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Nebraska rates for HCPCS J0290

Ampicillin 500 Mg Inj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.49 / $1.04 / $8.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $0.55 / $2.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $0.62 / $0.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.52 / $0.59 / $0.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.12 / $1.12 / $1.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.60 / $0.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.93 / $11.31 / $100.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $0.49 / $3.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $0.88 / $1.57
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.59 / $1.17 / $2.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.52 / $0.55 / $0.83