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Utah rates for HCPCS J0290

Injection, ampicillin sodium, 500 mg

Facilitymedian $51 · 10th–90th $30–$790%20%10th90th$51Professionalmedian $1 · 10th–90th $1–$10%20%40%10th90th$1$1.0$2.0$5.0$10.0$20.0$50.0$100.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $51.29 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.69 / $0.85 / $1.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.65 / $0.65 / $0.65
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.68 / $0.68 / $0.68
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.58 / $0.65 / $0.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.59 / $0.59 / $0.59