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Virginia rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $46 · 10th–90th $2–$980%5%10%10th90th$46Professionalmedian $1 · 10th–90th $1–$20%50%90th$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
$2.69 / $45.71 / $97.72
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $2.24
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.04 / $2.34 / $3.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.91 / $2.57 / $3.39
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $1.35
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.15 / $1.32 / $5.75
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $9.77 / $9.77
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.32 / $1.32 / $6.31
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.29 / $1.62 / $4.79
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.29 / $1.62 / $4.79
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.57 / $2.57 / $3.39
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $1.32 / $1.95