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Iowa rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $5 · 10th–90th $1–$930%20%10th90th$5Professionalmedian $1 · 10th–90th $1–$70%20%40%10th90th$1$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$2.00 / $14.79 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.32 / $6.92
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.70 / $1.70
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $2.69 / $17.38
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.78 / $3.02 / $41.69
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.48 / $1.48 / $3.39
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.14 / $2.14 / $2.75
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $2,238.72 / $6,165.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.57 / $2.57 / $2.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $1.32 / $1.58
Wellmark
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.32 / $1.32 / $1.38