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
DEFIBROTIDE IV 4 MG/ML NS
Boston, MA
See all hospitals reporting HCPCS J3490 →Price type
Boston Children's Hospital’s median price of $87 is 81% above the median hospital's median price ($48), higher than 69% 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: 8 payers, 14 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 all products sat outpatient fee schedule · both | $64.90 | $64.90 | $64.90 – $64.90 |
| 2 | UnitedHealthcare medicare inpatient/outpatient percent of total billed charges · bothfrom % of charges | $66.52 | $1,322 | $44.71 – $3,222 |
| 3 | Aetna medicaid inpatient/outpatient percent of total billed charges · bothfrom % of charges | $66.73 | $1,327 | $44.85 – $3,232 |
| 4 | Optum medicaid/medicare inpatient/outpatient percent of total billed charges · bothfrom % of charges | $72.29 | $1,437 | $48.59 – $3,501 |
| 5 | Blue Cross Blue Shield indem outpatient percent of total billed charges · bothfrom % of charges | $73.42 | $1,460 | $49.35 – $3,556 |
| 6 | Optum comm chd onc outpatient percent of total billed charges · bothfrom % of charges | $92.31 | $1,835 | $62.04 – $4,471 |
| 7 | UnitedHealthcare comm inpatient/outpatient percent of total billed charges · bothfrom % of charges | $92.92 | $1,847 | $62.45 – $4,500 |
| 8 | Aetna comm inpatient/outpatient percent of total billed charges · bothfrom % of charges | $93.23 | $1,853 | $62.66 – $4,515 |
| 9 | Optum comm outpatient percent of total billed charges · bothfrom % of charges | $94.53 | $1,879 | $63.54 – $4,578 |
| 10 | Cigna all products outpatient percent of total billed charges · bothfrom % of charges | $97.45 | $1,937 | $63.54 – $4,861 |
| 11 | Humana all products inpatient/outpatient percent of total billed charges · bothfrom % of charges | $100.09 | $1,990 | $67.27 – $4,848 |
| 12 | First Health all products inpatient/outpatient percent of total billed charges · bothfrom % of charges | $102.32 | $2,034 | $68.77 – $4,955 |
| 13 | MultiPlan phcs clients inpatient/outpatient percent of total billed charges · bothfrom % of charges | $102.32 | $2,034 | $68.77 – $4,955 |
| 14 | MultiPlan multiplan clients inpatient/outpatient percent of total billed charges · bothfrom % of charges | $105.66 | $2,100 | $71.01 – $5,117 |
Last updated: Apr 1, 2026
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