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HCPCS J2760

Injection, phentolamine mesylate, up to 5 mg

Current codeInjection - Vasodilator45 hospitals with prices

Description from CMS's HCPCS Level II code file.

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.

HospitalMedicaid managed care rates (lowest – highest)Cash priceList price (before discounts)
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$725$1,812
EvergreenHealth Medical CenterKirkland—$2,406$3,007
EvergreenHealth MonroeMonroe$4581 plan$2,406$3,007
Highline Medical CenterBurienFile dated 2026-02-28—$139 – $1,619$454 – $5,302
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$954 – $1,117$1,363 – $1,596
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$792$1,980
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27—$575$1,437
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$124 – $502$311 – $1,255
Olympic Medical CenterPort AngelesFile dated 2026-06-24$73.10 – $80.065 plans$930$1,163
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01—$479 – $1,430$959 – $2,860
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$835 – $1,219$1,193 – $1,741
Providence Centralia HospitalCentraliaFile dated 2026-04-01—$1,497$2,879
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$835 – $1,219$1,193 – $1,741
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$835 – $1,219$1,193 – $1,741
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$835 – $1,219$1,193 – $1,741
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$1,787 – $2,608$2,553 – $3,726
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$1,096 – $1,497$2,108 – $2,879
Seattle Children's HospitalSeattle—$2,779 – $3,235$2,779 – $3,235
St Anthony HospitalGig HarborFile dated 2026-02-28—$138 – $1,613$454 – $5,302
St Clare HospitalLakewoodFile dated 2026-02-28—$131 – $1,528$454 – $5,302
St Elizabeth HospitalEnumclawFile dated 2026-02-28$127 – $1,7595 plans$160 – $1,874$454 – $5,302
St Francis Community HospitalFederal WayFile dated 2026-02-28—$142 – $1,664$454 – $5,302
St Joseph Medical CenterTacomaFile dated 2026-02-28—$150 – $1,756$454 – $5,302
St Michael Medical CenterSilverdaleFile dated 2026-02-28—$200 – $2,340$454 – $5,302
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$813 – $1,186$1,693 – $2,471
Swedish IssaquahIssaquahFile dated 2026-04-01—$1,186$2,471
Swedish Medical CenterSeattleFile dated 2026-04-01—$813 – $1,186$1,693 – $2,471
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$1,186$2,471
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$463 – $648$1,156 – $1,619
Virginia Mason Medical CenterSeattle—$645$1,265
Yakima Valley MemorialYakimaFile dated 2026-08-27—$531 – $704$1,328 – $1,759

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)
$297 (APC 1458)
Surgery center payment (national)
$297