HCPCS J1097
Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml
Current code34 hospitals with prices
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $94.68 – $104 | — | — |
| Deaconess Medical Center | $94.68 – $104 | — | — |
| Harborview Medical Center | $96.91 – $107 | — | — |
| Island Hospital | $113 – $120 | — | — |
| Kadlec Regional Medical Center | $96.61 – $116 | — | — |
| Legacy Salmon Creek Medical Center | $99.51 – $108 | — | — |
| Mary Bridge Children's Hospital | $94.68 – $104 | — | — |
| MultiCare Auburn Medical Center | $94.68 – $104 | — | — |
| MultiCare Covington Medical Center | $94.68 – $104 | — | — |
| MultiCare Good Samaritan Hospital | $94.68 – $104 | — | — |
| MultiCare Valley Hospital | $97.52 – $104 | — | — |
| Olympic Medical Center | $119 – $153 | — | — |
| Overlake Hospital Medical Center & Clinics | $96.61 – $100 | — | — |
| PeaceHealth Peace Island Medical Center | — | $1,050 | $1,616 |
| PeaceHealth Southwest Medical Cente | $106 – $122 | $1,050 | $1,616 |
| PeaceHealth St John Medical Center | $83.08 – $117 | $1,040 – $1,050 | $1,600 – $1,616 |
| PeaceHealth St Joseph Medical Center | $106 – $117 | $1,050 | $1,616 |
| PeaceHealth United General Medical Center | — | $1,050 | $1,616 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $96.61 – $116 | — | — |
| Providence Centralia Hospital | $96.61 – $155 | — | — |
| Providence Holy Family Hospital | $96.61 – $106 | — | — |
| Providence Regional Medical Center Everett | $96.61 – $106 | — | — |
| Providence St Joseph Hospital | — | $622 | $888 |
| Providence St Mary Medical Center | $96.61 – $106 | $1,032 | $1,475 |
| Providence St Peter Hospital | $96.61 – $155 | — | — |
| Swedish Edmonds Hospital | $96.61 – $116 | — | — |
| Swedish Issaquah | $96.61 – $116 | — | — |
| Swedish Medical Center | $96.61 – $116 | — | — |
| Swedish Medical Center / Cherry Hill | $96.61 – $116 | — | — |
| Tacoma General Allenmore Hospital | $94.68 – $104 | — | — |
| University of Washington Medical Ctr | $96.91 – $107 | — | — |
| Virginia Mason Medical Center | $67.84 – $102 | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $94.68 – $106 | — | — |
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)
- $96.06 (APC 9324)
- Surgery center payment (national)
- $96.06