HCPCS J3410

Injection, hydroxyzine hcl, up to 25 mg

Current code34 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Prices for HCPCS J3410 by hospital
HospitalCommercial insurance rates (lowest – highest)Cash priceList price (before discounts)
BHC Fairfax HospitalKirkland$56.701 plan$81.00$81.00
Cascade Valley HospitalArlington$2.12 – $1,4638 plans$2.34 – $133$2.92 – $166
Deaconess Medical CenterSpokaneFile dated 2026-08-27$79.97 – $1262 plans$45.06 – $69.23$113 – $173
EvergreenHealth Medical CenterKirkland$21.34 – $2007 plans$172$215
EvergreenHealth MonroeMonroe$135 – $20012 plans$172$215
Island HospitalAnacortes$13.00 – $40.8513 plans$43.00$43.00
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$40.25 – $42.06$57.50 – $60.09
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$45.49 – $83.783 plans$30.84 – $45.91$77.10 – $115
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$45.49 – $83.663 plans$30.84 – $45.84$77.10 – $115
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$58.67 – $1242 plans$32.60 – $68.76$81.48 – $172
Olympic Medical CenterPort AngelesFile dated 2026-06-24$57.02 – $1026 plans$81.61$102
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$187$268
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$187$268
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$114 – $187$163 – $268
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$171 – $187$245 – $268
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$62.96$89.94
Seattle Children's HospitalSeattle$145 – $25898 plans$269$269
Skagit Valley HospitalMount Vernon$2.32 – $1587 plans$2.34 – $133$2.92 – $166
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$36.04$75.08
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$45.71 – $83.663 plans$30.99 – $45.84$77.47 – $115
Virginia Mason Medical CenterSeattle$24.65 – $46.184 plans$19.63 – $29.44$38.49 – $57.72
Yakima Valley MemorialYakimaFile dated 2026-08-27$47.66 – $54.011 plan$34.04 – $38.58$85.10 – $96.45

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.