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Alabama rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.38 / $9.14 / $62.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $1.39 / $2.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $1.39 / $3.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.39 / $1.39 / $1.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $1.39 / $6.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $1.39 / $1.39