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
SODIUM ZIRCONIUM CYCLOSILICATE 10 G PO PACK
Philadelphia, PA
See all hospitals reporting HCPCS J3490 →Price type
The Trustees of the University of Pennsylvania D/B/A The Hospital of the University of Pennsylvania’s median price of $95 is 97% above the median hospital's median price ($48), higher than 71% 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: 14 payers, 35 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 | UnitedHealthcare unitedhealthcare non options facility · case rate · inpatient | $36.00 | $36.00 | $36.00 – $36.00 |
| 2 | Optum optum urn-transplant managed medicaid facility · other · outpatient | $18.64 | $85.82 | $0.15 – $547.78 |
| 3 | Aetna aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $27.47 | $126.50 | $0.23 – $807.44 |
| 4 | Aetna aetna commercial hmo with capitation facility · percent of total billed charges · outpatientfrom % of charges | $27.47 | $126.50 | $0.23 – $807.44 |
| 5 | Cigna cigna new business facility · fee schedule · outpatient | $30.25 | $139.31 | $0.25 – $889.25 |
| 6 | Highmark highmark facility · other · outpatient | $30.25 | $139.31 | $0.25 – $889.25 |
| 7 | Bcbs Nj horizon blue cross of nj-hmo pos and direct access facility · percent of total billed charges · outpatientfrom % of charges | $32.67 | $150.46 | $0.27 – $960.39 |
| 8 | UnitedHealthcare unitedhealthcare non options facility · percent of total billed charges · outpatientfrom % of charges | $46.46 | $190.83 | $0.40 – $1,437 |
| 9 | UnitedHealthcare unitedhealthcare new business facility · percent of total billed charges · outpatientfrom % of charges | $46.92 | $192.72 | $0.41 – $1,451 |
| 10 | Cigna cigna facility · percent of total billed charges · outpatientfrom % of charges | $41.92 | $193.03 | $0.35 – $1,232 |
| 11 | Devoted devoted health medicare advantage facility · other · outpatient | $48.40 | $222.90 | $0.40 – $1,423 |
| 12 | UnitedHealthcare unitedhealthcare community (fka americhoice ma) facility · percent of total billed charges · outpatientfrom % of charges | $48.40 | $222.90 | $0.40 – $1,423 |
| 13 | Cigna cigna lifesource facility · percent of total billed charges · outpatientfrom % of charges | $54.45 | $250.76 | $0.45 – $1,601 |
| 14 | Aetna aetna hmo facility · percent of total billed charges · outpatientfrom % of charges | $57.48 | $264.69 | $0.47 – $1,690 |
| 15 | First Health first health global facility · percent of total billed charges · inpatientfrom % of charges | $60.50 | $278.63 | $0.50 – $1,779 |
| 16 | First Health first health global facility · percent of total billed charges · outpatientfrom % of charges | $60.50 | $278.63 | $0.50 – $1,779 |
| 17 | Bcbs Nj horizon blue cross of nj-ppo facility · percent of total billed charges · outpatientfrom % of charges | $61.71 | $284.20 | $0.51 – $1,814 |
| 18 | Blue Cross Blue Shield personal choice-ibc ppo facility · percent of total billed charges · outpatientfrom % of charges | $67.46 | $310.67 | $0.56 – $1,983 |
| 19 | Blue Cross Blue Shield keystone health plan east-ibc hmo facility · percent of total billed charges · outpatientfrom % of charges | $70.84 | $326.22 | $0.59 – $2,082 |
| 20 | Kaiser kaiser permanente facility · percent of total billed charges · outpatientfrom % of charges | $72.60 | $334.35 | $0.60 – $2,134 |
| 21 | Bcbs Nj horizon blue cross of nj-indemnity facility · percent of total billed charges · outpatientfrom % of charges | $73.81 | $339.92 | $0.61 – $2,170 |
| 22 | Blue Cross Blue Shield ibc traditional facility · percent of total billed charges · outpatientfrom % of charges | $74.94 | $345.11 | $0.62 – $2,203 |
| 23 | Humana humana choice care facility · percent of total billed charges · inpatientfrom % of charges | $96.80 | $445.80 | $0.80 – $2,846 |
| 24 | Humana humana choice care facility · percent of total billed charges · outpatientfrom % of charges | $96.80 | $445.80 | $0.80 – $2,846 |
| 25 | Optum optum urn-cancer resource services facility · other · outpatient | $96.80 | $445.80 | $0.80 – $2,846 |
Last updated: Feb 10, 2026
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