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Michigan rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Facilitymedian $51 · 10th–90th $26–$830%10%10th90th$51Professionalmedian $26 · 10th–90th $18–$390%50%10th90th$26$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
$25.70 / $47.86 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.70 / $38.90
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $57.54 / $112.20
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $16.98 / $16.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $17.78 / $24.55
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $51.29 / $83.18
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $26.92 / $39.81
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $17.78 / $24.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $31.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $25.70 / $26.92