go back

Kentucky rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.23 / $19.84 / $33.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $22.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.46 / $23.40 / $23.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.86 / $19.84 / $19.84
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.84 / $21.44 / $31.74
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $21.82 / $30.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.84 / $19.84 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.14 / $19.84 / $57.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $19.84