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New Jersey rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $10 · 10th–90th $3–$950%10%10th90th$10Professionalmedian $1 · 10th–90th $1–$20%50%90th$1$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$2.95 / $10.00 / $91.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.00
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.45 / $1.55 / $2,754.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.35 / $1.62 / $2.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $5.01
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.37 / $10,471.29 / $25,118.86
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.55 / $1.62 / $1.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.51 / $4.79 / $4.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $1.32 / $1.62