go back

Maine rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $23 · 10th–90th $3–$1000%5%10%10th90th$23Professionalmedian $1 · 10th–90th $1–$20%50%90th$1$1.0$5.0$20.0$100.0

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
$3.09 / $23.44 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.17 / $4.17 / $4.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $1.51 / $3.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.35
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.62
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $1.78
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $1.35 / $3.72