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Missouri rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $42 · 10th–90th $2–$980%5%10th90th$42Professionalmedian $1 · 10th–90th $1–$70%20%40%10th90th$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
$1.70 / $42.66 / $97.72
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $7.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.48 / $2.29 / $3.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.55 / $2.51 / $3.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.35
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.66 / $6.92 / $100.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.17 / $1.48 / $1.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.58 / $2.09 / $2.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.20 / $1.32 / $1.86