HCPCS J9017
Injection, arsenic trioxide, 1 mg
Current codeChemotherapeutic Agent43 hospitals with prices
What Washington hospitals publish for this code
Commercial insurance: Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.
| Hospital | Commercial insurance rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $6.55 – $110 | — | — |
| Cascade Valley Hospital | $7.49 – $7,104 | $263 – $1,369 | $328 – $1,711 |
| Deaconess Medical Center | $5.36 – $61.10 | $5.78 – $30.44 | $14.44 – $76.10 |
| EvergreenHealth Medical Center | $128 – $1,423 | $1,224 | $1,530 |
| Harborview Medical Center | $23.56 | — | — |
| Highline Medical Center | $4.68 – $4,627 | $1,099 – $1,570 | $3,600 – $5,141 |
| Island Hospital | $7.39 | — | — |
| Kadlec Regional Medical Center | $6.40 – $49.86 | $1,090 – $3,931 | $1,557 – $5,615 |
| Legacy Salmon Creek Medical Center | $10.78 – $43.00 | — | — |
| Mary Bridge Children's Hospital | $25.45 – $571 | $68.04 – $239 | $170 – $597 |
| MultiCare Auburn Medical Center | $6.55 – $109 | — | — |
| MultiCare Covington Medical Center | $6.55 – $109 | — | — |
| MultiCare Good Samaritan Hospital | $6.55 – $109 | — | — |
| MultiCare Valley Hospital | $6.55 – $60.97 | — | — |
| Olympic Medical Center | — | — | — |
| Overlake Hospital Medical Center & Clinics | $4.21 – $163 | — | — |
| PeaceHealth Peace Island Medical Center | — | $189 – $4,067 | $291 – $6,257 |
| PeaceHealth Southwest Medical Cente | $4.68 – $11.45 | $189 – $4,067 | $291 – $6,257 |
| PeaceHealth St John Medical Center | $12.85 | $189 – $4,067 | $291 – $6,257 |
| PeaceHealth St Joseph Medical Center | $12.79 | $189 – $4,067 | $291 – $6,257 |
| PeaceHealth United General Medical Center | — | $189 – $4,067 | $291 – $6,257 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $10.30 – $50.74 | $1,753 | $2,504 |
| Providence Centralia Hospital | $10.69 – $63.76 | — | — |
| Providence Holy Family Hospital | $10.30 – $16.04 | $1,753 | $2,504 |
| Providence Regional Medical Center Everett | $10.30 – $51.85 | $154 – $362 | $297 – $697 |
| Providence St Mary Medical Center | $10.30 – $75.51 | — | — |
| Providence St Peter Hospital | $10.69 – $68.40 | $29.17 – $640 | $56.10 – $1,232 |
| Seattle Children's Hospital | $324 – $576 | $600 | $600 |
| Skagit Valley Hospital | $7.49 – $1,625 | $263 – $1,369 | $328 – $1,711 |
| St Anthony Hospital | $4.68 – $3,856 | $1,095 – $1,564 | $3,600 – $5,141 |
| St Clare Hospital | $4.68 – $3,856 | $1,038 – $1,482 | $3,600 – $5,141 |
| St Elizabeth Hospital | $9.18 – $4,627 | $1,272 – $1,817 | $3,600 – $5,141 |
| St Francis Community Hospital | $4.68 – $3,856 | $1,130 – $1,613 | $3,600 – $5,141 |
| St Joseph Medical Center | $4.68 – $3,856 | $1,192 – $1,703 | $3,600 – $5,141 |
| St Michael Medical Center | $10.69 – $4,627 | $1,589 – $2,269 | $3,600 – $5,141 |
| Swedish Edmonds Hospital | $11.57 – $50.52 | $164 | $341 |
| Swedish Issaquah | $10.69 – $63.98 | $164 | $341 |
| Swedish Medical Center | $10.69 – $63.98 | $164 – $265 | $341 – $551 |
| Swedish Medical Center / Cherry Hill | $10.69 – $47.44 | $164 | $341 |
| Tacoma General Allenmore Hospital | $6.55 – $80.33 | — | — |
| University of Washington Medical Ctr | $16.25 – $72.72 | — | — |
| Virginia Mason Medical Center | $7.20 – $40.58 | $9.59 | $18.81 |
| Yakima Valley Memorial | $10.76 – $81.63 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.