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Michigan rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $10 · 10th–90th $2–$560%5%10%10th90th$10Professionalmedian $1 · 10th–90th $1–$40%20%40%90th$1$0.5$2.0$10.0$50.0$200.0

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
$2.63 / $10.47 / $57.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $4.27
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.58 / $2.95 / $5.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.43 / $0.45 / $0.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $2.14 / $2.14
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.74 / $10.72 / $63.10
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.45 / $2.63
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.14 / $2.14 / $2.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $2.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $1.32 / $1.58