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Utah rates for HCPCS J0290

Ampicillin 500 Mg Inj

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.63 / $49.28 / $79.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.63 / $0.63 / $0.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.83 / $0.94 / $1.41
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 / $0.55