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 University Hospital - Fox Chase Campus’s median price of $4 is 91% below the median hospital's median price ($48), higher than 10% 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, 22 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 | Highmark medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $0.68 | $0.62 | $0.50 – $0.68 |
| 2 | Highmark commercial facility · percent of total billed charges · outpatientfrom % of charges | $20.99 | $20.97 | $0.51 – $20.99 |
| 3 | Aetna coventry facility · percent of total billed charges · outpatientfrom % of charges | $1.14 | $32.50 | $0.01 – $4,220 |
| 4 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $1.14 | $32.50 | $0.01 – $4,220 |
| 5 | Cigna medicare dsnp/medicare hmo/medicare ppo facility · percent of total billed charges · outpatientfrom % of charges | $2.06 | $58.77 | $0.01 – $7,630 |
| 6 | Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $2.54 | $72.46 | $0.01 – $9,408 |
| 7 | Bcbs Nj indemnity facility · percent of total billed charges · outpatientfrom % of charges | $2.80 | $79.92 | $0.02 – $10,377 |
| 8 | Bcbs Nj managed care facility · percent of total billed charges · outpatientfrom % of charges | $2.80 | $79.92 | $0.02 – $10,377 |
| 9 | Bcbs Nj ppo facility · percent of total billed charges · outpatientfrom % of charges | $2.80 | $79.92 | $0.02 – $10,377 |
| 10 | Oscar pennsylvania health plan facility · percent of total billed charges · outpatientfrom % of charges | $3.17 | $90.57 | $0.02 – $11,760 |
| 11 | Bcbs Pa medicare advantage hmo/medicare advantage ppo facility · percent of total billed charges · outpatientfrom % of charges | $3.33 | $95.10 | $0.02 – $12,348 |
| 12 | Bcbs Pa medicare advantage select 65 facility · percent of total billed charges · outpatientfrom % of charges | $3.33 | $95.10 | $0.02 – $12,348 |
| 13 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $5.01 | $143.32 | $0.03 – $18,609 |
| 14 | Aetna first health facility · percent of total billed charges · outpatientfrom % of charges | $5.01 | $143.32 | $0.03 – $18,609 |
| 15 | Aetna workers' comp facility · percent of total billed charges · outpatientfrom % of charges | $5.01 | $143.32 | $0.03 – $18,609 |
| 16 | Bcbs Pa hmo facility · percent of total billed charges · outpatientfrom % of charges | $5.52 | $157.81 | $0.03 – $20,491 |
| 17 | Bcbs Pa ppo facility · percent of total billed charges · outpatientfrom % of charges | $6.02 | $172.35 | $0.04 – $22,379 |
| 18 | Bcbs Pa temple member facility · percent of total billed charges · outpatientfrom % of charges | $6.02 | $172.35 | $0.04 – $22,379 |
| 19 | UnitedHealthcare options ppo facility · percent of total billed charges · inpatientfrom % of charges | $6.33 | $181.15 | $0.04 – $23,521 |
| 20 | UnitedHealthcare options ppo facility · percent of total billed charges · outpatientfrom % of charges | $6.33 | $181.15 | $0.04 – $23,521 |
| 21 | Bcbs Pa indemnity facility · percent of total billed charges · outpatientfrom % of charges | $6.62 | $189.35 | $0.04 – $24,586 |
| 22 | UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges | $9.32 | $266.66 | $0.06 – $34,589 |
Last updated: Apr 13, 2026
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