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Oregon rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $13 · 10th–90th $1–$2140%5%10th90th$13Professionalmedian $1 · 10th–90th $1–$30%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
$1.82 / $28.18 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.45
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.78 / $2.34 / $3.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.51
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $3.24 / $4.27
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.35 / $1.48 / $85.11
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.48 / $4.17
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $1.51 / $3.55
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.32 / $2.34 / $4.79
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.58 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $1.32 / $1.51