HCPCS J0200
Injection, alatrofloxacin mesylate, 100 mg
Retired code16 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) |
|---|---|---|---|
| Capital Medical Center | $102 | — | — |
| Deaconess Medical Center | $44.28 | — | — |
| Mary Bridge Children's Hospital | $131 | — | — |
| MultiCare Auburn Medical Center | $123 | — | — |
| MultiCare Covington Medical Center | $123 | — | — |
| MultiCare Good Samaritan Hospital | $123 | — | — |
| MultiCare Valley Hospital | $44.28 | — | — |
| Overlake Hospital Medical Center & Clinics | $31.60 – $48.57 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $34.06 | — | — |
| Providence Centralia Hospital | $42.92 | — | — |
| Providence Holy Family Hospital | $34.06 | — | — |
| Providence Regional Medical Center Everett | $34.06 | — | — |
| Providence St Mary Medical Center | $34.06 | — | — |
| Providence St Peter Hospital | $35.42 | — | — |
| Tacoma General Allenmore Hospital | $123 | — | — |
| Virginia Mason Medical Center | $53.11 – $123 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.