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New Jersey rates for HCPCS J0290

Injection, ampicillin sodium, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.83 / $5.04 / $29.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.55
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.67 / $242.00 / $1,210.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.55 / $1.01 / $1.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.55
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.60 / $8,702.00 / $13,785.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.51 / $0.51 / $1.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.67