HCPCS S0028
Injection, famotidine, 20 mg
Retired code12 hospitals with prices
This code is retired. Some hospitals still list it.
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Kadlec Regional Medical Center | $1.12 | — | — |
| Legacy Salmon Creek Medical Center | — | — | $1.00 |
| Overlake Hospital Medical Center & Clinics | $1.69 – $1.80 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $1.82 | — | — |
| Providence Centralia Hospital | $2.29 | — | — |
| Providence Holy Family Hospital | $1.82 | — | — |
| Providence Regional Medical Center Everett | $1.82 | — | — |
| Providence St Mary Medical Center | $1.82 | — | — |
| Providence St Peter Hospital | $1.89 | — | — |
| Skagit Valley Hospital | $3.18 – $3.80 | $3.20 | $4.00 |
| Virginia Mason Medical Center | $2.84 – $3.23 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.