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 Sodium 200 MG/2ML Soln 2 mL Vial
Jersey Shore, PA
See all hospitals reporting HCPCS J3490 →Price type
Geisinger Jersey Shore Hospital’s median price of $286 is 492% above the median hospital's median price ($48), higher than 87% 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: 6 payers, 15 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 | Medicaid medicaid fee schedule · outpatient | $1.00 | $1.00 | $1.00 – $1.00 |
| 2 | UnitedHealthcare united healthcare - managed medicaid fee schedule · outpatient | $1.47 | $1.47 | $1.47 – $1.47 |
| 3 | UnitedHealthcare united healthcare - chip - managed medicare fee schedule · outpatient | $2.50 | $2.50 | $2.50 – $2.50 |
| 4 | Blue Cross Blue Shield highmark freedom blue - medicare advantage percent of total billed charges · outpatientfrom % of charges | $243.01 | $254.36 | $74.97 – $445.09 |
| 5 | Blue Cross Blue Shield capital - enhanced network rates percent of total billed charges · outpatientfrom % of charges | $274.37 | $287.18 | $84.64 – $502.53 |
| 6 | Aetna aetna - medicare advantage percent of total billed charges · outpatientfrom % of charges | $277.73 | $290.70 | $85.68 – $508.68 |
| 7 | Cigna cigna percent of total billed charges · outpatientfrom % of charges | $555.45 | $581.39 | $171.36 – $1,017 |
| 8 | Blue Cross Blue Shield first priority health percent of total billed charges · outpatientfrom % of charges | $862.92 | $903.21 | $266.21 – $1,581 |
| 9 | Blue Cross Blue Shield highmark - access care ii percent of total billed charges · outpatientfrom % of charges | $862.92 | $903.21 | $266.21 – $1,581 |
| 10 | Blue Cross Blue Shield highmark - non access care ii percent of total billed charges · outpatientfrom % of charges | $862.92 | $903.21 | $266.21 – $1,581 |
| 11 | MultiPlan multiplan/private health care system percent of total billed charges · inpatientfrom % of charges | $925.75 | $968.98 | $285.60 – $1,696 |
| 12 | MultiPlan multiplan/private health care system percent of total billed charges · outpatientfrom % of charges | $925.75 | $968.98 | $285.60 – $1,696 |
| 13 | Blue Cross Blue Shield first priority health case rate · inpatient | $8,940 | $8,940 | $8,940 – $8,940 |
| 14 | Blue Cross Blue Shield highmark - access care ii case rate · inpatient | $15,104 | $15,104 | $15,104 – $15,104 |
| 15 | Blue Cross Blue Shield highmark - non access care ii case rate · inpatient | $15,635 | $15,635 | $15,635 – $15,635 |
Last updated: Jul 1, 2026
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