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Montana rates for HCPCS J0290

Injection, ampicillin sodium, 500 mg

Facilitymedian $2 · 10th–90th $1–$780%20%10th90th$2Professionalmedian $1 · 10th–90th $1–$30%20%10th90th$1$1.0$10.0$100.0$1.0K$10.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $70.79 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.68 / $1.62 / $2.82
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.09 / $69,183.10 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.68 / $0.68 / $2.75
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.65 / $0.65 / $0.68
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.07 / $1.07 / $2.95
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.07 / $1.07 / $2.95
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.68 / $0.68 / $2.75
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.65 / $79.43 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.59 / $0.59 / $0.59