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
oxyCODONE 5 mg tablet
Plano, TX
See all hospitals reporting HCPCS J3490 →Price type
Baylor Scott & White Medical Center - Plano’s median price of $2 is 96% below the median hospital's median price ($48), higher than 5% 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, 24 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 | Superior Healthplan medicaid facility · percent of total billed charges · outpatientfrom % of charges | $0.36 | $11.61 | — – $2,745 |
| 2 | UnitedHealthcare medicaid/chip facility · percent of total billed charges · outpatientfrom % of charges | $0.39 | $12.42 | — – $2,937 |
| 3 | Blue Cross Blue Shield blue advantage facility · percent of total billed charges · outpatientfrom % of charges | $1.06 | $33.86 | $0.01 – $8,006 |
| 4 | Cigna local plus facility · percent of total billed charges · outpatientfrom % of charges | $1.50 | $47.69 | $0.01 – $11,277 |
| 5 | Baylor Scott White Health Plan bsw premier - large group/bsw premier direct to employer (rate 1)/bswh employee facility · percent of total billed charges · outpatientfrom % of charges | $1.50 | $47.77 | $0.01 – $11,277 |
| 6 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $1.67 | $53.21 | $0.01 – $12,581 |
| 7 | Cigna hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges | $1.76 | $56.11 | $0.01 – $13,267 |
| 8 | Baylor Scott White Health Plan bsw plus - large group/bsw premier direct to employer (rate 2) facility · percent of total billed charges · outpatientfrom % of charges | $1.76 | $56.20 | $0.01 – $13,267 |
| 9 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $1.82 | $58.05 | $0.01 – $13,724 |
| 10 | UnitedHealthcare charter facility · percent of total billed charges · outpatientfrom % of charges | $1.89 | $60.17 | $0.01 – $14,225 |
| 11 | UnitedHealthcare nexus facility · percent of total billed charges · outpatientfrom % of charges | $1.89 | $60.17 | $0.01 – $14,225 |
| 12 | Ambetter ambetter exchange facility · percent of total billed charges · outpatientfrom % of charges | $1.98 | $62.88 | $0.01 – $14,868 |
| 13 | Blue Cross Blue Shield city of dallas facility · percent of total billed charges · outpatientfrom % of charges | $2.04 | $64.82 | $0.01 – $15,326 |
| 14 | UnitedHealthcare commercial broad facility · percent of total billed charges · outpatientfrom % of charges | $2.10 | $66.85 | $0.01 – $15,806 |
| 15 | Blue Cross Blue Shield blue essentials (hmo) facility · percent of total billed charges · outpatientfrom % of charges | $2.13 | $67.72 | $0.01 – $16,012 |
| 16 | First Health ppo facility · percent of total billed charges · inpatientfrom % of charges | $2.13 | $67.72 | $0.01 – $16,012 |
| 17 | First Health ppo facility · percent of total billed charges · outpatientfrom % of charges | $2.13 | $67.72 | $0.01 – $16,012 |
| 18 | Optum commercial facility · percent of total billed charges · outpatientfrom % of charges | $2.13 | $67.72 | $0.01 – $16,012 |
| 19 | Humana commercial ppo facility · percent of total billed charges · outpatientfrom % of charges | $2.13 | $67.76 | $0.01 – $16,012 |
| 20 | Blue Cross Blue Shield blue premier/high performance network/my bluehealth facility · percent of total billed charges · outpatientfrom % of charges | $2.25 | $71.59 | $0.01 – $16,927 |
| 21 | Blue Cross Blue Shield bluechoice (ppo) facility · percent of total billed charges · outpatientfrom % of charges | $2.25 | $71.59 | $0.01 – $16,927 |
| 22 | Humana commercial ppo facility · percent of total billed charges · inpatientfrom % of charges | $60.75 | $86.18 | $20.25 – $279.00 |
| 23 | Baylor Scott White Health Plan bsw premier - large group/bsw premier direct to employer (rate 1)/bswh employee facility · percent of total billed charges · inpatientfrom % of charges | $22.39 | $90.90 | $0.01 – $321.30 |
| 24 | Baylor Scott White Health Plan bsw plus - large group/bsw premier direct to employer (rate 2) facility · percent of total billed charges · inpatientfrom % of charges | $26.34 | $106.94 | $0.01 – $378.00 |
Last updated: Jun 29, 2026
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