HCPCS J2790

Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.)

Current codeInjection - Immune Globulin46 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 J2790 by hospital
HospitalMedicaid (state program) rates (lowest – highest)Cash priceList price (before discounts)
BHC Fairfax HospitalKirkland—$326 – $427$326 – $427
Capital Medical CenterOlympiaFile dated 2026-08-27—$92.80$232
Cascade Medical CenterLeavenworth$1371 plan$205$256
Cascade Valley HospitalArlington—$270 – $336$338 – $420
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$117$293
Highline Medical CenterBurienFile dated 2026-02-28—$110$361
Island HospitalAnacortes—$311$311
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$239$341
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$92.80$232
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27—$92.80$232
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27—$92.80$232
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$92.80$232
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27—$117$293
Olympic Medical CenterPort AngelesFile dated 2026-06-24—$377$472
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$600 – $824$857 – $1,177
Providence Centralia HospitalCentraliaFile dated 2026-04-01—$348 – $354$669 – $681
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$730 – $824$1,043 – $1,177
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$730 – $824$1,043 – $1,177
Providence Regional Medical Center EverettEverettFile dated 2026-04-01—$66.54$128
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$134 – $824$192 – $1,177
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$551 – $601$787 – $858
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$332 – $374$638 – $720
Skagit Valley HospitalMount Vernon—$270 – $336$338 – $420
St Anthony HospitalGig HarborFile dated 2026-02-28—$110$361
St Clare HospitalLakewoodFile dated 2026-02-28—$104$361
St Elizabeth HospitalEnumclawFile dated 2026-02-28—$128$361
St Francis Community HospitalFederal WayFile dated 2026-02-28—$113$361
St Joseph Medical CenterTacomaFile dated 2026-02-28—$120$361
St Michael Medical CenterSilverdaleFile dated 2026-02-28—$159$361
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$185 – $224$385 – $467
Swedish IssaquahIssaquahFile dated 2026-04-01—$185$385
Swedish Medical CenterSeattleFile dated 2026-04-01—$224 – $224$467 – $467
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$224 – $224$467 – $467
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$92.80$232
Virginia Mason Medical CenterSeattle—$150$295

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

CMS publishes no national amount for this code.