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
HYDROXYZINE 25 MG / 1 ML SDV IM ONLY
Ord, NE
See all hospitals reporting HCPCS J3410 →Price type
Valley County Hospital’s median price of $61 is 88% above the median hospital's median price ($32), higher than 68% of the 2,079 hospitals reporting HCPCS J3410. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 8 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 Ne medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $22 | $22 | — | — | — | $22 – $22 |
| 2 | Medica medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $22 | $22 | — | — | — | $22 – $22 |
| 3 | UnitedHealthcare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $22 | $22 | — | — | — | $22 – $22 |
| 4 | Humana medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $23 | $23 | — | — | — | $23 – $23 |
| 5 | UnitedHealthcare managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $53 | $53 | — | — | — | $53 – $53 |
| 6 | Molina managed medicaid/chip facility · percent of total billed charges · outpatientfrom % of charges | $57 | $57 | — | — | — | $57 – $57 |
| 7 | Molina dual eligible plan facility · percent of total billed charges · outpatientfrom % of charges | $58 | $58 | — | — | — | $58 – $58 |
| 8 | WellCare medicare advantage/dual needs plan facility · percent of total billed charges · outpatientfrom % of charges | $61 | $61 | — | — | — | $61 – $61 |
| 9 | Medica individual and family business plans facility · percent of total billed charges · inpatientfrom % of charges | $101 | $101 | — | — | — | $101 – $101 |
| 10 | Medica individual and family business plans facility · percent of total billed charges · outpatientfrom % of charges | $101 | $101 | — | — | — | $101 – $101 |
| 11 | Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $107 | $107 | — | — | — | $107 – $107 |
| 12 | Bcbs Ne commercial facility · percent of total billed charges · inpatientfrom % of charges | $107 | $107 | — | — | — | $107 – $107 |
| 13 | Bcbs Ne commercial facility · percent of total billed charges · outpatientfrom % of charges | $107 | $107 | — | — | — | $107 – $107 |
| 14 | Medica commercial plans/care system products facility · percent of total billed charges · inpatientfrom % of charges | $107 | $107 | — | — | — | $107 – $107 |
| 15 | Medica commercial plans/care system products facility · percent of total billed charges · outpatientfrom % of charges | $107 | $107 | — | — | — | $107 – $107 |
| 16 | MultiPlan primary/complementary ppo facility · percent of total billed charges · inpatientfrom % of charges | $109 | $109 | — | — | — | $109 – $109 |
| 17 | MultiPlan primary/complementary ppo facility · percent of total billed charges · outpatientfrom % of charges | $109 | $109 | — | — | — | $109 – $109 |
Last updated: Jun 15, 2026
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