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 Southcrest Hospital, LLC’s median price of $245 is 408% above the median hospital's median price ($48), higher than 85% 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: 7 payers, 14 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 | Cigna cigna [126008] facility · percent of total billed charges · bothfrom % of charges | $62.52 | $66.15 | $17.23 – $118.71 |
| 2 | Healthcare Highways hch john soules foods [221011] facility · percent of total billed charges · bothfrom % of charges | $139.54 | $147.66 | $38.45 – $264.98 |
| 3 | Oscar oscar insurance company [700500] facility · percent of total billed charges · bothfrom % of charges | $139.54 | $147.66 | $38.45 – $264.98 |
| 4 | Healthcare Highways hch 90 degree benefits [221013] facility · percent of total billed charges · bothfrom % of charges | $240.01 | $253.97 | $66.13 – $455.77 |
| 5 | Healthcare Highways hch broken arrow [221012] facility · percent of total billed charges · bothfrom % of charges | $240.01 | $253.97 | $66.13 – $455.77 |
| 6 | Healthcare Highways health plans inc [221008] facility · percent of total billed charges · bothfrom % of charges | $240.01 | $253.97 | $66.13 – $455.77 |
| 7 | Healthcare Highways taro health plan [221010] facility · percent of total billed charges · bothfrom % of charges | $240.01 | $253.97 | $66.13 – $455.77 |
| 8 | Aetna aetna aco wilco [101532] facility · percent of total billed charges · bothfrom % of charges | $245.04 | $259.29 | $67.52 – $465.30 |
| 9 | Aetna meritain aetna ardent employee [368502] facility · percent of total billed charges · bothfrom % of charges | $245.04 | $259.29 | $67.52 – $465.30 |
| 10 | Medica medica quest [291001] facility · percent of total billed charges · bothfrom % of charges | $328.76 | $347.88 | $90.59 – $624.29 |
| 11 | MultiPlan providence health plan [168004] facility · percent of total billed charges · bothfrom % of charges | $328.76 | $347.88 | $90.59 – $624.29 |
| 12 | Phcs lifestyle health plans [178013] facility · percent of total billed charges · bothfrom % of charges | $418.63 | $442.97 | $115.35 – $794.94 |
| 13 | MultiPlan ihc hs [168011] facility · percent of total billed charges · bothfrom % of charges | $446.54 | $472.51 | $123.04 – $847.94 |
| 14 | Phcs group health cooperative scw [178012] facility · percent of total billed charges · bothfrom % of charges | $446.54 | $472.51 | $123.04 – $847.94 |
Last updated: Mar 31, 2026
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