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NDC 50458002802

50458-0028-02 - esketamine 28 mg Spray

Reported by 56 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

$50

Average

$759

Median

$472

High

$2.1k

Hospitals reporting this code

#HospitalLocation
1IOM Health System LPFort Wayne, IN$953$1.9k$2.1k$3.5k$765
2Lutheran Musculoskeletal Center LLCFort Wayne, IN$854$1.7k$1.9k$3.6k$665
3St. Joseph Health System, LLCWayne, IN$648$1.6k$1.7k$2.7k$619
4UPMC Magee-Womens HospitalPittsburgh, PA$435$1.6k$1.8k$3.7k$736
5UPMC St MargaretPittsburgh, PA$435$956$1.2k$2.7k$547
6UPMC PresbyterianPittsburgh, PA$395$2.3k$2.0k$3.3k$683
7UPMC Passavant - McCandlessPittsburgh, PA$415$1.4k$1.7k$3.0k$765
8UPMC Horizon - GreenvilleGreenville, PA$395$956$1.2k$2.0k$402
9UPMC MuncyMuncy, PA$342$1.5k$1.3k$2.3k$568
10UPMC MercyPittsburgh, PA$598$1.1k$1.2k$2.2k$470
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