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Minnesota rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.84 / $19.84 / $34.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $57.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $22.82 / $54.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.78 / $17.23 / $28.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.56 / $76.68 / $93.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.62 / $24.67 / $28.25
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.44 / $69.98 / $87.83
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.43 / $19.43 / $26.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.23 / $26.68 / $124.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.23 / $17.23 / $31.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $39.14