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Florida rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.71 / $63.10 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $1.32 / $1.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.32 / $1.32 / $1.45
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.32 / $1.32 / $4.68
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.32 / $1.41 / $1.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.91 / $2.57 / $2.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.32 / $1.32 / $2.40
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.32 / $1.32 / $1.32