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
INDOCYANINE GREEN 25MG IN
San Bernardino, CA
See all hospitals reporting HCPCS J3490 →Price type
Community Hospital Of San Bernardino’s median price of $102 is 111% above the median hospital's median price ($48), higher than 72% 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: 9 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 | Anthem medicaid|all plans fee schedule · inpatient | $58.75 | $183.36 | $0.50 – $2,208 |
| 2 | Anthem medicaid|all plans fee schedule · outpatient | $58.75 | $183.36 | $0.50 – $2,208 |
| 3 | Cigna commercial|all other plans fee schedule · outpatient | $105.75 | $330.05 | $0.90 – $3,974 |
| 4 | Cigna commercial|ppo fee schedule · outpatient | $105.75 | $330.05 | $0.90 – $3,974 |
| 5 | UnitedHealthcare commercial|all other plans fee schedule · outpatient | $122.20 | $381.39 | $1.04 – $4,592 |
| 6 | Aetna commercial|gatekeeper fee schedule · outpatient | $133.95 | $418.06 | $1.14 – $5,033 |
| 7 | Magellan commercial|all plans fee schedule · inpatient | $141.00 | $440.06 | $1.20 – $5,298 |
| 8 | Magellan commercial|all plans fee schedule · outpatient | $141.00 | $440.06 | $1.20 – $5,298 |
| 9 | Kaiser commercial|all plans fee schedule · inpatient | $145.70 | $454.73 | $1.24 – $5,475 |
| 10 | Kaiser commercial|all plans fee schedule · outpatient | $145.70 | $454.73 | $1.24 – $5,475 |
| 11 | Aetna commercial|non-gatekeeper fee schedule · outpatient | $159.80 | $498.74 | $1.36 – $6,004 |
| 12 | First Health commercial|all plans fee schedule · inpatient | $164.50 | $513.41 | $1.40 – $6,181 |
| 13 | First Health commercial|all plans fee schedule · outpatient | $164.50 | $513.41 | $1.40 – $6,181 |
| 14 | Blue Cross Blue Shield medicare|blueshield promise fee schedule · outpatient | $176.25 | $550.08 | $1.50 – $6,623 |
| 15 | MultiPlan commercial|all plans fee schedule · inpatient | $188.00 | $586.75 | $1.60 – $7,064 |
| 16 | MultiPlan commercial|all plans fee schedule · outpatient | $188.00 | $586.75 | $1.60 – $7,064 |
| 17 | Anthem commercial|all other plans fee schedule · outpatient | $209.15 | $652.76 | $1.78 – $7,859 |
| 18 | UnitedHealthcare commercial|hmo fee schedule · outpatient | $227.95 | $711.43 | $1.94 – $8,565 |
| 19 | Anthem commercial|mcs fee schedule · outpatient | $235.00 | $733.44 | $2.00 – $8,830 |
Last updated: Feb 28, 2026
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