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NDC 00143-9284-01

PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION

Reported by 22 hospitals in the network under the fee schedule methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects negotiated fee schedule rates with commercial payers.

National pricing summary

Low

$5

Average

$55

Median

$58

High

$221

Hospitals reporting this code

#HospitalLocation
1Alegent Creighton HealthOmaha, NE$16$60$58$85$22
2Alegent Health Memorial Hospital, SchuylerSchuyler, NE$21$96$84$113$21
3Alegent Creighton HealthPlainview, NE$61$96$88$135$15
4Alegent Creighton HealthPapillion, NE$18$60$58$85$22
5Alegent Health Bergan Mercy Health SystemOmaha, NE$17$72$60$85$23
6Alegent Health Community Memorial Hospital Of Missouri Valley, IowaMissouri Valley, IA$35$96$81$98$24
7Alegent Health Immanuel Medical CenterOmaha, NE$14$60$58$85$22
8Alegent Health - Mercy Hospital, Corning IowaCorning, IA$43$96$81$98$23
9Alegent Health Bergan Mercy Health SystemCouncil Bluffs, IA$15$60$60$85$19
10Alegent Health Bergan Mercy Health SystemOmaha, NE$17$60$58$85$21
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