go back

New Hampshire rates for HCPCS J0290

Injection, ampicillin sodium, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.49 / $1.83 / $78.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.55
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.66 / $0.83 / $2.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $0.55 / $0.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.52 / $0.55 / $0.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.55
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.75 / $0.92 / $1.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.55
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.66 / $3.97 / $6.09