HCPCS J9017
Injection, arsenic trioxide, 1 mg
Current codeChemotherapeutic Agent43 hospitals with prices
What Washington hospitals publish for this code
Other government program: TRICARE, VA, Indian Health Service, workers' compensation, or another public program.
| Hospital | Other government program rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Cascade Valley Hospital | — | $263 – $1,369 | $328 – $1,711 |
| Deaconess Medical Center | — | $5.78 – $30.44 | $14.44 – $76.10 |
| EvergreenHealth Medical Center | — | $1,224 | $1,530 |
| Highline Medical Center | — | $1,099 – $1,570 | $3,600 – $5,141 |
| Kadlec Regional Medical Center | — | $1,090 – $3,931 | $1,557 – $5,615 |
| Mary Bridge Children's Hospital | — | $68.04 – $239 | $170 – $597 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | — | $1,753 | $2,504 |
| Providence Holy Family Hospital | — | $1,753 | $2,504 |
| Providence Regional Medical Center Everett | — | $154 – $362 | $297 – $697 |
| Providence St Peter Hospital | — | $29.17 – $640 | $56.10 – $1,232 |
| Seattle Children's Hospital | $246 | $600 | $600 |
| Skagit Valley Hospital | — | $263 – $1,369 | $328 – $1,711 |
| St Anthony Hospital | — | $1,095 – $1,564 | $3,600 – $5,141 |
| St Clare Hospital | — | $1,038 – $1,482 | $3,600 – $5,141 |
| St Elizabeth Hospital | — | $1,272 – $1,817 | $3,600 – $5,141 |
| St Francis Community Hospital | — | $1,130 – $1,613 | $3,600 – $5,141 |
| St Joseph Medical Center | — | $1,192 – $1,703 | $3,600 – $5,141 |
| St Michael Medical Center | — | $1,589 – $2,269 | $3,600 – $5,141 |
| Swedish Edmonds Hospital | — | $164 | $341 |
| Swedish Issaquah | — | $164 | $341 |
| Swedish Medical Center | — | $164 – $265 | $341 – $551 |
| Swedish Medical Center / Cherry Hill | — | $164 | $341 |
| Virginia Mason Medical Center | — | $9.59 | $18.81 |
Medicare (traditional) reference
CMS publishes no national amount for this code.