HCPCS J3410
Injection, hydroxyzine hcl, up to 25 mg
Current code34 hospitals with prices
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.
| Hospital | Medicaid managed care rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| BHC Fairfax Hospital | — | $81.00 | $81.00 |
| Cascade Valley Hospital | $2.92 – $166 | $2.34 – $133 | $2.92 – $166 |
| Deaconess Medical Center | — | $45.06 – $69.23 | $113 – $173 |
| EvergreenHealth Medical Center | — | $172 | $215 |
| EvergreenHealth Monroe | — | $172 | $215 |
| Island Hospital | $21.50 | $43.00 | $43.00 |
| Kadlec Regional Medical Center | — | $40.25 – $42.06 | $57.50 – $60.09 |
| MultiCare Auburn Medical Center | — | $30.84 – $45.91 | $77.10 – $115 |
| MultiCare Good Samaritan Hospital | — | $30.84 – $45.84 | $77.10 – $115 |
| MultiCare Valley Hospital | — | $32.60 – $68.76 | $81.48 – $172 |
| Olympic Medical Center | — | $81.61 | $102 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $187 | $268 |
| Providence Holy Family Hospital | — | $187 | $268 |
| Providence Mount Carmel Hospital | — | $114 – $187 | $163 – $268 |
| Providence St Joseph Hospital | — | $171 – $187 | $245 – $268 |
| Providence St Mary Medical Center | — | $62.96 | $89.94 |
| Seattle Children's Hospital | $69.18 – $87.50 | $269 | $269 |
| Skagit Valley Hospital | — | $2.34 – $133 | $2.92 – $166 |
| Swedish Edmonds Hospital | — | $36.04 | $75.08 |
| Tacoma General Allenmore Hospital | — | $30.99 – $45.84 | $77.47 – $115 |
| Virginia Mason Medical Center | — | $19.63 – $29.44 | $38.49 – $57.72 |
| Yakima Valley Memorial | — | $34.04 – $38.58 | $85.10 – $96.45 |
Medicare (traditional) reference
CMS publishes no national amount for this code.