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
SOD BIPHOSPHATE/66ML 66ML EN
Ogallala, NE
See all hospitals reporting HCPCS J3490 →Price type
Banner Ogallala Community Hospital’s median price of $48 is about the same as the median hospital's median price ($48), higher than 49% 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, 15 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 | Medica medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $4.22 | $9.77 | $1.63 – $23.45 |
| 2 | Medica commercial facility · percent of total billed charges · outpatientfrom % of charges | $9.13 | $21.15 | $3.53 – $50.79 |
| 3 | Bcbs Wy medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $23.45 | $931.36 | $1.63 – $2,314 |
| 4 | UnitedHealthcare uhc medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $24.52 | $973.69 | $1.70 – $2,419 |
| 5 | UnitedHealthcare va community care facility · percent of total billed charges · outpatientfrom % of charges | $24.52 | $973.69 | $1.70 – $2,419 |
| 6 | Molina medicaid/chip facility · percent of total billed charges · outpatientfrom % of charges | $26.12 | $1,037 | $1.81 – $2,577 |
| 7 | UnitedHealthcare nebraska medicaid/chip facility · percent of total billed charges · outpatientfrom % of charges | $26.12 | $1,037 | $1.81 – $2,577 |
| 8 | UnitedHealthcare commercial/individual exchange facility · percent of total billed charges · inpatientfrom % of charges | $50.63 | $2,011 | $3.52 – $4,996 |
| 9 | UnitedHealthcare commercial/individual exchange facility · percent of total billed charges · outpatientfrom % of charges | $50.63 | $2,011 | $3.52 – $4,996 |
| 10 | Bcbs Wy network blue facility · percent of total billed charges · inpatientfrom % of charges | $51.17 | $2,032 | $3.55 – $5,048 |
| 11 | Bcbs Wy network blue facility · percent of total billed charges · outpatientfrom % of charges | $51.17 | $2,032 | $3.55 – $5,048 |
| 12 | First Health medical rental facility · percent of total billed charges · inpatientfrom % of charges | $51.17 | $2,032 | $3.55 – $5,048 |
| 13 | First Health medical rental facility · percent of total billed charges · outpatientfrom % of charges | $51.17 | $2,032 | $3.55 – $5,048 |
| 14 | MultiPlan commercial facility · percent of total billed charges · inpatientfrom % of charges | $51.70 | $2,053 | $3.59 – $5,101 |
| 15 | MultiPlan commercial facility · percent of total billed charges · outpatientfrom % of charges | $51.70 | $2,053 | $3.59 – $5,101 |
Last updated: Feb 12, 2026
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