HCPCS J0490

Injection, belimumab, 10 mg

Current codeInjection - Monoclonal Antibodies44 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for HCPCS J0490 by hospital
HospitalMedicaid managed care rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27$1,966 – $2,9135 plans——
Cascade Valley HospitalArlington$59.30 – $6,5194 plans$4,340 – $5,188$5,424 – $6,486
Deaconess Medical CenterSpokaneFile dated 2026-08-27$1,799 – $1,9055 plans——
EvergreenHealth Medical CenterKirkland—$3,241 – $10,784$4,051 – $13,480
Harborview Medical CenterSeattleFile dated 2026-04-01———
Highline Medical CenterBurienFile dated 2026-02-28—$898 – $2,992$2,940 – $9,798
Island HospitalAnacortes$1,856 – $2,0143 plans——
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$1,687$2,409
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01———
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27$1,861 – $2,0105 plans$106 – $147$264 – $368
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$1,827 – $1,9735 plans——
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27$1,827 – $1,9735 plans$88.06 – $88.80$220 – $222
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$1,869 – $2,0195 plans——
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$1,786 – $1,8915 plans——
Olympic Medical CenterPort AngelesFile dated 2026-06-24$2,300 – $2,5195 plans$1,934 – $5,468$2,417 – $6,834
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01———
PeaceHealth Peace Island Medical CenterFriday Harbor—$618 – $8,366$950 – $12,871
PeaceHealth Southwest Medical CenteVancouver$59.451 plan$1,110 – $8,043$1,708 – $12,374
PeaceHealth St John Medical CenterLongview$44.58 – $60.023 plans$1,110 – $3,263$1,708 – $5,021
PeaceHealth St Joseph Medical CenterBellingham$60.022 plans$1,110 – $3,263$1,708 – $5,021
PeaceHealth United General Medical CenterSedro Woolley—$1,110 – $3,263$1,708 – $5,021
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$1,840$2,628
Providence Centralia HospitalCentraliaFile dated 2026-04-01—$2,147 – $6,641$4,129 – $12,771
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$1,840$2,628
Providence Regional Medical Center EverettEverettFile dated 2026-04-01———
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$2,787 – $6,598$3,981 – $9,426
Providence St Peter HospitalOlympiaFile dated 2026-04-01———
Seattle Children's HospitalSeattle$766 – $3,26112 plans$2,981 – $10,030$2,981 – $10,030
Skagit Valley HospitalMount Vernon$53.07 – $2,3285 plans$4,340 – $5,188$5,424 – $6,486
St Anthony HospitalGig HarborFile dated 2026-02-28—$894 – $2,980$2,940 – $9,798
St Clare HospitalLakewoodFile dated 2026-02-28—$847 – $2,824$2,940 – $9,798
St Elizabeth HospitalEnumclawFile dated 2026-02-28$500 – $2,0285 plans$1,039 – $3,462$2,940 – $9,798
St Francis Community HospitalFederal WayFile dated 2026-02-28—$922 – $3,075$2,940 – $9,798
St Joseph Medical CenterTacomaFile dated 2026-02-28—$974 – $3,245$2,940 – $9,798
St Michael Medical CenterSilverdaleFile dated 2026-02-28—$1,297 – $4,324$2,940 – $9,798
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$1,790 – $5,968$3,730 – $12,432
Swedish IssaquahIssaquahFile dated 2026-04-01—$1,790 – $5,968$3,730 – $12,432
Swedish Medical CenterSeattleFile dated 2026-04-01—$1,790 – $5,968$3,730 – $12,432
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$1,790 – $5,968$3,730 – $12,432
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$1,870 – $2,0205 plans$87.31 – $88.61$218 – $222
University of Washington Medical CtrSeattleFile dated 2026-04-01———
Virginia Mason Medical CenterSeattle—$104$203 – $203
Wellfound Behavioral Health HospitalTacomaFile dated 2026-08-27———
Yakima Valley MemorialYakimaFile dated 2026-08-27$1,787 – $2,0765 plans$85.57 – $91.62$214 – $229

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.

Hospital outpatient payment (national)
$58.33 (APC 1353)
Surgery center payment (national)
$58.33