HCPCS J2787
Riboflavin 5'-phosphate, ophthalmic solution (photrexa viscous/photrexa), up to 3 ml
Current code13 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) |
|---|---|---|---|
| Kadlec Regional Medical Center | $2,628 – $10,397 | — | — |
| Legacy Salmon Creek Medical Center | $6,156 | — | — |
| Overlake Hospital Medical Center & Clinics | $4,326 – $4,605 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $2,074 – $4,233 | — | — |
| Providence Centralia Hospital | $5,334 – $10,397 | — | — |
| Providence Holy Family Hospital | $2,074 – $4,233 | — | — |
| Providence Regional Medical Center Everett | $2,074 – $4,233 | — | — |
| Providence St Mary Medical Center | $4,233 | — | — |
| Providence St Peter Hospital | $4,402 | — | — |
| Swedish Edmonds Hospital | $2,074 | — | — |
| Swedish Issaquah | $2,074 | — | — |
| Swedish Medical Center | $2,074 | — | — |
| Swedish Medical Center / Cherry Hill | $2,074 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.