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
LETERMOVIR 480 MG/24 ML INTRAVENOUS SOLUTION
Chicago, IL
See all hospitals reporting HCPCS J3490 →Price type
Ann & Robert H. Lurie Children's Hospital of Chicago’s median price of $2.7k is 5406% above the median hospital's median price ($48), higher than 97% 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: 10 payers, 44 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.
Filter by billing methodology
Filter by billing class
| # | ||||
|---|---|---|---|---|
| 1 | Blue Cross Blue Shield bcbs hmo percent of total billed charges · outpatientfrom % of charges | $545.27 | $545.27 | $522.78 – $567.76 |
| 2 | Blue Cross Blue Shield bcbs ppo percent of total billed charges · outpatientfrom % of charges | $574.24 | $574.24 | $550.55 – $597.92 |
| 3 | Magellan magellan behavioral health per diem · inpatient | $900.00 | $900.00 | $900.00 – $900.00 |
| 4 | Medicare medicare percent of total billed charges · outpatientfrom % of charges | $1,317 | $1,474 | $205.25 – $3,058 |
| 5 | Medicare medicare per diem · inpatient | $2,656 | $2,656 | $2,656 – $2,656 |
| 6 | Cigna cigna local plus percent of total billed charges · inpatientfrom % of charges | $3,254 | $3,643 | $507.09 – $7,555 |
| 7 | Cigna cigna local plus percent of total billed charges · outpatientfrom % of charges | $3,254 | $3,643 | $507.09 – $7,555 |
| 8 | Aetna aetna northwestern percent of total billed charges · inpatientfrom % of charges | $3,874 | $4,336 | $603.67 – $8,994 |
| 9 | Aetna aetna northwestern percent of total billed charges · outpatientfrom % of charges | $3,874 | $4,336 | $603.67 – $8,994 |
| 10 | Aetna aetna percent of total billed charges · outpatientfrom % of charges | $4,117 | $4,579 | $945.36 – $9,138 |
| 11 | Aetna aetna illinois preferred percent of total billed charges · inpatientfrom % of charges | $4,107 | $4,597 | $639.90 – $9,533 |
| 12 | Aetna aetna illinois preferred percent of total billed charges · outpatientfrom % of charges | $4,107 | $4,597 | $639.90 – $9,533 |
| 13 | Blue Cross Blue Shield unified physicians network percent of total billed charges · outpatientfrom % of charges | $4,339 | $4,857 | $676.12 – $10,073 |
| 14 | Cigna cigna c-5 percent of total billed charges · inpatientfrom % of charges | $4,463 | $4,996 | $695.43 – $10,361 |
| 15 | Cigna cigna c-5 percent of total billed charges · outpatientfrom % of charges | $4,463 | $4,996 | $695.43 – $10,361 |
| 16 | Blue Cross Blue Shield dupage medical group percent of total billed charges · inpatientfrom % of charges | $4,649 | $5,204 | $724.41 – $10,793 |
| 17 | Blue Cross Blue Shield dupage medical group percent of total billed charges · outpatientfrom % of charges | $4,649 | $5,204 | $724.41 – $10,793 |
| 18 | Blue Cross Blue Shield northwestern medicine physician network ipa percent of total billed charges · inpatientfrom % of charges | $4,649 | $5,204 | $724.41 – $10,793 |
| 19 | Blue Cross Blue Shield northwestern medicine physician network ipa percent of total billed charges · outpatientfrom % of charges | $4,649 | $5,204 | $724.41 – $10,793 |
| 20 | Blue Cross Blue Shield northshore physician associates percent of total billed charges · inpatientfrom % of charges | $5,037 | $5,637 | $784.78 – $11,692 |
| 21 | Blue Cross Blue Shield northshore physician associates percent of total billed charges · outpatientfrom % of charges | $5,037 | $5,637 | $784.78 – $11,692 |
| 22 | Blue Cross Blue Shield illinois health partners percent of total billed charges · inpatientfrom % of charges | $5,424 | $6,071 | $845.14 – $12,591 |
| 23 | Blue Cross Blue Shield illinois health partners percent of total billed charges · outpatientfrom % of charges | $5,424 | $6,071 | $845.14 – $12,591 |
| 24 | Blue Cross Blue Shield lake county physician association percent of total billed charges · inpatientfrom % of charges | $5,424 | $6,071 | $845.14 – $12,591 |
| 25 | Blue Cross Blue Shield lake county physician association percent of total billed charges · outpatientfrom % of charges | $5,424 | $6,071 | $845.14 – $12,591 |
Last updated: Apr 1, 2026
See Flumazenil IV injection pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.