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
Carthage, TX
See all hospitals reporting HCPCS J3490 →Price type
Carthage Hospital, LLC’s median price of $641 is 1228% 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: 8 payers, 19 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 | $455.84 | $455.84 | $455.84 – $455.84 |
| 2 | Cigna cigna healthspring medicaid replacement [394500] facility · percent of total billed charges · bothfrom % of charges | $455.84 | $455.84 | $455.84 – $455.84 |
| 3 | Molina molina medicaid new mexico [225500] facility · percent of total billed charges · bothfrom % of charges | $455.84 | $455.84 | $455.84 – $455.84 |
| 4 | UnitedHealthcare uhc medicaid community plan [375501] facility · percent of total billed charges · bothfrom % of charges | $455.84 | $455.84 | $455.84 – $455.84 |
| 5 | Healthcare Highways hch 90 degree benefits [221013] facility · percent of total billed charges · bothfrom % of charges | $473.85 | $473.85 | $473.85 – $473.85 |
| 6 | Healthcare Highways hch broken arrow [221012] facility · percent of total billed charges · bothfrom % of charges | $473.85 | $473.85 | $473.85 – $473.85 |
| 7 | Healthcare Highways hch john soules foods [221011] facility · percent of total billed charges · bothfrom % of charges | $473.85 | $473.85 | $473.85 – $473.85 |
| 8 | Blue Cross Blue Shield blue cross hmo of texas [115504] facility · percent of total billed charges · bothfrom % of charges | $547.77 | $547.77 | $547.77 – $547.77 |
| 9 | Blue Cross Blue Shield blue cross advantage hmo of texas [115525] facility · percent of total billed charges · bothfrom % of charges | $640.64 | $640.64 | $640.64 – $640.64 |
| 10 | UnitedHealthcare uhc medica choice [206030] facility · percent of total billed charges · bothfrom % of charges | $938.22 | $938.22 | $938.22 – $938.22 |
| 11 | UnitedHealthcare united healthcare student svc [206012] facility · percent of total billed charges · bothfrom % of charges | $938.22 | $938.22 | $938.22 – $938.22 |
| 12 | Blue Cross Blue Shield blue cross preferred ppo of texas [115526] facility · percent of total billed charges · bothfrom % of charges | $968.54 | $968.54 | $968.54 – $968.54 |
| 13 | Blue Cross Blue Shield blue cross traditional of texas [115503] facility · percent of total billed charges · bothfrom % of charges | $968.54 | $968.54 | $968.54 – $968.54 |
| 14 | Cigna cigna ppo [126025] facility · percent of total billed charges · bothfrom % of charges | $1,058 | $1,058 | $1,058 – $1,058 |
| 15 | Aetna aetna [101529] facility · percent of total billed charges · bothfrom % of charges | $1,158 | $1,158 | $1,158 – $1,158 |
| 16 | Aetna meritain aetna [368500] facility · percent of total billed charges · bothfrom % of charges | $1,158 | $1,158 | $1,158 – $1,158 |
| 17 | Cigna cigna - great west [126009] facility · percent of total billed charges · bothfrom % of charges | $1,194 | $1,194 | $1,194 – $1,194 |
| 18 | Humana humana commercial [214001] facility · percent of total billed charges · bothfrom % of charges | $1,194 | $1,194 | $1,194 – $1,194 |
| 19 | Phcs phcs multiplan [178000] facility · percent of total billed charges · bothfrom % of charges | $1,194 | $1,194 | $1,194 – $1,194 |
Last updated: Feb 12, 2026
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