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Pennsylvania rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $11 · 10th–90th $3$980%10%10th90th$11Professionalmedian $1 · 10th–90th $1$40%50%90th$1$1.0$10.0$100.0$1.0K$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 / $14.45 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $4.47
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.45 / $1.45 / $2.04
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.23 / $1.45 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $1.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.35 / $4.68 / $5.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.35
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.35
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.04 / $2.34 / $2.34
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4.79 / $14.79 / $57.54
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.45 / $1.45 / $2.04
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $2.51 / $47.86
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.35
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,348.96 / $1,659.59
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.62 / $1.62 / $2.63
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.62 / $1.62 / $2.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $1.32 / $2.45