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
LIDOCAINE 5 % TOP PTMD
Breaux Bridge, LA
See all hospitals reporting HCPCS J3490 →Price type
St Martin Hospital Inc’s median price of $51 is 5% above the median hospital's median price ($48), higher than 53% 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: 10 payers, 13 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 | Aetna all payor other · outpatient | $32.56 | $68.32 | $1.54 – $534.66 |
| 2 | Bcbs La all payor other · outpatient | $32.56 | $68.32 | $1.54 – $534.66 |
| 3 | Optum all payor other · outpatient | $32.56 | $68.32 | $1.54 – $534.66 |
| 4 | WellCare all payor other · outpatient | $32.56 | $68.32 | $1.54 – $534.66 |
| 5 | Tricare all payor percent of total billed charges · outpatientfrom % of charges | $37.53 | $78.70 | $1.79 – $620.03 |
| 6 | Humana all payor other · outpatient | $40.23 | $89.99 | $1.54 – $880.97 |
| 7 | UnitedHealthcare all payor other · outpatient | $40.23 | $90.08 | $1.54 – $880.97 |
| 8 | Aetna Better Health all payor other · outpatient | $53.97 | $111.85 | $2.54 – $880.97 |
| 9 | Amerihealth Caritas all payor other · outpatient | $53.97 | $111.85 | $2.54 – $880.97 |
| 10 | Bcbs La all payor percent of total billed charges · outpatientfrom % of charges | $69.32 | $148.06 | $3.22 – $1,215 |
| 11 | UnitedHealthcare all payor percent of total billed charges · outpatientfrom % of charges | $110.32 | $231.34 | $5.25 – $1,823 |
| 12 | Cigna all payor other · outpatient | $125.03 | $262.19 | $5.95 – $2,066 |
| 13 | Aetna all payor percent of total billed charges · outpatientfrom % of charges | $133.85 | $280.69 | $6.37 – $2,212 |
Last updated: Apr 1, 2026
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