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Arkansas rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.67 / $23.81 / $624.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $22.04 / $23.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.69 / $18.69 / $18.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.69 / $18.69 / $19.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.72 / $19.84 / $35.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $19.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $44.68