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Texas rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $26 · 10th–90th $3$2140%5%10th90th$26Professionalmedian $1 · 10th–90th $1$30%50%90th$1$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
$3.47 / $30.90 / $218.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $2.24
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.88 / $7.41 / $13.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.16 / $3.16 / $8.32
Baylor Scott & White
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $3.16 / $43.65
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $19.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $3.24 / $9.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.35
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.91 / $27.54 / $204.17
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.32 / $3.72
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.48 / $1.48 / $1.62
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,862.09 / $2,454.71
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.35 / $1.95 / $5.89
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.91 / $2.57 / $2.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $1.32 / $1.58