HCPCS A4216

Sterile water, saline and/or dextrose, diluent/flush, 10 ml

Current code18 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Prices for HCPCS A4216 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
Cascade Valley HospitalArlington$4.36 – $6088 plans$4.80 – $48.00$6.00 – $60.00
EvergreenHealth Medical CenterKirkland$8.96 – $26.047 plans$22.40$28.00
EvergreenHealth MonroeMonroe$16.38 – $24.1812 plans$20.80$26.00
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01——$1.17
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$1.062 plans——
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$1.121 plan——
Providence Holy Family HospitalSpokaneFile dated 2026-04-01$1.121 plan——
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$1.121 plan——
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$39.89$76.71
Seattle Children's HospitalSeattle$2.70 – $4.8098 plans$5.00$5.00
Skagit Valley HospitalMount Vernon$4.78 – $57.007 plans$4.80 – $48.00$6.00 – $60.00
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$1.121 plan——
Swedish IssaquahIssaquahFile dated 2026-04-01$1.121 plan——
Swedish Medical CenterSeattleFile dated 2026-04-01$1.121 plan——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$1.121 plan——
Three Rivers HospitalBrewster—$5.57 – $38.22$5.57 – $38.22
WhidbeyHealth Medical CenterCoupeville—$2,702$2,702

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Equipment fee, Washington
$0.54 (fee)