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
niTRIC oxide 1 Each
Wilkes-Barre, PA
See all hospitals reporting HCPCS J3490 →Price type
Geisinger Wyoming Valley’s median price of $384 is 696% above the median hospital's median price ($48), higher than 90% 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, 16 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 bc/bs - special care percent of total billed charges · outpatientfrom % of charges | $301.78 | $517.88 | $47.19 – $2,272 |
| 5 | Blue Cross Blue Shield capital - enhanced network rates percent of total billed charges · outpatientfrom % of charges | $334.85 | $574.64 | $52.37 – $2,521 |
| 6 | Blue Cross Blue Shield highmark bc/bs percent of total billed charges · outpatientfrom % of charges | $431.15 | $739.90 | $67.43 – $3,246 |
| 7 | Cigna cigna percent of total billed charges · outpatientfrom % of charges | $605.16 | $1,039 | $94.64 – $4,556 |
| 8 | Aetna aetna percent of total billed charges · outpatientfrom % of charges | $684.92 | $1,175 | $107.11 – $5,156 |
| 9 | Aetna first health network percent of total billed charges · inpatientfrom % of charges | $961.53 | $1,650 | $150.37 – $7,239 |
| 10 | Aetna first health network percent of total billed charges · outpatientfrom % of charges | $961.53 | $1,650 | $150.37 – $7,239 |
| 11 | MultiPlan beech street percent of total billed charges · inpatientfrom % of charges | $1,244 | $2,135 | $194.54 – $9,365 |
| 12 | MultiPlan beech street percent of total billed charges · outpatientfrom % of charges | $1,244 | $2,135 | $194.54 – $9,365 |
| 13 | MultiPlan multiplan/private health care system percent of total billed charges · inpatientfrom % of charges | $1,244 | $2,135 | $194.54 – $9,365 |
| 14 | MultiPlan multiplan/private health care system percent of total billed charges · outpatientfrom % of charges | $1,244 | $2,135 | $194.54 – $9,365 |
| 15 | Blue Cross Blue Shield highmark bc/bs - special care case rate · inpatient | $16,229 | $16,229 | $16,229 – $16,229 |
| 16 | Blue Cross Blue Shield highmark bc/bs case rate · inpatient | $23,185 | $23,185 | $23,185 – $23,185 |
Last updated: Jul 1, 2026
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