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
Amoxicillin 400MG/5ML 50ML TH
Wagner, SD
See all hospitals reporting HCPCS J3490 →Price type
Wagner Community Memorial’s median price of $9 is 81% below the median hospital's median price ($48), higher than 17% of the 1,788 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: 4 payers, 11 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 | Wellmark hmo outpatient | $14 | $14 | — | — | 249 | $14 – $14 |
| 2 | Medica ind percent of total billed charges · inpatientfrom % of charges | $7 | $30 | $112 | 367% | — | $3 – $2.0k |
| 3 | Medica ind percent of total billed charges · outpatientfrom % of charges | $7 | $31 | $114 | 367% | — | $3 – $2.1k |
| 4 | Medica com percent of total billed charges · inpatientfrom % of charges | $8 | $36 | $133 | 367% | — | $3 – $2.4k |
| 5 | Medica com percent of total billed charges · outpatientfrom % of charges | $8 | $37 | $136 | 366% | — | $3 – $2.4k |
| 6 | Wellmark ppo percent of total billed charges · inpatientfrom % of charges | $9 | $39 | $144 | 367% | — | $4 – $2.6k |
| 7 | Wellmark ppo percent of total billed charges · outpatientfrom % of charges | $9 | $39 | $144 | 367% | 249 | $4 – $2.6k |
| 8 | UnitedHealthcare com percent of total billed charges · inpatientfrom % of charges | $9 | $40 | $146 | 366% | — | $4 – $2.6k |
| 9 | UnitedHealthcare com percent of total billed charges · outpatientfrom % of charges | $9 | $40 | $146 | 366% | 27 | $4 – $2.6k |
| 10 | Healthpartners com percent of total billed charges · inpatientfrom % of charges | $10 | $45 | $163 | 367% | — | $4 – $2.9k |
| 11 | Healthpartners com percent of total billed charges · outpatientfrom % of charges | $10 | $45 | $163 | 367% | — | $4 – $2.9k |
Last updated: Apr 1, 2026
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