Hydroxyzine hydrochloride injection

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HYDROXYZINE HCL 25 MG/ML IM SOLN [3769]

Payers reporting HCPCS J3410

Payer pricing summary

Low

Average

$342

Median

$76

High

$6.2k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +29 other terms	496	$21	$47	$484	1032%	54–90	$0 – $18.0k
2	Blue Cross Blue Shield fee schedule · outpatient · +28 other terms	308	$17	$17	$23	134%	47–335	$0 – $181
3	Kaiser fee schedule · both · +15 other terms	48	$21	$70	$538	770%	30	$1 – $5.9k
4	Anthem fee schedule · outpatient · +21 other terms	115	$20	$18	$13	70%	8–80	$8 – $124
5	Wellmark fee schedule · outpatient · +16 other terms	27	$18	$20	$23	115%	5–50	$13 – $237
6	Aetna fee schedule · outpatient · +25 other terms	273	$28	$34	$41	121%	3–30	$0 – $852
7	Medica fee schedule · outpatient · +14 other terms	56	$19	$26	$20	78%	3–30	$0 – $197
8	Bcbs Al facility · other · outpatient · +1 other terms	5	$33	$95	$106	111%	3–30	$18 – $302
9	Molina fee schedule · outpatient · +18 other terms	53	$26	$23	$10	42%	1–10	$1 – $70
10	Cigna fee schedule · outpatient · +23 other terms	396	$24	$39	$31	81%	—	$0 – $297
11	Humana fee schedule · outpatient · +22 other terms	188	$17	$34	$25	72%	—	$0 – $172
12	MultiPlan fee schedule · inpatient · +18 other terms	75	$50	$68	$40	59%	—	$0 – $222
13	Caresource fee schedule · outpatient · +15 other terms	59	$18	$19	$10	54%	—	$0 – $63
14	Highmark facility · fee schedule · outpatient · +12 other terms	34	$17	$11	$8	68%	—	$2 – $51
15	Medicaid facility · fee schedule · outpatient · +10 other terms	33	$12	$27	$58	220%	—	$1 – $282
16	First Health fee schedule · inpatient · +16 other terms	30	$38	$58	$35	60%	—	$4 – $202
17	Oscar facility · fee schedule · outpatient · +12 other terms	27	$21	$20	$3	17%	—	$13 – $22
18	Baylor Scott White Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	26	$77	$68	$49	72%	—	$1 – $130
19	Regence professional · fee schedule · outpatient · +13 other terms	26	$11	$14	$4	29%	—	$11 – $19
20	Amerihealth Caritas other · outpatient · +12 other terms	24	$51	$3.9k	$5.6k	145%	—	$3 – $12.2k
21	Bcbs Tx fee schedule · outpatient · +4 other terms	22	$3	$3	$1	37%	—	$1 – $10
22	Phcs fee schedule · inpatient · +13 other terms	22	$78	$81	$23	29%	—	$4 – $125
23	Bcbs La fee schedule · outpatient · +3 other terms	21	$14	$13	$1	10%	—	$10 – $20
24	Beechstreet percent of total billed charges · outpatientfrom % of charges · +3 other terms	21	$108	$128	$55	43%	—	$3 – $268
25	WellCare fee schedule · outpatient · +12 other terms	21	$17	$20	$7	33%	—	$0 – $31

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