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North Carolina rates for HCPCS J0290

Injection, ampicillin sodium, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $22.28 / $94.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.92 / $2.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.46 / $1.80 / $4.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $0.49 / $1.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $2.95
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.65 / $0.92 / $3.25
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.12 / $2.12 / $2.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.73
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00