HCPCS J7639
Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram
Current code36 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 | — | $44.02 | $110 |
| Cascade Valley Hospital | $14,040 – $14,688 | $374 – $375 | $468 – $469 |
| Deaconess Medical Center | — | $72.62 | $182 |
| EvergreenHealth Medical Center | — | $534 | $667 |
| Harborview Medical Center | — | — | — |
| Island Hospital | — | — | — |
| Kadlec Regional Medical Center | — | $330 – $423 | $472 – $605 |
| Legacy Salmon Creek Medical Center | — | — | — |
| Mary Bridge Children's Hospital | — | $54.28 – $54.66 | $136 – $137 |
| MultiCare Auburn Medical Center | — | $52.15 | $130 |
| MultiCare Covington Medical Center | — | — | — |
| MultiCare Good Samaritan Hospital | — | $45.04 – $53.62 | $113 – $134 |
| MultiCare Valley Hospital | — | $61.73 | $154 |
| Olympic Medical Center | — | $482 | $602 |
| Overlake Hospital Medical Center & Clinics | — | — | — |
| PeaceHealth Peace Island Medical Center | — | $106 | $163 |
| PeaceHealth Southwest Medical Cente | — | $106 | $163 |
| PeaceHealth St John Medical Center | — | $106 | $163 |
| PeaceHealth St Joseph Medical Center | — | $106 | $163 |
| PeaceHealth United General Medical Center | — | $106 | $163 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $157 – $200 | $225 – $285 |
| Providence Centralia Hospital | — | $103 | $197 |
| Providence Holy Family Hospital | — | $157 – $200 | $225 – $285 |
| Providence Regional Medical Center Everett | — | $62.70 – $79.51 | $121 – $153 |
| Providence St Mary Medical Center | — | $272 – $349 | $389 – $499 |
| Providence St Peter Hospital | — | $103 | $197 |
| Seattle Children's Hospital | — | $1,061 | $1,061 |
| Skagit Valley Hospital | — | $374 – $375 | $468 – $469 |
| Swedish Edmonds Hospital | — | $301 – $386 | $627 – $803 |
| Swedish Issaquah | — | $301 | $627 |
| Swedish Medical Center | — | $301 | $627 |
| Swedish Medical Center / Cherry Hill | — | $301 | $627 |
| Tacoma General Allenmore Hospital | — | $42.72 – $51.78 | $107 – $129 |
| University of Washington Medical Ctr | — | — | — |
| Virginia Mason Medical Center | — | $105 | $205 |
| Yakima Valley Memorial | — | $37.69 – $44.02 | $94.22 – $110 |
Medicare (traditional) reference
CMS publishes no national amount for this code.