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

Unknown: The source file doesn't say which population this rate applies to.

Prices for HCPCS A4216 by hospital
HospitalUnknown rates (lowest – highest)Cash priceList price (before discounts)
Cascade Valley HospitalArlington—$4.80 – $48.00$6.00 – $60.00
EvergreenHealth Medical CenterKirkland$25.201 plan$22.40$28.00
EvergreenHealth MonroeMonroe$18.03 – $21.194 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———
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01———
Providence Holy Family HospitalSpokaneFile dated 2026-04-01———
Providence Regional Medical Center EverettEverettFile dated 2026-04-01———
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$39.89$76.71
Seattle Children's HospitalSeattle$1.26 – $4.505 plans$5.00$5.00
Skagit Valley HospitalMount Vernon—$4.80 – $48.00$6.00 – $60.00
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01———
Swedish IssaquahIssaquahFile dated 2026-04-01———
Swedish Medical CenterSeattleFile dated 2026-04-01———
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01———
Three Rivers HospitalBrewster$3.76 – $31.342 plans$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)