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Minnesota rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $3 · 10th–90th $2–$470%10%20%10th90th$3Professionalmedian $1 · 10th–90th $1–$20%20%40%10th90th$1$1.0$2.0$5.0$10.0$20.0$50.0$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
$1.32 / $43.65 / $47.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.58 / $3.31 / $3.31
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.07 / $1.32 / $1.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.72 / $6.92 / $8.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.58 / $1.70
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.47 / $4.37 / $6.61
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.37 / $15.85 / $36.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.48 / $1.48 / $2.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $1.41 / $2.75