HCPCS J1120
Injection, acetazolamide sodium, up to 500 mg
Current codeInjection - Enzymes45 hospitals with prices
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) |
|---|---|---|---|
| Cascade Valley Hospital | $17.82 – $1,800 | $168 | $210 |
| Deaconess Medical Center | $88.12 – $228 | $94.88 – $125 | $237 – $312 |
| EvergreenHealth Medical Center | $23.93 – $297 | $222 – $255 | $278 – $319 |
| EvergreenHealth Monroe | $132 – $195 | $168 | $210 |
| Harborview Medical Center | $28.55 | — | — |
| Highline Medical Center | $96.82 – $203 | $68.76 | $225 |
| Island Hospital | $25.59 | — | — |
| Kadlec Regional Medical Center | $26.85 – $82.16 | $46.56 – $150 | $66.51 – $215 |
| Legacy Salmon Creek Medical Center | $31.25 – $47.62 | — | — |
| Mary Bridge Children's Hospital | $58.03 – $101 | $35.94 – $49.46 | $89.85 – $124 |
| MultiCare Auburn Medical Center | $113 – $163 | $62.00 – $89.16 | $155 – $223 |
| MultiCare Good Samaritan Hospital | $121 – $163 | $66.06 – $89.18 | $165 – $223 |
| MultiCare Valley Hospital | $88.12 – $225 | $94.88 – $125 | $237 – $312 |
| Olympic Medical Center | $96.71 – $173 | $138 | $173 |
| Overlake Hospital Medical Center & Clinics | $40.21 – $42.81 | $9.28 – $23.99 | $18.56 – $47.98 |
| PeaceHealth Peace Island Medical Center | — | $59.15 – $94.74 | $91.00 – $146 |
| PeaceHealth Southwest Medical Cente | $39.67 | $59.15 – $94.74 | $91.00 – $146 |
| PeaceHealth St John Medical Center | $44.53 | $59.15 – $94.74 | $91.00 – $146 |
| PeaceHealth St Joseph Medical Center | $44.31 | $59.15 – $94.74 | $91.00 – $146 |
| PeaceHealth United General Medical Center | — | $59.15 – $94.74 | $91.00 – $146 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $32.67 – $47.56 | $250 – $408 | $357 – $583 |
| Providence Centralia Hospital | $59.93 – $122 | $162 | $311 |
| Providence Holy Family Hospital | $32.67 – $47.56 | $250 – $408 | $357 – $583 |
| Providence Mount Carmel Hospital | — | $250 – $408 | $357 – $583 |
| Providence Regional Medical Center Everett | $32.67 – $47.56 | — | — |
| Providence St Joseph Hospital | — | $250 – $325 | $357 – $464 |
| Providence St Mary Medical Center | $47.56 – $149 | $167 – $273 | $239 – $390 |
| Providence St Peter Hospital | $35.24 – $49.46 | $149 – $191 | $286 – $368 |
| Seattle Children's Hospital | $82.30 – $322 | $152 – $336 | $152 – $336 |
| Skagit Valley Hospital | $30.25 – $199 | $168 | $210 |
| St Anthony Hospital | $113 – $169 | $68.48 | $225 |
| St Clare Hospital | $113 – $169 | $64.90 | $225 |
| St Elizabeth Hospital | $30.15 – $203 | $79.56 | $225 |
| St Francis Community Hospital | $113 – $169 | $70.66 | $225 |
| St Joseph Medical Center | $113 – $169 | $74.57 | $225 |
| St Michael Medical Center | $29.04 – $203 | $99.37 | $225 |
| Swedish Edmonds Hospital | $32.67 – $35.24 | $62.42 – $102 | $130 – $212 |
| Swedish Issaquah | $32.67 – $35.24 | $74.51 | $155 |
| Swedish Medical Center | $32.67 – $35.24 | $62.42 – $102 | $130 – $212 |
| Swedish Medical Center / Cherry Hill | $32.67 – $35.24 | $62.42 – $102 | $130 – $212 |
| Tacoma General Allenmore Hospital | $109 – $163 | $59.60 – $89.18 | $149 – $223 |
| University of Washington Medical Ctr | $28.55 | — | — |
| Virginia Mason Medical Center | $25.68 – $46.76 | $21.83 – $27.01 | $42.80 – $52.97 |
| Yakima Valley Memorial | $43.78 – $191 | $35.74 – $89.18 | $89.35 – $223 |
Medicare (traditional) reference
CMS publishes no national amount for this code.