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
GABAPENTIN 250 MG/5 ML ORAL SOLUTION
Philadelphia, PA
See all hospitals reporting HCPCS J3490 →Price type
Temple Health - Chestnut Hill Hospital’s median price of $6 is 87% below the median hospital's median price ($48), higher than 13% 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: 5 payers, 17 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 | Bcbs Pa medicare advantage hmo/medicare advantage ppo facility · percent of total billed charges · outpatientfrom % of charges | $1.79 | $51.15 | $0.01 – $6,641 |
| 2 | Bcbs Nj indemnity facility · percent of total billed charges · outpatientfrom % of charges | $2.61 | $74.59 | $0.02 – $9,685 |
| 3 | Bcbs Nj managed care facility · percent of total billed charges · outpatientfrom % of charges | $2.61 | $74.59 | $0.02 – $9,685 |
| 4 | Bcbs Nj ppo facility · percent of total billed charges · outpatientfrom % of charges | $2.61 | $74.59 | $0.02 – $9,685 |
| 5 | Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $3.08 | $87.91 | $0.02 – $11,414 |
| 6 | UnitedHealthcare chip facility · percent of total billed charges · outpatientfrom % of charges | $3.73 | $106.56 | $0.02 – $13,836 |
| 7 | UnitedHealthcare community plan facility · percent of total billed charges · outpatientfrom % of charges | $3.73 | $106.56 | $0.02 – $13,836 |
| 8 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $5.09 | $145.45 | $0.03 – $18,886 |
| 9 | UnitedHealthcare vaccn facility · percent of total billed charges · outpatientfrom % of charges | $7.45 | $213.11 | $0.04 – $27,671 |
| 10 | Cigna medicare hmo facility · percent of total billed charges · outpatientfrom % of charges | $9.31 | $266.39 | $0.06 – $34,589 |
| 11 | Bcbs Pa indemnity facility · percent of total billed charges · outpatientfrom % of charges | $9.61 | $275.07 | $0.06 – $35,717 |
| 12 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $11.17 | $319.67 | $0.07 – $41,507 |
| 13 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $11.18 | $320.00 | $0.07 – $41,507 |
| 14 | Bcbs Pa tiered ppaca facility · percent of total billed charges · outpatientfrom % of charges | $11.56 | $330.59 | $0.07 – $42,925 |
| 15 | Bcbs Pa hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges | $12.16 | $347.91 | $0.07 – $45,173 |
| 16 | Aetna first health facility · percent of total billed charges · inpatientfrom % of charges | $16.94 | $484.83 | $0.10 – $62,952 |
| 17 | Aetna first health facility · percent of total billed charges · outpatientfrom % of charges | $16.94 | $484.83 | $0.10 – $62,952 |
Last updated: Apr 8, 2026
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