HCPCS J3415
Injection, pyridoxine hcl, 100 mg
Current code41 hospitals with prices
What Washington hospitals publish for this code
Medicaid (state program): Washington Apple Health fee-for-service. Applies only to Medicaid enrollees.
| Hospital | Medicaid (state program) rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Deaconess Medical Center | — | $62.90 | $157 |
| EvergreenHealth Medical Center | — | $81.60 – $114 | $102 – $142 |
| Harborview Medical Center | — | — | — |
| Highline Medical Center | — | $1.91 – $4.78 | $3.15 – $15.65 |
| Island Hospital | — | — | — |
| Kadlec Regional Medical Center | — | $34.61 – $45.53 | $49.44 – $65.04 |
| Legacy Salmon Creek Medical Center | — | — | — |
| Mary Bridge Children's Hospital | — | $42.42 | $106 |
| MultiCare Good Samaritan Hospital | — | $32.88 – $41.46 | $82.20 – $104 |
| MultiCare Valley Hospital | — | $62.90 | $157 |
| Olympic Medical Center | — | $85.43 | $107 |
| Overlake Hospital Medical Center & Clinics | — | $6.08 – $9.75 | $12.16 – $19.50 |
| PeaceHealth Peace Island Medical Center | — | $54.26 | $83.47 |
| PeaceHealth Southwest Medical Cente | — | $54.26 | $83.47 |
| PeaceHealth St John Medical Center | — | $54.26 | $83.47 |
| PeaceHealth St Joseph Medical Center | — | $54.26 – $54.34 | $83.47 – $83.60 |
| PeaceHealth United General Medical Center | — | $54.26 | $83.47 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $124 | $176 |
| Providence Centralia Hospital | — | $87.45 | $168 |
| Providence Holy Family Hospital | — | $124 | $176 |
| Providence Mount Carmel Hospital | — | $70.66 – $124 | $101 – $176 |
| Providence Regional Medical Center Everett | — | $40.79 – $60.66 | $78.44 – $117 |
| Providence St Joseph Hospital | — | $70.66 – $124 | $101 – $176 |
| Providence St Mary Medical Center | — | $30.00 – $68.14 | $42.86 – $97.34 |
| Providence St Peter Hospital | — | $45.17 – $87.45 | $86.87 – $168 |
| Seattle Children's Hospital | — | $121 | $121 |
| St Anthony Hospital | — | $1.91 – $4.76 | $3.15 – $15.65 |
| St Clare Hospital | — | $1.81 – $4.52 | $3.15 – $15.65 |
| St Elizabeth Hospital | — | $1.12 – $5.54 | $3.15 – $15.65 |
| St Francis Community Hospital | — | $1.97 – $4.92 | $3.15 – $15.65 |
| St Joseph Medical Center | — | $1.05 – $5.19 | $3.15 – $15.65 |
| St Michael Medical Center | — | $1.40 – $6.91 | $3.15 – $15.65 |
| Swedish Edmonds Hospital | — | $36.04 | $75.08 |
| Swedish Issaquah | — | $36.04 | $75.08 |
| Swedish Medical Center | — | $36.04 | $75.08 |
| Swedish Medical Center / Cherry Hill | — | $36.04 | $75.08 |
| Tacoma General Allenmore Hospital | — | $31.16 – $41.46 | $77.90 – $104 |
| Three Rivers Hospital | $89.38 | $128 | $128 |
| University of Washington Medical Ctr | — | — | — |
| Virginia Mason Medical Center | — | $31.84 | $62.44 |
| Yakima Valley Memorial | — | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.