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South Dakota rates for HCPCS J0290

Injection, ampicillin sodium, 500 mg

Facilitymedian $1 · 10th–90th $1–$710%20%10th90th$1Professionalmedian $1 · 10th–90th $1–$10%20%10th90th$1$0.5$1.0$2.0$5.0$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.17 / $40.74 / $70.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.12 / $16.98 / $16.98
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.59 / $0.62 / $0.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $0.60 / $0.76
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.71 / $0.85 / $2.57
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.49 / $0.49 / $0.60
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.59 / $0.59 / $0.59
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.65 / $0.65 / $0.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.59 / $0.59 / $0.93
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.55 / $0.55 / $0.59