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Maryland rates for HCPCS J0290

Ampicillin 500 Mg Inj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.28 / $8.99 / $44.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.63
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $0.49 / $0.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.70
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $3.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.57
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.71 / $0.71