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
DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION
Keene, NH
See all hospitals reporting HCPCS J3490 →Price type
Cheshire Medical Center’s median price of $9 is 82% below the median hospital's median price ($48), higher than 17% 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, 40 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 | Amerihealth Caritas amerihealth caritas - nh managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $0.98 | $2.33 | $0.84 – $8.52 |
| 2 | Cigna cigna hmo-pos facility · percent of total billed charges · outpatientfrom % of charges | $3.95 | $9.42 | $3.41 – $34.44 |
| 3 | Cigna cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $3.95 | $9.42 | $3.41 – $34.44 |
| 4 | UnitedHealthcare uhc - freedom plan facility · percent of total billed charges · inpatientfrom % of charges | $4.71 | $11.23 | $4.06 – $41.05 |
| 5 | UnitedHealthcare uhc - freedom plan facility · percent of total billed charges · outpatientfrom % of charges | $4.84 | $11.55 | $4.18 – $42.24 |
| 6 | Aetna aetna hmo/pos/ppo facility · percent of total billed charges · outpatientfrom % of charges | $5.46 | $13.01 | $4.71 – $47.59 |
| 7 | UnitedHealthcare uhc - hmo/pos/ppo facility · percent of total billed charges · inpatientfrom % of charges | $5.89 | $14.04 | $5.08 – $51.35 |
| 8 | UnitedHealthcare uhc - hmo/pos/ppo facility · percent of total billed charges · outpatientfrom % of charges | $6.06 | $14.44 | $5.22 – $52.81 |
| 9 | Anthem anthem - federal employee program facility · percent of total billed charges · inpatientfrom % of charges | $6.11 | $14.57 | $5.27 – $53.28 |
| 10 | Anthem anthem - indemnity facility · percent of total billed charges · inpatientfrom % of charges | $6.11 | $14.57 | $5.27 – $53.28 |
| 11 | Anthem anthem - federal employee program facility · percent of total billed charges · outpatientfrom % of charges | $6.11 | $14.58 | $5.27 – $53.31 |
| 12 | Bcbs Vt bcbs of vermont - the vermont health plan facility · percent of total billed charges · inpatientfrom % of charges | $6.34 | $15.11 | $5.47 – $55.27 |
| 13 | Bcbs Vt bcbs of vermont - the vermont health plan facility · percent of total billed charges · outpatientfrom % of charges | $6.34 | $15.11 | $5.47 – $55.27 |
| 14 | Bcbs Vt bcbs of vermont - vermont health partnership facility · percent of total billed charges · inpatientfrom % of charges | $6.34 | $15.11 | $5.47 – $55.27 |
| 15 | Bcbs Vt bcbs of vermont - vermont health partnership facility · percent of total billed charges · outpatientfrom % of charges | $6.34 | $15.11 | $5.47 – $55.27 |
| 16 | Bcbs Vt bcbs of vermont non-managed care plans facility · percent of total billed charges · inpatientfrom % of charges | $6.34 | $15.11 | $5.47 – $55.27 |
| 17 | Bcbs Vt bcbs of vermont non-managed care plans facility · percent of total billed charges · outpatientfrom % of charges | $6.34 | $15.11 | $5.47 – $55.27 |
| 18 | First Health first health/hcvm facility · percent of total billed charges · outpatientfrom % of charges | $6.78 | $16.17 | $5.85 – $59.14 |
| 19 | Phcs phcs facility · percent of total billed charges · inpatientfrom % of charges | $7.18 | $17.12 | $6.19 – $62.62 |
| 20 | Phcs phcs facility · percent of total billed charges · outpatientfrom % of charges | $7.18 | $17.12 | $6.19 – $62.62 |
| 21 | Amerihealth Caritas amerihealth caritas - nh managed medicaid professional · percent of total billed charges · outpatientfrom % of charges | $16.36 | $19.90 | $1.14 – $59.22 |
| 22 | Cigna cigna hmo-pos professional · percent of total billed charges · outpatientfrom % of charges | $66.14 | $80.48 | $4.61 – $239.48 |
| 23 | Cigna cigna ppo professional · percent of total billed charges · outpatientfrom % of charges | $66.14 | $80.48 | $4.61 – $239.48 |
| 24 | UnitedHealthcare uhc - freedom plan professional · percent of total billed charges · inpatientfrom % of charges | $78.84 | $95.92 | $5.49 – $285.44 |
| 25 | UnitedHealthcare uhc - freedom plan professional · percent of total billed charges · outpatientfrom % of charges | $81.11 | $98.69 | $5.65 – $293.66 |
Last updated: Jan 1, 2026
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