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Missouri rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Facilitymedian $39 · 10th–90th $16–$910%10%20%10th90th$39Professionalmedian $26 · 10th–90th $25–$480%20%40%10th90th$26$10.0$20.0$50.0$100.0

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
$16.22 / $38.90 / $91.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.70 / $66.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $25.70 / $64.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $30.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $43.65 / $57.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $24.55
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $47.86 / $100.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $17.38 / $20.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $25.70 / $30.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $25.70 / $31.62