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Utah rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Facilitymedian $98 · 10th–90th $29–$2240%10%10th90th$98Professionalmedian $26 · 10th–90th $25–$290%50%10th90th$26$20.0$50.0$100.0$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
$28.84 / $97.72 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $27.54 / $28.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $33.88 / $45.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $24.55
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $25.12 / $25.12
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $24.55 / $30.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70