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Alaska rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $9 · 10th–90th $1–$710%10%20%10th90th$9Professionalmedian $1 · 10th–90th $1–$70%50%90th$1$1.0$5.0$20.0$100.0$500.0

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
$5.62 / $19.05 / $81.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.35
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $63.10
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $4.37
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.24 / $2.24 / $10.96
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.45 / $2.45 / $3.55
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.45 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $2.00 / $70.79