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Kentucky rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $2 · 10th–90th $2–$630%20%10th90th$2Professionalmedian $1 · 10th–90th $1–$10%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
$1.38 / $28.84 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.55 / $1.58 / $1.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $1.35 / $1.35
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $2.24
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.45 / $1.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $85.11 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $8.13 / $8.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $1.32 / $1.32