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
folic acid 5 mg/mL Solfolic acid 5 mg/mL Inj 10 mL [CCH]
Grand Coulee, WA
See all hospitals reporting HCPCS J3490 →Price type
Coulee Medical Center’s median price of $25 is 49% below the median hospital's median price ($48), higher than 29% 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, 18 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.
Filter by billing methodology
Filter by billing class
| # | ||||
|---|---|---|---|---|
| 1 | Tricare all facility · percent of total billed charges · outpatientfrom % of charges | $16.51 | $26.87 | $3.19 – $144.08 |
| 2 | Tricare all facility · percent of total billed charges · inpatientfrom % of charges | $15.97 | $28.21 | $10.73 – $71.00 |
| 3 | Premera all facility · percent of total billed charges · outpatientfrom % of charges | $29.05 | $47.29 | $5.62 – $253.58 |
| 4 | Aetna all facility · percent of total billed charges · outpatientfrom % of charges | $29.71 | $48.36 | $5.74 – $259.34 |
| 5 | Cigna all facility · percent of total billed charges · outpatientfrom % of charges | $29.71 | $48.36 | $5.74 – $259.34 |
| 6 | Kaiser all facility · percent of total billed charges · outpatientfrom % of charges | $29.71 | $48.36 | $5.74 – $259.34 |
| 7 | Regence all facility · percent of total billed charges · outpatientfrom % of charges | $29.71 | $48.36 | $5.74 – $259.34 |
| 8 | UnitedHealthcare all facility · percent of total billed charges · outpatientfrom % of charges | $29.71 | $48.36 | $5.74 – $259.34 |
| 9 | MultiPlan all facility · percent of total billed charges · outpatientfrom % of charges | $30.37 | $49.44 | $5.87 – $265.10 |
| 10 | Premera all facility · percent of total billed charges · inpatientfrom % of charges | $28.10 | $49.65 | $18.88 – $124.97 |
| 11 | Aetna all facility · percent of total billed charges · inpatientfrom % of charges | $28.74 | $50.78 | $19.31 – $127.81 |
| 12 | Cigna all facility · percent of total billed charges · inpatientfrom % of charges | $28.74 | $50.78 | $19.31 – $127.81 |
| 13 | Kaiser all facility · percent of total billed charges · inpatientfrom % of charges | $28.74 | $50.78 | $19.31 – $127.81 |
| 14 | Regence all facility · percent of total billed charges · inpatientfrom % of charges | $28.74 | $50.78 | $19.31 – $127.81 |
| 15 | UnitedHealthcare all facility · percent of total billed charges · inpatientfrom % of charges | $28.74 | $50.78 | $19.31 – $127.81 |
| 16 | First Health all facility · percent of total billed charges · outpatientfrom % of charges | $31.36 | $51.05 | $6.06 – $273.75 |
| 17 | MultiPlan all facility · percent of total billed charges · inpatientfrom % of charges | $29.38 | $51.91 | $19.74 – $130.65 |
| 18 | First Health all facility · percent of total billed charges · inpatientfrom % of charges | $30.34 | $53.60 | $20.38 – $134.91 |
Last updated: Jan 21, 2026
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