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

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Prices for HCPCS J3410 by hospital
HospitalMedicare Advantage rates (lowest – highest)Cash priceList price (before discounts)
BHC Fairfax HospitalKirkland—$81.00$81.00
Cascade Valley HospitalArlington$111 – $1,4631 plan$2.34 – $133$2.92 – $166
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$45.06 – $69.23$113 – $173
EvergreenHealth Medical CenterKirkland—$172$215
EvergreenHealth MonroeMonroe—$172$215
Harborview Medical CenterSeattleFile dated 2026-04-01———
Island HospitalAnacortes$27.951 plan$43.00$43.00
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$40.25 – $42.06$57.50 – $60.09
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01———
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27—$30.84 – $45.91$77.10 – $115
MultiCare Good Samaritan HospitalPuyallupFile dated 2026-08-27—$30.84 – $45.84$77.10 – $115
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27—$32.60 – $68.76$81.48 – $172
Olympic Medical CenterPort AngelesFile dated 2026-06-24—$81.61$102
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01———
PeaceHealth St Joseph Medical CenterBellingham—$73.16$113
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$187$268
Providence Centralia HospitalCentraliaFile dated 2026-04-01———
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$187$268
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$114 – $187$163 – $268
Providence Regional Medical Center EverettEverettFile dated 2026-04-01———
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
Providence St Peter HospitalOlympiaFile dated 2026-04-01———
Seattle Children's HospitalSeattle—$269$269
Skagit Valley HospitalMount Vernon—$2.34 – $133$2.92 – $166
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$36.04$75.08
Swedish IssaquahIssaquahFile dated 2026-04-01———
Swedish Medical CenterSeattleFile dated 2026-04-01———
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01———
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$30.99 – $45.84$77.47 – $115
University of Washington Medical CtrSeattleFile dated 2026-04-01———
Virginia Mason Medical CenterSeattle—$19.63 – $29.44$38.49 – $57.72
WhidbeyHealth Medical CenterCoupeville—$4.00$4.00
Yakima Valley MemorialYakimaFile dated 2026-08-27—$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.