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South Carolina rates for HCPCS J1120

Acetazolamid Sodium Injectio

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.83 / $191.87 / $191.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.83 / $27.90 / $29.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.15 / $29.88 / $34.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $27.60 / $36.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.72 / $18.72 / $19.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $19.84
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.83 / $27.40 / $60.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $19.84