go back

Maine rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Facilitymedian $65 · 10th–90th $59–$2450%20%40%10th90th$65Professionalmedian $25 · 10th–90th $25–$310%50%10th90th$25$20.0$50.0$100.0$200.0

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
$58.88 / $64.57 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $30.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $24.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $27.54 / $70.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $24.55
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $29.51
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $32.36
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.70 / $26.92
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $25.70 / $37.15