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Ohio rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Facilitymedian $52 · 10th–90th $26$1580%10%10th90th$52Professionalmedian $26 · 10th–90th $25$390%50%10th90th$26$0.5$2.0$10.0$50.0$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 / $54.95 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.70 / $33.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $52.48 / $158.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $28.18 / $46.77
Aultcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $32.36
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $19.95
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $26.92 / $26.92
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $51.29 / $81.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $24.55
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $23.99 / $25.70
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $64.57
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $27.54 / $35.48
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $40.74 / $56.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $40.74 / $40.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $25.70 / $28.84