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$41.84 – $1265 plans$45.06 – $69.23$113 – $173
EvergreenHealth Medical CenterKirkland$21.34 – $2007 plans$172$215
EvergreenHealth MonroeMonroe$135 – $20012 plans$172$215
Harborview Medical CenterSeattleFile dated 2026-04-01$14.271 plan——
Island HospitalAnacortes$13.00 – $40.8513 plans$43.00$43.00
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01$15.29 – $46.784 plans$40.25 – $42.06$57.50 – $60.09
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01$24.09 – $39.964 plans——
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27$56.28 – $83.782 plans$30.84 – $45.91$77.10 – $115
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27$56.28 – $83.662 plans$30.84 – $45.84$77.10 – $115
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27$30.27 – $1245 plans$32.60 – $68.76$81.48 – $172
Olympic Medical CenterPort AngelesFile dated 2026-06-24$57.02 – $1026 plans$81.61$102
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01$22.90 – $24.373 plans——
PeaceHealth St Joseph Medical CenterBellingham—$73.16$113
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01$14.98 – $32.833 plans$187$268
Providence Centralia HospitalCentraliaFile dated 2026-04-01$34.12 – $1144 plans——
Providence Holy Family HospitalSpokaneFile dated 2026-04-01$14.98 – $32.833 plans$187$268
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$114 – $187$163 – $268
Providence Regional Medical Center EverettEverettFile dated 2026-04-01$14.98 – $32.834 plans——
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$171 – $187$245 – $268
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01$27.08 – $89.672 plans$62.96$89.94
Providence St Peter HospitalOlympiaFile dated 2026-04-01$28.16 – $32.832 plans——
Seattle Children's HospitalSeattle$145 – $25898 plans$269$269
Skagit Valley HospitalMount Vernon$2.32 – $158at least 7 plans$2.34 – $133$2.92 – $166
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01$14.98 – $33.864 plans$36.04$75.08
Swedish IssaquahIssaquahFile dated 2026-04-01$14.98 – $33.863 plans——
Swedish Medical CenterSeattleFile dated 2026-04-01$14.98 – $32.832 plans——
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01$14.98 – $32.832 plans——
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27$56.55 – $83.662 plans$30.99 – $45.84$77.47 – $115
University of Washington Medical CtrSeattleFile dated 2026-04-01$14.271 plan——
Virginia Mason Medical CenterSeattle$16.60 – $46.189 plans$19.63 – $29.44$38.49 – $57.72
WhidbeyHealth Medical CenterCoupeville—$4.00$4.00
Yakima Valley MemorialYakimaFile dated 2026-08-27$28.31 – $82.667 plans$34.04 – $38.58$85.10 – $96.45

Lowest and highest amounts each hospital lists for this code as an outpatient, 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.