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
Moxifloxacin PF 0.1 1mg/ml Op
Great Barrington, MA
See all hospitals reporting HCPCS J3490 →Price type
Fairview Hospital’s median price of $448 is 828% above the median hospital's median price ($48), higher than 91% 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: 7 payers, 29 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 mcrmanaged blue cross vt medicare hmo facility · fee schedule · outpatient | $250.09 | $517.48 | $55.08 – $2,141 |
| 2 | Medicare mcr traditional medicare facility · fee schedule · outpatient | $250.09 | $517.48 | $55.08 – $2,141 |
| 3 | Medicare mcrmanaged medicare hmo facility · fee schedule · outpatient | $250.09 | $517.48 | $55.08 – $2,141 |
| 4 | UnitedHealthcare mcrmanaged united vaccn facility · fee schedule · outpatient | $254.16 | $525.90 | $55.98 – $2,176 |
| 5 | Blue Cross Blue Shield comm blue cross ma hmo facility · percent of total billed charges · outpatientfrom % of charges | $396.01 | $819.41 | $87.23 – $3,391 |
| 6 | Blue Cross Blue Shield comm blue cross ma indem facility · percent of total billed charges · outpatientfrom % of charges | $441.96 | $914.49 | $97.35 – $3,784 |
| 7 | Blue Cross Blue Shield comm blue cross ma ppo facility · percent of total billed charges · outpatientfrom % of charges | $444.30 | $919.33 | $97.87 – $3,804 |
| 8 | UnitedHealthcare comm united bh facility · percent of total billed charges · outpatientfrom % of charges | $446.50 | $923.87 | $98.35 – $3,823 |
| 9 | UnitedHealthcare comm united bh professional · fee schedule · outpatient | $446.50 | $923.87 | $98.35 – $3,823 |
| 10 | Blue Cross Blue Shield comm blue cross vt ppo facility · percent of total billed charges · inpatientfrom % of charges | $416.94 | $982.01 | $0.01 – $4,235 |
| 11 | Aetna comm aetna facility · percent of total billed charges · inpatientfrom % of charges | $428.53 | $1,009 | $0.01 – $4,352 |
| 12 | Blue Cross Blue Shield comm blue cross vt ppo facility · percent of total billed charges · outpatientfrom % of charges | $494.58 | $1,023 | $108.94 – $4,235 |
| 13 | Aetna comm aetna facility · percent of total billed charges · outpatientfrom % of charges | $508.32 | $1,052 | $111.97 – $4,352 |
| 14 | UnitedHealthcare comm unitedhealthcare facility · percent of total billed charges · inpatientfrom % of charges | $498.01 | $1,173 | $0.01 – $5,058 |
| 15 | Blue Cross Blue Shield comm blue cross vt ppo professional · fee schedule · outpatient | $583.88 | $1,208 | $128.61 – $4,999 |
| 16 | UnitedHealthcare comm unitedhealthcare facility · percent of total billed charges · outpatientfrom % of charges | $590.75 | $1,222 | $130.13 – $5,058 |
| 17 | UnitedHealthcare comm unitedhealthcare professional · fee schedule · outpatient | $590.75 | $1,222 | $130.13 – $5,058 |
| 18 | Cigna comm cigna carelink facility · percent of total billed charges · outpatientfrom % of charges | $618.23 | $1,279 | $136.18 – $5,293 |
| 19 | Cigna comm cigna hmo pos facility · percent of total billed charges · outpatientfrom % of charges | $618.23 | $1,279 | $136.18 – $5,293 |
| 20 | Cigna comm cigna carelink professional · fee schedule · outpatient | $618.23 | $1,279 | $136.18 – $5,293 |
| 21 | Cigna comm cigna hmo pos professional · fee schedule · outpatient | $618.23 | $1,279 | $136.18 – $5,293 |
| 22 | First Health comm first health facility · percent of total billed charges · inpatientfrom % of charges | $550.13 | $1,296 | $0.01 – $5,588 |
| 23 | Phcs comm phcs facility · percent of total billed charges · inpatientfrom % of charges | $550.13 | $1,296 | $0.01 – $5,588 |
| 24 | Cigna comm cigna ppo facility · percent of total billed charges · outpatientfrom % of charges | $638.84 | $1,322 | $140.72 – $5,470 |
| 25 | Cigna comm cigna ppo professional · fee schedule · outpatient | $638.84 | $1,322 | $140.72 – $5,470 |
Last updated: Oct 7, 2026
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