HCPCS S0164 at Cascade Medical Center

Injection, pantoprazole sodium, 40 mg

Cascade Medical Center, Leavenworth

Description from CMS's HCPCS Level II code file.

What Cascade Medical Center publishes for this code: during a hospital stay

Cascade Medical Center’s prices for HCPCS S0164, during a hospital stay
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$12.74 – $20.322 plans	—
Medicare AdvantageInsurer rates	$11.35 – $16.997 plans	—
Medicaid managed careInsurer rates	$11.30 – $16.994 plans	—
Medicaid (state program)Insurer rates	$10.851 plan	—
Medicare (traditional)Insurer rates	$11.751 plan	—
Other government programInsurer rates	$18.13 – $20.322 plans	—
UnknownInsurer rates	$13.21 – $20.326 plans	—
Cash pricePaying yourself, without insurance	$16.26	—
List priceBefore any discount; few people pay it	$20.32	—

Lowest and highest amounts Cascade Medical Center lists for this code during a hospital stay, including lines it lists for both settings or without saying which. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in the rest of Washington for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

Bills to expect for HCPCS S0164 at Cascade Medical Center
Bill	What it’s for	Original Medicare allows	Private plan estimate
Hospital's feeThe hospital	The service	—	The price above

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare HCPCS S0164 at every Washington hospital, with Medicare’s reference amounts.