HCPCS J1120
Injection, acetazolamide sodium, up to 500 mg
Current codeInjection - Enzymes45 hospitals with prices
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.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Cascade Medical Center | $66.26 – $99.57 | $95.28 | $119 |
| Cascade Valley Hospital | $210 | $168 | $210 |
| Deaconess Medical Center | — | $94.88 – $125 | $237 – $312 |
| EvergreenHealth Medical Center | — | $222 – $255 | $278 – $319 |
| EvergreenHealth Monroe | — | $168 | $210 |
| Highline Medical Center | — | $68.76 | $225 |
| Kadlec Regional Medical Center | — | $46.56 – $150 | $66.51 – $215 |
| Mary Bridge Children's Hospital | — | $35.94 – $49.46 | $89.85 – $124 |
| MultiCare Auburn Medical Center | — | $62.00 – $89.16 | $155 – $223 |
| MultiCare Good Samaritan Hospital | — | $66.06 – $89.18 | $165 – $223 |
| MultiCare Valley Hospital | — | $94.88 – $125 | $237 – $312 |
| Olympic Medical Center | — | $138 | $173 |
| Overlake Hospital Medical Center & Clinics | — | $9.28 – $23.99 | $18.56 – $47.98 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $250 – $408 | $357 – $583 |
| Providence Centralia Hospital | — | $162 | $311 |
| Providence Holy Family Hospital | — | $250 – $408 | $357 – $583 |
| Providence Mount Carmel Hospital | — | $250 – $408 | $357 – $583 |
| Providence St Joseph Hospital | — | $250 – $325 | $357 – $464 |
| Providence St Mary Medical Center | — | $167 – $273 | $239 – $390 |
| Providence St Peter Hospital | — | $149 – $191 | $286 – $368 |
| Seattle Children's Hospital | $39.17 – $109 | $152 – $336 | $152 – $336 |
| Skagit Valley Hospital | — | $168 | $210 |
| St Anthony Hospital | — | $68.48 | $225 |
| St Clare Hospital | — | $64.90 | $225 |
| St Elizabeth Hospital | $63.05 – $74.69 | $79.56 | $225 |
| St Francis Community Hospital | — | $70.66 | $225 |
| St Joseph Medical Center | — | $74.57 | $225 |
| St Michael Medical Center | — | $99.37 | $225 |
| Swedish Edmonds Hospital | — | $62.42 – $102 | $130 – $212 |
| Swedish Issaquah | — | $74.51 | $155 |
| Swedish Medical Center | — | $62.42 – $102 | $130 – $212 |
| Swedish Medical Center / Cherry Hill | — | $62.42 – $102 | $130 – $212 |
| Tacoma General Allenmore Hospital | — | $59.60 – $89.18 | $149 – $223 |
| Virginia Mason Medical Center | — | $21.83 – $27.01 | $42.80 – $52.97 |
| Yakima Valley Memorial | — | $35.74 – $89.18 | $89.35 – $223 |
Medicare (traditional) reference
CMS publishes no national amount for this code.