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North Carolina rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.00 / $38.85 / $148.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $29.01 / $40.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.36 / $59.56 / $84.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.23 / $17.23 / $18.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.84 / $19.84 / $19.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $47.64
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.61 / $29.01 / $52.40
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.25 / $35.25 / $35.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $30.75
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $100.00 / $100.00