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New Hampshire rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Facilitymedian $32 · 10th–90th $26–$710%20%10th90th$32Professionalmedian $26 · 10th–90th $25–$450%50%10th90th$26$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
$25.70 / $28.84 / $70.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $25.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $51.29 / $89.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $27.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $47.86 / $67.61
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
$25.70 / $42.66 / $46.77
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $25.70 / $48.98