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
ZIPRASIDONE MESYLATE 20 MG/ML (FINAL CONC.) INTRAMUSC SOLR [25411]
Arlington, TX
See all hospitals reporting HCPCS J3486 →Price type
AMH Cath Labs LLC’s median price of $69 is 61% above the median hospital's median price ($43), higher than 63% of the 2,009 hospitals reporting HCPCS J3486. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 payers, 25 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 | Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges | $11 | $11 | — | — | — | $11 – $11 |
| 2 | UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges | $11 | $11 | — | — | — | $11 – $11 |
| 3 | WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges | $12 | $12 | — | — | — | $12 – $12 |
| 4 | Molina managed medicaid percent of total billed charges · outpatientfrom % of charges | $12 | $12 | — | — | — | $12 – $12 |
| 5 | Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges | $12 | $12 | — | — | — | $12 – $12 |
| 6 | Aetna whole health percent of total billed charges · inpatientfrom % of charges | $43 | $43 | — | — | — | $43 – $43 |
| 7 | Blue Cross Blue Shield hmo fee schedule · outpatient | $51 | $51 | — | — | — | $51 – $51 |
| 8 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $52 | $52 | — | — | — | $52 – $52 |
| 9 | Blue Cross Blue Shield exchange fee schedule · outpatient | $52 | $52 | — | — | — | $52 – $52 |
| 10 | Blue Cross Blue Shield ppo fee schedule · outpatient | $57 | $57 | — | — | — | $57 – $57 |
| 11 | Aetna commercial percent of total billed charges · inpatientfrom % of charges | $58 | $58 | — | — | — | $58 – $58 |
| 12 | UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges | $65 | $65 | — | — | — | $65 – $65 |
| 13 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $69 | $69 | — | — | — | $69 – $69 |
| 14 | UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges | $69 | $69 | — | — | — | $69 – $69 |
| 15 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $69 | $69 | — | — | — | $69 – $69 |
| 16 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $87 | $87 | — | — | — | $87 – $87 |
| 17 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $88 | $88 | — | — | — | $88 – $88 |
| 18 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $88 | $88 | — | — | — | $88 – $88 |
| 19 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $88 | $88 | — | — | — | $88 – $88 |
| 20 | Phcs ppo percent of total billed charges · inpatientfrom % of charges | $94 | $94 | — | — | — | $94 – $94 |
| 21 | MultiPlan commercial percent of total billed charges · inpatientfrom % of charges | $109 | $109 | — | — | — | $109 – $109 |
| 22 | MultiPlan commercial percent of total billed charges · outpatientfrom % of charges | $109 | $109 | — | — | — | $109 – $109 |
| 23 | Cigna indemnity percent of total billed charges · inpatientfrom % of charges | $118 | $118 | — | — | — | $118 – $118 |
| 24 | Cigna indemnity percent of total billed charges · outpatientfrom % of charges | $118 | $118 | — | — | — | $118 – $118 |
| 25 | Blue Cross Blue Shield traditional fee schedule · outpatient | $231 | $231 | — | — | — | $231 – $231 |
Last updated: Apr 21, 2026
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