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Kansas rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.12 / $47.64 / $75.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $21.43 / $47.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.94 / $32.06 / $35.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.45 / $21.45 / $21.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.72 / $18.72 / $19.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $19.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.57 / $26.82 / $54.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.23 / $17.23 / $27.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $31.74