HCPCS J7121
5% dextrose in lactated ringers infusion, up to 1000 cc
Current codeIntravenous Infusion, Hydration30 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) |
|---|---|---|---|
| Capital Medical Center | — | $20.00 | $50.00 |
| Cascade Valley Hospital | $619 | $48.00 | $60.00 |
| Deaconess Medical Center | — | $28.66 – $28.80 | $71.65 – $72.00 |
| Island Hospital | $50.70 | $78.00 | $78.00 |
| Kadlec Regional Medical Center | — | $81.66 | $117 |
| Mary Bridge Children's Hospital | — | $23.60 | $59.00 |
| MultiCare Auburn Medical Center | — | $20.00 | $50.00 |
| MultiCare Covington Medical Center | — | $20.00 | $50.00 |
| MultiCare Good Samaritan Hospital | — | $20.00 | $50.00 |
| MultiCare Valley Hospital | — | $28.80 | $72.00 |
| Olympic Medical Center | — | $35.33 – $55.10 | $44.16 – $68.88 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $103 – $108 | $148 – $154 |
| Providence Centralia Hospital | — | $90.75 | $175 |
| Providence Holy Family Hospital | — | $103 – $108 | $148 – $154 |
| Providence Mount Carmel Hospital | — | $105 – $108 | $150 – $154 |
| Providence St Joseph Hospital | — | $103 – $108 | $148 – $154 |
| Providence St Mary Medical Center | — | $79.78 | $114 |
| Providence St Peter Hospital | — | $90.75 | $175 |
| Seattle Children's Hospital | — | $20.00 – $61.00 | $20.00 – $61.00 |
| Skagit Valley Hospital | — | $48.00 | $60.00 |
| Swedish Edmonds Hospital | — | $12.10 | $25.20 |
| Swedish Issaquah | — | $12.10 | $25.20 |
| Swedish Medical Center | — | $12.10 | $25.20 |
| Swedish Medical Center / Cherry Hill | — | $12.10 | $25.20 |
| Tacoma General Allenmore Hospital | — | $20.00 | $50.00 |
| Yakima Valley Memorial | — | $10.00 – $20.00 | $25.00 – $50.00 |
Medicare (traditional) reference
CMS publishes no national amount for this code.