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
LIDO-PRILO 2.5%/30GM 30GM CR
Mesa, AZ
See all hospitals reporting HCPCS J3490 →Price type
Banner Desert Medical Center’s median price of $32 is 34% below the median hospital's median price ($48), higher than 36% 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: 3 payers, 12 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 | UnitedHealthcare uhc doctor's plan facility · percent of total billed charges · outpatientfrom % of charges | $20.66 | $80.50 | $1.32 – $346.10 |
| 2 | UnitedHealthcare uhc core facility · percent of total billed charges · outpatientfrom % of charges | $21.60 | $84.16 | $1.38 – $361.80 |
| 3 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $22.75 | $88.63 | $1.45 – $381.06 |
| 4 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $13.38 | $324.20 | $0.54 – $1,052 |
| 5 | Aetna qualified health plan facility · percent of total billed charges · outpatientfrom % of charges | $16.99 | $411.73 | $0.69 – $1,336 |
| 6 | Aetna banner employee plans facility · percent of total billed charges · outpatientfrom % of charges | $22.48 | $544.65 | $0.91 – $1,767 |
| 7 | Aetna joint venture facility · percent of total billed charges · outpatientfrom % of charges | $30.91 | $748.90 | $1.26 – $2,429 |
| 8 | Aetna designated group facility · percent of total billed charges · outpatientfrom % of charges | $32.85 | $795.91 | $1.34 – $2,582 |
| 9 | Oscar commercial facility · percent of total billed charges · outpatientfrom % of charges | $33.45 | $810.49 | $1.36 – $2,629 |
| 10 | Aetna medical rental facility · percent of total billed charges · inpatientfrom % of charges | $35.26 | $854.26 | $1.43 – $2,771 |
| 11 | Aetna medical rental facility · percent of total billed charges · outpatientfrom % of charges | $35.26 | $854.26 | $1.43 – $2,771 |
| 12 | Aetna broad network facility · percent of total billed charges · outpatientfrom % of charges | $38.60 | $935.31 | $1.57 – $3,034 |
Last updated: Mar 2, 2026
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