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HCPCS J9017

Injection, arsenic trioxide, 1 mg

Current codeChemotherapeutic Agent43 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

HospitalMedicaid managed care rates (lowest – highest)Cash priceList price (before discounts)
Cascade Valley HospitalArlington$5.05 – $1,7134 plans$263 – $1,369$328 – $1,711
Deaconess Medical CenterSpokaneFile dated 2026-08-27—$5.78 – $30.44$14.44 – $76.10
EvergreenHealth Medical CenterKirkland—$1,224$1,530
Highline Medical CenterBurienFile dated 2026-02-28—$1,099 – $1,570$3,600 – $5,141
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$1,090 – $3,931$1,557 – $5,615
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27—$68.04 – $239$170 – $597
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$1,753$2,504
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$1,753$2,504
Providence Regional Medical Center EverettEverettFile dated 2026-04-01—$154 – $362$297 – $697
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$29.17 – $640$56.10 – $1,232
Seattle Children's HospitalSeattle$154 – $19512 plans$600$600
Skagit Valley HospitalMount Vernon$1,2251 plan$263 – $1,369$328 – $1,711
St Anthony HospitalGig HarborFile dated 2026-02-28—$1,095 – $1,564$3,600 – $5,141
St Clare HospitalLakewoodFile dated 2026-02-28—$1,038 – $1,482$3,600 – $5,141
St Elizabeth HospitalEnumclawFile dated 2026-02-28$1,008 – $1,7055 plans$1,272 – $1,817$3,600 – $5,141
St Francis Community HospitalFederal WayFile dated 2026-02-28—$1,130 – $1,613$3,600 – $5,141
St Joseph Medical CenterTacomaFile dated 2026-02-28—$1,192 – $1,703$3,600 – $5,141
St Michael Medical CenterSilverdaleFile dated 2026-02-28—$1,589 – $2,269$3,600 – $5,141
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$164$341
Swedish IssaquahIssaquahFile dated 2026-04-01—$164$341
Swedish Medical CenterSeattleFile dated 2026-04-01—$164 – $265$341 – $551
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$164$341
Virginia Mason Medical CenterSeattle—$9.59$18.81

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.