and billing class chosen below.
51 hospitals; the 90th percentile is 11.3× 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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71 hospital rates
iThe hospitals that file a UnitedHealthcare 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 · case rate · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 2 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 3 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 4 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 5 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 6 | CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient | 1 | $10 | $10 | — | — | — | $10 – $10 |
| 7 | Carle BroMenn Medical Center Normal, IL fee schedule · inpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 8 | Carle BroMenn Medical Center Normal, IL fee schedule · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 9 | Carle Eureka Hospital Eureka, IL fee schedule · inpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 10 | Carle Eureka Hospital Eureka, IL fee schedule · outpatient | 1 | $17 | $17 | — | — | — | $17 – $17 |
| 11 | Cheshire Medical Center Keene, NH professional · fee schedule · outpatient | 2 | $8 | $8 | $4 | 45% | — | $4 – $11 |
| 12 | Children's Mercy Hospital Kansas City, MO facility · percent of total billed charges · inpatientfrom % of charges | 2 | $56 | $56 | $3 | 6% | — | $53 – $59 |
| 13 | Children's Mercy Hospital Kansas City, MO facility · percent of total billed charges · outpatientfrom % of charges | 3 | $53 | $53 | $5 | 10% | — | $46 – $59 |
| 14 | Children's Mercy Hospital Kansas Overland Park, KS facility · percent of total billed charges · inpatientfrom % of charges | 2 | $56 | $56 | $3 | 6% | — | $53 – $59 |
| 15 | Children's Mercy Hospital Kansas Overland Park, KS facility · percent of total billed charges · outpatientfrom % of charges | 3 | $53 | $53 | $5 | 10% | — | $46 – $59 |
| 16 | Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient | 1 | $8 | $8 | — | — | — | $8 – $8 |
| 17 | Craig Hospital Englewood, CO facility · percent of total billed charges · inpatientfrom % of charges | 1 | $17 | $17 | $1 | 4% | — | $16 – $17 |
| 18 | Craig Hospital Englewood, CO facility · percent of total billed charges · outpatientfrom % of charges | 1 | $19 | $19 | $1 | 4% | — | $19 – $20 |
| 19 | East Valley Glendora Hospital, LLC Glendora, CA facility · percent of total billed charges · bothfrom % of charges | 1 | $51 | $51 | — | — | — | $51 – $51 |
| 20 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · inpatientfrom % of charges | 2 | $28 | $28 | $1 | 4% | — | $26 – $29 |
| 21 | Fairview Bethesda Hospital St. Paul, MN percent of total billed charges · outpatientfrom % of charges | 2 | $28 | $28 | $1 | 4% | — | $26 – $29 |
| 22 | Fairview Health Services Edina, MN percent of total billed charges · inpatientfrom % of charges | 2 | $20 | $20 | — | — | — | $20 – $20 |
| 23 | Fairview Health Services Edina, MN percent of total billed charges · outpatientfrom % of charges | 2 | $25 | $25 | — | — | — | $25 – $25 |
| 24 | Fairview Health Services Minneapolis, MN percent of total billed charges · inpatientfrom % of charges | 2 | $20 | $20 | — | — | — | $20 – $20 |
| 25 | Fairview Health Services Minneapolis, MN percent of total billed charges · outpatientfrom % of charges | 2 | $25 | $25 | — | — | — | $25 – $25 |
← Payers reporting HCPCS S0164 · Snapshot 20261112T181611Z-3fa9fb76