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Iowa rates for HCPCS J0295

Ampicillin Sodium Per 1.5 Gm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.64 / $17.23 / $88.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $5.04 / $13.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.61 / $1.89 / $2.02
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $2.52 / $17.07
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.79 / $3.00 / $24.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.49 / $1.49 / $3.18
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.79 / $1.97 / $3.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.79 / $2.52 / $6.24
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$810.18 / $3,670.45 / $6,339.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $1.39 / $1.43
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.49 / $1.49 / $1.49
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.49 / $1.49 / $1.49