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Wyoming rates for HCPCS J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 g

Facilitymedian $20 · 10th–90th $17–$720%20%10th90th$20Professionalmedian $5 · 10th–90th $1–$50%50%10th$5$1.0$2.0$5.0$10.0$20.0$50.0$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
$16.60 / $42.66 / $72.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.32 / $1.32
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.27 / $5.01 / $5.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.57 / $2.57 / $5.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.35 / $1.91 / $1.91
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 / $1.58