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NDC 50458002802

50458-0028-02 - esketamine 28 mg Spray

Reported by 51 hospitals in the network under the percent of billed charges 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 a negotiated percentage of total billed charges.

National pricing summary

Low

$53

Average

$779

Median

$465

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$1.5k$1.7k$2.7k$610
4UPMC Magee-Womens HospitalPittsburgh, PA$435$1.6k$1.8k$3.7k$715
5UPMC St MargaretPittsburgh, PA$435$1.1k$1.2k$2.7k$539
6UPMC PresbyterianPittsburgh, PA$395$2.4k$2.1k$3.3k$635
7UPMC Passavant - McCandlessPittsburgh, PA$415$1.5k$1.8k$3.0k$708
8UPMC Horizon - GreenvilleGreenville, PA$395$956$1.2k$2.0k$379
9UPMC MuncyMuncy, PA$342$1.5k$1.3k$2.3k$543
10UPMC MercyPittsburgh, PA$598$1.1k$1.2k$2.2k$470
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