HCPCS J3490
Unclassified drugs
Current code45 hospitals with prices
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| BHC Fairfax Hospital | $12.60 – $126 | $21.00 – $210 | $21.00 – $210 |
| Capital Medical Center | — | $5.31 – $2,558 | $13.26 – $6,396 |
| Cascade Medical Center | $6.99 – $138 | $10.00 – $132 | $12.50 – $165 |
| Cascade Valley Hospital | $60.00 – $12,528 | $1.92 – $4,381 | $2.40 – $5,477 |
| Deaconess Medical Center | — | $2.06 – $38.40 | $5.13 – $96.00 |
| EvergreenHealth Medical Center | — | $18.40 – $12,004 | $23.00 – $15,005 |
| EvergreenHealth Monroe | — | $60.80 – $12,004 | $76.00 – $15,005 |
| Highline Medical Center | — | $9.82 – $253 | $32.15 – $828 |
| Island Hospital | $6.50 – $115 | $10.00 – $177 | $10.00 – $177 |
| Kadlec Regional Medical Center | — | $34.61 – $1,273 | $49.44 – $1,819 |
| Mary Bridge Children's Hospital | — | $4.68 – $37.20 | $11.68 – $93.00 |
| MultiCare Auburn Medical Center | — | $5.37 – $37.20 | $13.40 – $93.00 |
| MultiCare Covington Medical Center | — | $4.62 – $37.20 | $11.54 – $93.00 |
| MultiCare Good Samaritan Hospital | — | $2.06 – $37.20 | $5.13 – $93.00 |
| MultiCare Valley Hospital | — | $5.68 – $28.32 | $14.18 – $70.80 |
| Olympic Medical Center | — | $5.92 – $3,543 | $7.40 – $4,429 |
| Overlake Hospital Medical Center & Clinics | — | $7.18 – $2,161 | $14.35 – $4,323 |
| PeaceHealth Southwest Medical Cente | — | $117 – $185 | $180 – $285 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $70.66 – $5,316 | $101 – $7,594 |
| Providence Centralia Hospital | — | $41.52 – $5,786 | $79.84 – $11,126 |
| Providence Holy Family Hospital | — | $70.66 – $5,316 | $101 – $7,594 |
| Providence Mount Carmel Hospital | — | $70.66 – $5,316 | $101 – $7,594 |
| Providence Regional Medical Center Everett | — | $6.76 – $4,635 | $13.00 – $8,914 |
| Providence St Joseph Hospital | — | $70.66 – $1,130 | $101 – $1,614 |
| Providence St Mary Medical Center | — | $12.61 – $5,720 | $18.01 – $8,171 |
| Providence St Peter Hospital | — | $41.95 – $5,786 | $80.68 – $11,126 |
| Seattle Children's Hospital | — | $58.25 – $180 | $58.25 – $180 |
| Skagit Valley Hospital | — | $1.92 – $4,381 | $2.40 – $5,477 |
| St Anthony Hospital | — | $9.78 – $252 | $32.15 – $828 |
| St Clare Hospital | — | $9.27 – $239 | $32.15 – $828 |
| St Elizabeth Hospital | $5.79 – $182 | $11.37 – $293 | $32.15 – $828 |
| St Francis Community Hospital | — | $10.09 – $260 | $32.15 – $828 |
| St Joseph Medical Center | — | $10.65 – $274 | $32.15 – $828 |
| St Michael Medical Center | — | $14.19 – $365 | $32.15 – $828 |
| Swedish Edmonds Hospital | — | $36.04 – $5,173 | $75.08 – $10,776 |
| Swedish Issaquah | — | $36.04 – $5,173 | $75.08 – $10,776 |
| Swedish Medical Center | — | $36.04 – $5,173 | $75.08 – $10,776 |
| Swedish Medical Center / Cherry Hill | — | $36.04 – $5,173 | $75.08 – $10,776 |
| Tacoma General Allenmore Hospital | — | $2.06 – $37.20 | $5.13 – $93.00 |
| Three Rivers Hospital | — | $9.42 | $9.42 |
| Virginia Mason Medical Center | — | $1.04 – $7,672 | $1.00 – $15,043 |
| Wellfound Behavioral Health Hospital | — | $37.72 | $94.28 |
| WhidbeyHealth Medical Center | — | $99.00 | $99.00 |
| Yakima Valley Memorial | — | $12.54 – $21.66 | $31.34 – $54.15 |
Medicare (traditional) reference
CMS publishes no national amount for this code.
How hospitals also write this code
Some price files write it differently. These are counted as HCPCS J3490:
- 12J3490 (with a number in front; 13 price lines)