go back

Rhode Island rates for HCPCS J0290

Injection, ampicillin sodium, 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.79 / $1.79 / $1.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.49 / $0.49 / $2.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $1.96