HCPCS C9064
Mitomycin pyelocalyceal instillation, 1 mg
Retired codeChemotherapeutic Agent17 hospitals with prices
This code is retired. Some hospitals still list it. CMS replaced it with HCPCS J9281.
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) |
|---|---|---|---|
| Capital Medical Center | $695 – $1,139 | — | — |
| Kadlec Regional Medical Center | $622 | — | — |
| Legacy Salmon Creek Medical Center | $351 – $413 | — | — |
| MultiCare Auburn Medical Center | $604 – $1,139 | — | — |
| MultiCare Covington Medical Center | $604 – $1,139 | — | — |
| MultiCare Good Samaritan Hospital | $604 – $1,139 | — | — |
| Overlake Hospital Medical Center & Clinics | $570 – $1,709 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $633 | — | — |
| Providence Centralia Hospital | $795 | — | — |
| Providence Regional Medical Center Everett | $647 | — | — |
| Providence St Peter Hospital | $853 | — | — |
| Swedish Edmonds Hospital | $592 – $630 | — | — |
| Swedish Issaquah | $600 – $826 | — | — |
| Swedish Medical Center | $600 – $826 | — | — |
| Swedish Medical Center / Cherry Hill | $597 – $826 | — | — |
| Tacoma General Allenmore Hospital | $604 – $843 | — | — |
| Yakima Valley Memorial | $542 – $889 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.