go back

South Carolina rates for HCPCS J0295

Ampicillin Sodium Per 1.5 Gm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.02 / $64.88 / $92.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.46 / $2.17 / $2.42
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.59 / $8.36 / $10.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $1.92 / $4.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.31 / $1.31 / $1.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $1.39 / $1.39
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.46 / $1.97 / $10.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.39 / $1.39 / $1.39