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Missouri rates for HCPCS J0290

Injection, ampicillin sodium, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.70 / $20.68 / $79.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.56 / $2.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.60 / $0.94 / $1.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.52 / $0.52 / $0.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.52 / $2.65 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.42 / $0.49 / $0.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.47 / $0.55 / $1.02