HCPCS J2251
MIDAZOLAM 1 MG/ML PCA SYRINGE,MIDAZOLAM HCL 100 MG/100ML IN NACL 0.9% IV SOLN,MIDAZOLAM HCL 55 MG/55ML-NACL 0.9% IV SOLN PREFILLED SYRINGE,MIDAZOLAM 50 MG/50ML-SODIUM CHLORIDE 0.9% IV SOLN,MIDAZOLAM HCL 50 MG/50ML-SODIUM CHLORIDE 0.9% IV SOLN,MIDAZOLAM HCL 50 MG/50ML-SODIUM CHLORIDE 0.8% IV SOLN,MIDAZOLAM HCL 100 MG/100ML IN NACL 0.8% IV SOLN,MIDAZOLAM IV SOLN 100 MG/100ML,MIDAZOLAM IV SOLN PREFILLED SYRINGE 50 MG/50ML,MIDAZOLAM IV SOLN PREFILLED SYRINGE 30 MG/30ML,MIDAZOLAM 100 MG/100ML-SODIUM CHLORIDE 0.9% IV SOLN,MIDAZOLAM 55 MG/55ML-NACL 0.9% IV SOLN PREFILLED SYRINGE,MIDAZOLAM 50 MG/50ML-NACL 0.9% IV SOLN PREFILLED SYRINGE,MIDAZOLAM 30 MG/30ML-NACL 0.9% IV SOLN PREFILLED SYRINGE,MIDAZOLAM IV SOLN PREFILLED SYRINGE 25 MG/25ML,MIDAZOLAM IV SOLN 50 MG/50ML,MIDAZOLAM 100 MG/100ML-SODIUM CHLORIDE 0.8% PF IV SOLUTION,MIDAZOLAM HCL 30 MG/30ML-NACL 0.9% IV SOLN PREFILLED SYRINGE,MIDAZOLAM HCL 50 MG/50ML-NACL 0.9% IV SOLN PREFILLED SYRINGE,MIDAZOLAM 50 MG/50ML-SODIUM CHLORIDE 0.9% PF IV SOLN,MIDAZOLAM 100 MG/100ML-SODIUM CHLORIDE 0.9% PF IV SOLN,MIDAZOLAM 50 MG/50ML-SODIUM CHLORIDE 0.8% PF IV SOLN - as described in hospitals' own price files.
| Hospital | Location | Cash price | Typical insurance | List price | Negotiated range |
|---|---|---|---|---|---|
| Orange County Global Medical Center | Santa Ana, CA | - | $0.17 | - | $0.17 - $0.28 |
| Los Angeles General Medical Center | Los Angeles, CA | - | $0.17 | - | $0.17 - $0.28 |
| San Francisco VA Medical Center | San Francisco, CA | - | $0.17 | - | $0.17 - $0.28 |
| San Mateo Medical Center | San Mateo, CA | - | $0.17 | - | $0.17 - $0.28 |
| Tri-City Medical Center | Oceanside, CA | - | $0.17 | - | $0.17 - $0.28 |
| Santa Clara Valley Medical Center | San Jose, CA | - | $0.17 | - | $0.17 - $0.28 |
| Sutter Medical Center, Sacramento | Sacramento, CA | - | $0.17 | - | $0.17 - $0.28 |
| Lompoc Valley Medical Center | Lompoc, CA | - | $0.17 | - | $0.17 - $0.28 |
| Sutter Roseville Medical Center | Roseville, CA | - | $0.17 | - | $0.17 - $0.28 |
| Oro Valley Hospital | Oro Valley, AZ | $0.12 | $0.25 | $0.50 | $0.08 - $0.50 |
| Western Arizona Regional Medical Center | Bullhead City, AZ | $0.06 | $0.33 | $0.52 | $0.06 - $0.52 |
| Medstar Franklin Square Medical Center | Rosedale, MD | $0.33 | $0.34 | $0.34 | $0.33 - $0.34 |
| Medstar Saint Mary'S Hospital | Leonardtown, MD | $0.37 | $0.38 | $0.38 | $0.37 - $0.38 |
| Medstar Montgomery Medical Center | Olney, MD | $0.43 | $0.44 | $0.44 | $0.43 - $0.44 |
| Medstar Southern Maryland Hospital Center | Clinton, MD | $0.61 | $0.62 | $0.62 | $0.61 - $0.62 |
| Regional Hospital Of Scranton | Scranton, PA | $0.27 | $0.64 | $1.00 | $0.09 - $2.87 |
| Medstar Harbor Hospital | Baltimore, MD | $0.76 | $0.78 | $0.78 | $0.75 - $0.78 |
| Medstar Union Memorial Hospital | Baltimore, MD | $0.76 | $0.78 | $0.78 | $0.76 - $0.78 |
| Ohiohealth Shelby Hospital | Shelby, OH | $0.84 | - | $1.30 | - |
| Doctors Hospital | Columbus, OH | $0.88 | - | $1.35 | - |
| Dublin Methodist Hospital | Dublin, OH | $0.88 | - | $1.35 | - |
| Grant Medical Center | Columbus, OH | $0.88 | - | $1.35 | - |
| Riverside Methodist Hospital | Columbus, OH | $0.88 | - | $1.35 | - |
| Hardin Memorial Hospital | Kenton, OH | $0.98 | - | $1.51 | - |
| Medstar Good Samaritan Hospital | Baltimore, MD | $1.02 | $1.04 | $1.04 | $1.02 - $1.04 |
| Northwest Health - Porter | Valparaiso, IN | $0.76 | $1.39 | $2.82 | $0.18 - $2.48 |
| Gadsden Regional Medical Center | Gadsden, AL | $0.39 | $2.08 | $3.25 | $0.26 - $1,525 |
| Christus Spohn Hospital Beeville | Beeville, TX | $9.24 | - | $46.20 | $0.17 - $285 |
| Christus Spohn Hospital Corpus Christi | Corpus Christi, TX | $9.24 | - | $46.20 | $0.17 - $285 |
| North Okaloosa Medical Center | Crestview, FL | $2.88 | $10.08 | $16.00 | $0.26 - $350 |
| Christus Southeast Texas- St. Elizabeth | Beaumont, TX | $20.79 | - | $63.00 | $0.17 - $340 |
| Christus St. Vincent Regional Medical Center | Santa Fe, NM | $37.80 | - | $63.00 | $55.35 - $332 |
| Chi-St Vincent Infirmary | Little Rock, AR | $52.77 | - | $206 | $28.79 - $103 |
| Mercy Gilbert Medical Center | Gilbert, AZ | $62.81 | - | $125 | $97.50 - $125 |
| Plains Regional Medical Center | Clovis, NM | $24.89 | $63.61 | $92.18 | $24.89 - $81.12 |
| Grady Memorial Hospital | Delaware, OH | $66.27 | - | $102 | - |
| Berger Hospital | Circleville, OH | $70.62 | - | $109 | - |
| Ohiohealth O'Bleness Hospital | Athens, OH | $70.62 | - | $109 | - |
| Swedish Edmonds Hospital | Edmonds, WA | $73.37 | - | $153 | - |
| Swedish Medical Center / Cherry Hill | Seattle, WA | $73.37 | - | $153 | - |
| Swedish Issaquah | Issaquah, WA | $73.37 | - | $153 | - |
| St. Mary Medical Center | Long Beach, CA | $81.19 | - | $169 | - |
| Saint John'S Health Center | Santa Monica, CA | $94.42 | - | $270 | - |
| Providence Centralia Hospital | Centralia, WA | $96.12 | - | $185 | - |
| Healdsburg Hospital | Healdsburg, CA | $99.87 | - | $196 | - |
| Kadlec Regional Medical Center | Richland, WA | $110 | - | $157 | - |
| Providence St. Jude Medical Center | Fullerton, CA | $111 | - | $231 | - |
| Providence Mission Hospital | Mission Viejo, CA | $111 | - | $231 | - |
| Lower Keys Medical Center | Key West, FL | $40.16 | $119 | $149 | $0.18 - $149 |
| Providence Little Co Of Mary Med Ctr San Pedro | San Pedro, CA | $126 | - | $360 | - |
| Providence Holy Cross Medical Center | Mission Hills, CA | $126 | - | $360 | - |
| Providence Little Company Of Mary Med Ctr Torrance | Torrance, CA | $126 | - | $360 | - |
| Providence Saint Joseph Medical Ctr | Burbank, CA | $126 | - | $360 | - |
| Providence Hood River Memorial Hospital | Hood River, OR | $150 | - | $199 | - |
| Providence Medford Medical Center | Medford, OR | $150 | - | $199 | - |
| Petaluma Valley Hospital | Petaluma, CA | $151 | - | $296 | - |
| Providence Santa Rosa Memorial Hospital | Santa Rosa, CA | $151 | - | $296 | - |
| Providence St. Peter Hospital | Olympia, WA | $158 | - | $304 | - |
| Covenant Hospital Plainview | Plainview, TX | $218 | - | $520 | - |
| Covenant Health Hobbs Hospital | Hobbs, NM | $218 | - | $520 | - |
| Providence Mount Carmel Hospital | Colville, WA | $294 | - | $420 | - |
| Providence St. Joseph Hospital | Chewelah, WA | $294 | - | $420 | - |
Prices are from each hospital's own machine-readable price file. Cash price is the published discounted cash price; typical insurance price is the median of the per-plan negotiated rates in the file; list price is the gross charge.