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North Carolina rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $26 · 10th–90th $3–$890%10%10th90th$26Professionalmedian $1 · 10th–90th $1–$40%20%40%10th90th$1$1.0$5.0$20.0$100.0$500.0$2.0K

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
$3.63 / $25.70 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.45 / $4.27
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.03 / $6.03 / $7.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $2.45 / $2.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $2.04 / $3.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.51
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.32 / $1.62 / $2.57
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,041.74 / $3,630.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.62 / $2.57 / $2.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $1.32 / $2.34
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00