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
SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION
Amarillo, TX
See all hospitals reporting HCPCS J3490 →Price type
BSA Hospital’s median price of $574 is 1089% above the median hospital's median price ($48), higher than 93% 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, 28 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 bcbs medicaid [116504] facility · percent of total billed charges · bothfrom % of charges | $101.90 | $125.87 | $66.90 – $232.79 |
| 2 | Blue Cross Blue Shield bcbs tx medicaid chip [116506] facility · percent of total billed charges · bothfrom % of charges | $101.90 | $125.87 | $66.90 – $232.79 |
| 3 | Aetna aetna better health [351001] facility · percent of total billed charges · bothfrom % of charges | $424.58 | $524.46 | $278.73 – $969.97 |
| 4 | Cigna cigna healthspring medicaid replacement [394500] facility · percent of total billed charges · bothfrom % of charges | $424.58 | $524.46 | $278.73 – $969.97 |
| 5 | Healthcare Highways hch 90 degree benefits [221013] facility · percent of total billed charges · bothfrom % of charges | $424.58 | $524.46 | $278.73 – $969.97 |
| 6 | Healthcare Highways hch broken arrow [221012] facility · percent of total billed charges · bothfrom % of charges | $424.58 | $524.46 | $278.73 – $969.97 |
| 7 | Healthcare Highways hch john soules foods [221011] facility · percent of total billed charges · bothfrom % of charges | $424.58 | $524.46 | $278.73 – $969.97 |
| 8 | UnitedHealthcare uhc comm mcaid health pla [225001] facility · percent of total billed charges · bothfrom % of charges | $424.58 | $524.46 | $278.73 – $969.97 |
| 9 | UnitedHealthcare uhc medicaid community plan [375501] facility · percent of total billed charges · bothfrom % of charges | $424.58 | $524.46 | $278.73 – $969.97 |
| 10 | UnitedHealthcare united healthcare core exclusive [206022] facility · percent of total billed charges · bothfrom % of charges | $465.94 | $575.56 | $305.89 – $1,064 |
| 11 | Cigna cigna pantex [126003] facility · percent of total billed charges · bothfrom % of charges | $511.67 | $632.05 | $335.91 – $1,169 |
| 12 | Blue Cross Blue Shield blue cross healthselect of texas [115530] facility · percent of total billed charges · bothfrom % of charges | $522.56 | $645.50 | $343.06 – $1,194 |
| 13 | Blue Cross Blue Shield blue cross advantage hmo of texas [115525] facility · percent of total billed charges · bothfrom % of charges | $555.21 | $685.84 | $364.50 – $1,268 |
| 14 | Blue Cross Blue Shield blue cross preferred ppo of texas [115526] facility · percent of total billed charges · bothfrom % of charges | $620.54 | $766.53 | $407.38 – $1,418 |
| 15 | Blue Cross Blue Shield blue cross traditional of texas [115503] facility · percent of total billed charges · bothfrom % of charges | $620.54 | $766.53 | $407.38 – $1,418 |
| 16 | UnitedHealthcare uhc surest bind [206032] facility · percent of total billed charges · bothfrom % of charges | $667.35 | $824.35 | $438.11 – $1,525 |
| 17 | UnitedHealthcare united healthcare student svc [206012] facility · percent of total billed charges · bothfrom % of charges | $667.35 | $824.35 | $438.11 – $1,525 |
| 18 | Aetna aetna client specific [101506] facility · percent of total billed charges · bothfrom % of charges | $707.63 | $874.11 | $464.56 – $1,617 |
| 19 | Medica medica harmony [291000] facility · percent of total billed charges · bothfrom % of charges | $762.06 | $941.35 | $500.29 – $1,741 |
| 20 | Phcs freedom life [178009] facility · percent of total billed charges · bothfrom % of charges | $762.06 | $941.35 | $500.29 – $1,741 |
| 21 | Phcs phcs multiplan [178000] facility · percent of total billed charges · bothfrom % of charges | $762.06 | $941.35 | $500.29 – $1,741 |
| 22 | Cigna cigna [126008] facility · percent of total billed charges · bothfrom % of charges | $790.37 | $976.31 | $518.87 – $1,806 |
| 23 | Healthpartners healthpartners [150000] facility · percent of total billed charges · bothfrom % of charges | $790.37 | $976.31 | $518.87 – $1,806 |
| 24 | UnitedHealthcare united healthcare shared svcs [206010] facility · percent of total billed charges · bothfrom % of charges | $791.46 | $977.66 | $519.59 – $1,808 |
| 25 | Aetna american continental [101507] facility · percent of total billed charges · bothfrom % of charges | $816.50 | $1,009 | $536.03 – $1,865 |
Last updated: Feb 12, 2026
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