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.
Original text from hospital filings
SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION
Tulsa, OK
See all hospitals reporting HCPCS J3490 →Price type
AHS Hillcrest Medical Center, LLC’s median price of $284 is 489% above the median hospital's median price ($48), higher than 86% of the 1,749 hospitals reporting HCPCS J3490. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 13 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Healthcare Highways hch john soules foods [221011] facility · percent of total billed charges · bothfrom % of charges | $139.54 | $139.54 | $139.54 – $139.54 |
| 2 | Oscar oscar insurance company [700500] facility · percent of total billed charges · bothfrom % of charges | $139.54 | $139.54 | $139.54 – $139.54 |
| 3 | Healthcare Highways hch 90 degree benefits [221013] facility · percent of total billed charges · bothfrom % of charges | $215.45 | $215.45 | $215.45 – $215.45 |
| 4 | Healthcare Highways hch broken arrow [221012] facility · percent of total billed charges · bothfrom % of charges | $215.45 | $215.45 | $215.45 – $215.45 |
| 5 | Healthcare Highways health plans inc [221008] facility · percent of total billed charges · bothfrom % of charges | $215.45 | $215.45 | $215.45 – $215.45 |
| 6 | Healthcare Highways taro health plan [221010] facility · percent of total billed charges · bothfrom % of charges | $215.45 | $215.45 | $215.45 – $215.45 |
| 7 | Aetna aetna aco wilco [101532] facility · percent of total billed charges · bothfrom % of charges | $245.04 | $245.04 | $245.04 – $245.04 |
| 8 | Aetna meritain aetna ardent employee [368502] facility · percent of total billed charges · bothfrom % of charges | $245.04 | $245.04 | $245.04 – $245.04 |
| 9 | Medica medica quest [291001] facility · percent of total billed charges · bothfrom % of charges | $317.04 | $317.04 | $317.04 – $317.04 |
| 10 | MultiPlan providence health plan [168004] facility · percent of total billed charges · bothfrom % of charges | $317.04 | $317.04 | $317.04 – $317.04 |
| 11 | Phcs lifestyle health plans [178013] facility · percent of total billed charges · bothfrom % of charges | $407.46 | $407.46 | $407.46 – $407.46 |
| 12 | MultiPlan ihc hs [168011] facility · percent of total billed charges · bothfrom % of charges | $480.03 | $480.03 | $480.03 – $480.03 |
| 13 | Phcs group health cooperative scw [178012] facility · percent of total billed charges · bothfrom % of charges | $480.03 | $480.03 | $480.03 – $480.03 |
Last updated: Mar 31, 2026
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