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NDC 0085433401

MOMETASONE 200 MCG/ACTUATION HFA AEROSOL INHALER

Reported by 20 hospitals in the network.

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.

National pricing summary

Low

$104

Average

$136

Median

$137

High

$180

Hospitals reporting this code

#HospitalLocation
1Catholic Health Initiatives ColoradoColorado Springs, CO$53$107$117$198$46
2Catholic Health Initiatives ColoradoSalt Lake City, UT$80$122$138$225$41
3Catholic Health Initiatives ColoradoColorado Springs, CO$61$112$130$198$45
4Catholic Health Initiatives ColoradoLehi, UT$80$122$138$225$41
5St Francis HospitalColorado Springs, CO$53$102$109$191$41
6Longmont United HospitalLongmont, CO$53$90$110$202$48
7Catholic Health Initiatives ColoradoFrisco, CO$61$135$148$207$48
8Commonspirit Kansas, Inc.Ulysses, KS$72$188$157$214$60
9Commonspirit Kansas, Inc.Dodge City, KS$79$180$173$202$31
10Catholic Health Initiatives ColoradoPueblo, CO$62$130$132$198$45
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