HCPCS J1190

Injection, dexrazoxane hydrochloride, per 250 mg

Current code44 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicaid (state program): Washington Apple Health fee-for-service. Applies only to Medicaid enrollees.

Prices for HCPCS J1190 by hospital
Hospital	Medicaid (state program) rates (lowest – highest)	Cash price	List price (before discounts)
Cascade Valley HospitalArlington	—	$467 – $3,043	$584 – $3,804
EvergreenHealth Medical CenterKirkland	—	$965 – $1,168	$1,206 – $1,460
Highline Medical CenterBurienFile dated 2026-02-28	—	$317 – $1,393	$1,037 – $4,562
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27	—	$30.18 – $309	$75.44 – $774
PeaceHealth Peace Island Medical CenterFriday Harbor	—	$145	$223
PeaceHealth Southwest Medical CenteVancouver	—	$145	$223
PeaceHealth St John Medical CenterLongview	—	$145	$223
PeaceHealth St Joseph Medical CenterBellingham	—	$145	$223
PeaceHealth United General Medical CenterSedro Woolley	—	$145	$223
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01	—	$622 – $968	$889 – $1,384
Providence Holy Family HospitalSpokaneFile dated 2026-04-01	—	$622 – $968	$889 – $1,384
Providence Regional Medical Center EverettEverettFile dated 2026-04-01	—	$368	$708
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01	—	$787 – $1,826	$1,124 – $2,608
Providence St Peter HospitalOlympiaFile dated 2026-04-01	—	$234	$450
Seattle Children's HospitalSeattle	$462 – $9111 plan	$1,833 – $3,615	$1,833 – $3,615
Skagit Valley HospitalMount Vernon	—	$467 – $3,043	$584 – $3,804
St Anthony HospitalGig HarborFile dated 2026-02-28	—	$315 – $1,387	$1,037 – $4,562
St Clare HospitalLakewoodFile dated 2026-02-28	—	$299 – $1,315	$1,037 – $4,562
St Elizabeth HospitalEnumclawFile dated 2026-02-28	—	$366 – $1,612	$1,037 – $4,562
St Francis Community HospitalFederal WayFile dated 2026-02-28	—	$325 – $1,432	$1,037 – $4,562
St Joseph Medical CenterTacomaFile dated 2026-02-28	—	$343 – $1,511	$1,037 – $4,562
St Michael Medical CenterSilverdaleFile dated 2026-02-28	—	$458 – $2,013	$1,037 – $4,562
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01	—	$411	$857
Swedish IssaquahIssaquahFile dated 2026-04-01	—	$327 – $411	$681 – $857
Swedish Medical CenterSeattleFile dated 2026-04-01	—	$411 – $696	$857 – $1,450
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01	—	$411 – $851	$857 – $1,772
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27	—	$102	$256
Virginia Mason Medical CenterSeattle	—	$141 – $398	$277 – $780

Lowest and highest amounts each hospital lists for this code during a hospital stay, 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): $30.83 (APC 0726)
Surgery center payment (national): $30.83