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HCPCS J9309
POLATUZUMAB VEDOTIN-PIIQ FOR IV SOLUTION 140 MG - as described in hospitals' own price files.
43hospitals publishing a price
$6,993median cash price
$189median typical insurance price
| Hospital | Location | Cash price | Typical insurance | List price | Negotiated range |
|---|---|---|---|---|---|
| Doctors Hospital | Columbus, OH | $109 | - | $167 | - |
| Dublin Methodist Hospital | Dublin, OH | $109 | - | $167 | - |
| Grant Medical Center | Columbus, OH | $109 | - | $167 | - |
| Riverside Methodist Hospital | Columbus, OH | $109 | - | $167 | - |
| Orange County Global Medical Center | Santa Ana, CA | $27,896 | $136 | $53,646 | $136 - $229 |
| Los Angeles General Medical Center | Los Angeles, CA | $27,896 | $136 | $53,646 | $136 - $229 |
| San Francisco VA Medical Center | San Francisco, CA | $6,993 | $136 | $12,488 | $136 - $229 |
| San Mateo Medical Center | San Mateo, CA | $6,993 | $136 | $12,488 | $136 - $229 |
| Tri-City Medical Center | Oceanside, CA | $6,993 | $136 | $12,488 | $136 - $229 |
| Santa Clara Valley Medical Center | San Jose, CA | $6,993 | $136 | $12,488 | $136 - $229 |
| Sutter Medical Center, Sacramento | Sacramento, CA | $6,993 | $136 | $12,488 | $136 - $229 |
| Lompoc Valley Medical Center | Lompoc, CA | $27,896 | $136 | $53,646 | $136 - $229 |
| Sutter Roseville Medical Center | Roseville, CA | $6,993 | $136 | $12,488 | $136 - $229 |
| Aiken Regional Medical Center | Aiken, SC | $8,511 | $151 | $21,279 | $139 - $18,087 |
| Medstar Franklin Square Medical Center | Rosedale, MD | $185 | $189 | $189 | $185 - $189 |
| Medstar Saint Mary'S Hospital | Leonardtown, MD | $195 | $199 | $199 | $195 - $199 |
| Medstar Montgomery Medical Center | Olney, MD | $243 | $248 | $248 | $243 - $248 |
| Medstar Southern Maryland Hospital Center | Clinton, MD | $348 | $355 | $355 | $348 - $355 |
| Milton S Hershey Medical Center | Hershey, PA | $215 | $358 | $649 | $117 - $519 |
| Penn State Health St. Joseph | Reading, PA | $187 | $359 | $718 | $137 - $1,814 |
| Wilkes-Barre General Hospital | Wilkes-Barre, PA | $431 | $431 | $1,796 | $130 - $1,796 |
| Medstar Union Memorial Hospital | Baltimore, MD | $433 | $442 | $442 | $433 - $442 |
| Medstar Harbor Hospital | Baltimore, MD | $439 | $448 | $448 | $439 - $448 |
| Medstar Good Samaritan Hospital | Baltimore, MD | $535 | $546 | $546 | $535 - $546 |
| St. Mary'S Regional Medical Center | Enid, OK | - | $561 | $99,869 | $155 - $78,897 |
| Mercy Gilbert Medical Center | Gilbert, AZ | $3,824 | - | $7,610 | $137 - $35,511 |
| St. Elizabeth Community Hospital | Red Bluff, CA | $4,521 | - | $7,610 | $137 - $35,511 |
| Dominican Hospital | Santa Cruz, CA | $5,610 | - | $12,683 | $137 - $50,307 |
| Chi-St Vincent Infirmary | Little Rock, AR | $7,301 | - | $28,453 | $113 - $14,227 |
| Bakersfield Memorial Hospital | Bakersfield, CA | $7,336 | - | $20,191 | $137 - $76,320 |
| Providence Regional Medical Center Everett | Everett, WA | $9,490 | - | $18,249 | - |
| Providence Queen Of The Valley Medical Center | Napa, CA | $11,916 | - | $23,364 | - |
| Swedish Edmonds Hospital | Edmonds, WA | $12,305 | - | $25,635 | - |
| Swedish Medical Center / Cherry Hill | Seattle, WA | $12,305 | - | $25,635 | - |
| Swedish Issaquah | Issaquah, WA | $12,305 | - | $25,635 | - |
| Chi St. Luke'S Health Brazosport | Lake Jackson, TX | $14,731 | - | $42,089 | $133 - $65,659 |
| Providence St. Mary Medical Center | Walla Walla, WA | $17,222 | - | $24,603 | - |
| Providence Seaside Hospital | Seaside, OR | $21,280 | - | $28,373 | - |
| Allen County Regional Hospital | Iola, KS | $32,384 | - | $53,973 | $15,450 - $52,893 |
| Sierra Nevada Memorial Hospital | Grass Valley, CA | $49,978 | - | $89,961 | $152 - $88,162 |
| Berger Hospital | Circleville, OH | $50,235 | - | $77,284 | - |
| Ohiohealth O'Bleness Hospital | Athens, OH | $50,235 | - | $77,284 | - |
| Providence Alaska Medical Center | Anchorage, AK | $101,110 | - | $129,628 | - |
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.
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