HCPCS J0696

Injection, ceftriaxone sodium, per 250 mg

Current code48 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Prices for HCPCS J0696 by hospital
HospitalMedicare Advantage rates (lowest – highest)Cash priceList price (before discounts)
BHC Fairfax HospitalKirkland$12.00 – $42.001 plan$16.00 – $209$16.00 – $209
Capital Medical CenterOlympiaFile dated 2026-08-27—$4.17 – $15.84$10.41 – $39.60
Cascade Medical CenterLeavenworth$3.35 – $8.787 plans$4.80 – $8.40$6.00 – $10.50
Cascade Valley HospitalArlington$126 – $1,4761 plan$2.50 – $134$3.13 – $168
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$6.54 – $48.92$16.34 – $122
EvergreenHealth Medical CenterKirkland—$20.80 – $248$26.00 – $310
EvergreenHealth MonroeMonroe—$20.80 – $426$26.00 – $533
Highline Medical CenterBurienFile dated 2026-02-28—$50.48 – $6,283$165 – $20,575
Island HospitalAnacortes$2.60 – $14.951 plan$4.00 – $23.00$4.00 – $23.00
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$34.61 – $42.13$49.44 – $60.19
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01———
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$4.91 – $60.68$12.26 – $152
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27—$4.17 – $15.86$10.41 – $39.63
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27—$4.20 – $15.60$10.48 – $38.99
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$4.17 – $30.84$10.41 – $77.10
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27—$6.54 – $24.77$16.34 – $61.92
Olympic Medical CenterPort AngelesFile dated 2026-06-24—$38.64 – $104$48.30 – $130
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01—$4.88 – $61.04$1.36 – $122
PeaceHealth Peace Island Medical CenterFriday Harbor—$9.54 – $164$14.68 – $253
PeaceHealth Southwest Medical CenteVancouver—$113 – $748$174 – $1,150
PeaceHealth St John Medical CenterLongview—$9.54 – $498$14.68 – $767
PeaceHealth St Joseph Medical CenterBellingham—$113 – $161$174 – $248
PeaceHealth United General Medical CenterSedro Woolley—$113 – $150$174 – $230
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$70.66 – $173$101 – $247
Providence Centralia HospitalCentraliaFile dated 2026-04-01—$39.87 – $107$76.68 – $205
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$70.66 – $173$101 – $247
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$70.66 – $165$101 – $235
Providence Regional Medical Center EverettEverettFile dated 2026-04-01—$37.06 – $69.40$71.27 – $133
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$70.66 – $118$101 – $169
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$30.00 – $90.85$42.86 – $130
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$39.90 – $99.62$76.74 – $192
Seattle Children's HospitalSeattle—$70.00 – $163$70.00 – $163
Skagit Valley HospitalMount Vernon—$2.50 – $134$3.13 – $168
St Anthony HospitalGig HarborFile dated 2026-02-28—$50.28 – $6,258$165 – $20,575
St Clare HospitalLakewoodFile dated 2026-02-28—$47.65 – $5,931$165 – $20,575
St Elizabeth HospitalEnumclawFile dated 2026-02-28$29.76 – $4,52712 plans$58.42 – $7,271$165 – $20,575
St Francis Community HospitalFederal WayFile dated 2026-02-28—$51.88 – $6,457$165 – $20,575
St Joseph Medical CenterTacomaFile dated 2026-02-28—$54.75 – $6,814$165 – $20,575
St Michael Medical CenterSilverdaleFile dated 2026-02-28—$72.96 – $9,081$165 – $20,575
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$36.04 – $43.24$75.08 – $90.09
Swedish IssaquahIssaquahFile dated 2026-04-01—$36.04$75.08
Swedish Medical CenterSeattleFile dated 2026-04-01—$36.04 – $42.16$75.08 – $87.83
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$36.04 – $42.16$75.08 – $87.83
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$4.17 – $30.02$10.41 – $75.05
Three Rivers HospitalBrewster—$27.83 – $147$27.83 – $147
Virginia Mason Medical CenterSeattle—$1.31 – $21.44$1.16 – $42.04
WhidbeyHealth Medical CenterCoupeville—$3.00$3.00
Yakima Valley MemorialYakimaFile dated 2026-08-27—$1.75 – $31.02$2.36 – $77.55

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

CMS publishes no national amount for this code.