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Nebraska rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $3 · 10th–90th $1–$7760%20%10th90th$3Professionalmedian $1 · 10th–90th $1–$50%20%10th90th$1$0.2$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
$1.32 / $5.50 / $776.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.82 / $4.90
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.15 / $1.51 / $1.51
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.45 / $1.51
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.34 / $2.34 / $2.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.70
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.82 / $30.20 / $100.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.48 / $3.02
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $1.91 / $1.91
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $2,290.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.35 / $1.91 / $4.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.26 / $1.32 / $2.00