HCPCS S0104
Zidovudine, oral, 100 mg
Current code15 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) |
|---|---|---|---|
| EvergreenHealth Medical Center | $1.11 – $1,787 | $14.40 – $1,538 | $18.00 – $1,922 |
| EvergreenHealth Monroe | $11.34 – $1,787 | $14.40 – $1,538 | $18.00 – $1,922 |
| Kadlec Regional Medical Center | $2.48 | — | — |
| Overlake Hospital Medical Center & Clinics | $2.88 – $15.50 | — | — |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $1.66 – $3.10 | — | — |
| Providence Centralia Hospital | $3.91 | — | — |
| Providence Holy Family Hospital | $1.66 – $3.10 | — | — |
| Providence Regional Medical Center Everett | $1.66 – $3.10 | — | — |
| Providence St Mary Medical Center | $3.10 | — | — |
| Providence St Peter Hospital | $3.22 | — | — |
| Swedish Edmonds Hospital | $1.66 | — | — |
| Swedish Issaquah | $1.66 | — | — |
| Swedish Medical Center | $1.66 | — | — |
| Swedish Medical Center / Cherry Hill | $1.66 | — | — |
| Virginia Mason Medical Center | $4.84 – $5.50 | — | — |
Medicare (traditional) reference
CMS publishes no national amount for this code.