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West Virginia rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $17 · 10th–90th $7–$650%5%10th90th$17Professionalmedian $1 · 10th–90th $1–$10%50%90th$1$1.0$5.0$20.0$100.0

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
$7.08 / $16.60 / $64.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.32
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $2.09 / $2.09
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.24 / $3.24 / $3.24
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.35 / $2.04 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.35 / $8.13
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.31 / $4.90 / $41.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.19 / $2.19 / $2.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.32 / $1.32 / $4.90