HCPCS J7504
Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg
Current codeInjection - Immune Globulin36 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 | $5,187 – $5,705 | — | — |
| Deaconess Medical Center | $5,187 – $5,705 | — | — |
| Harborview Medical Center | $5,135 – $5,649 | — | — |
| Highline Medical Center | $5,580 – $6,417 | $120 – $68,533 | $393 – $224,436 |
| Island Hospital | $5,999 – $6,359 | — | — |
| Kadlec Regional Medical Center | $5,292 – $6,351 | $10,327 – $10,330 | $14,752 – $14,757 |
| Legacy Salmon Creek Medical Center | $5,451 – $5,928 | — | — |
| Mary Bridge Children's Hospital | $5,187 – $5,705 | — | — |
| MultiCare Auburn Medical Center | $5,187 – $5,705 | — | — |
| MultiCare Covington Medical Center | $5,187 – $5,705 | — | — |
| MultiCare Good Samaritan Hospital | $5,187 – $5,705 | — | — |
| MultiCare Valley Hospital | $5,342 – $5,705 | — | — |
| Olympic Medical Center | $6,299 – $8,098 | — | — |
| Overlake Hospital Medical Center & Clinics | $5,292 – $5,504 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $5,292 – $6,351 | $13,249 – $13,254 | $18,928 – $18,934 |
| Providence Centralia Hospital | $5,292 – $8,468 | — | — |
| Providence Holy Family Hospital | $5,292 – $5,822 | $13,249 – $13,254 | $18,928 – $18,934 |
| Providence Regional Medical Center Everett | $5,292 – $5,822 | — | — |
| Providence St Mary Medical Center | $5,292 – $5,822 | $14,256 – $14,261 | $20,366 – $20,373 |
| Providence St Peter Hospital | $5,292 – $8,468 | $14,091 – $14,095 | $27,098 – $27,107 |
| Seattle Children's Hospital | — | $39,923 | $39,923 |
| St Anthony Hospital | $5,682 – $6,534 | $120 – $68,262 | $393 – $224,436 |
| St Clare Hospital | $4,960 – $5,704 | $113 – $64,692 | $393 – $224,436 |
| St Elizabeth Hospital | $70.74 – $49,376 | $139 – $79,308 | $393 – $224,436 |
| St Francis Community Hospital | $5,580 – $6,417 | $123 – $70,433 | $393 – $224,436 |
| St Joseph Medical Center | $3,763 – $6,534 | $130 – $74,333 | $393 – $224,436 |
| St Michael Medical Center | $4,930 – $6,310 | $173 – $99,054 | $393 – $224,436 |
| Swedish Edmonds Hospital | $5,292 – $6,351 | $12,897 | $26,869 |
| Swedish Issaquah | $5,292 – $6,351 | $12,893 – $12,897 | $26,861 – $26,869 |
| Swedish Medical Center | $5,292 – $6,351 | $12,893 | $26,861 |
| Swedish Medical Center / Cherry Hill | $5,292 – $6,351 | $12,893 | $26,861 |
| Tacoma General Allenmore Hospital | $5,187 – $5,705 | — | — |
| University of Washington Medical Ctr | $5,135 – $5,649 | — | — |
| Virginia Mason Medical Center | $3,595 – $5,392 | $5,948 | $11,663 |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $5,187 – $5,809 | — | — |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Hospital outpatient payment (national)
- $5,509 (APC 0890)
- Surgery center payment (national)
- $5,509