go back

Washington rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.83 / $36.01 / $256.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $21.83 / $30.27
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.84 / $25.49 / $100.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $23.45 / $47.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.72 / $18.72 / $38.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $24.33
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.23 / $22.40 / $42.11
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.49 / $39.54 / $39.54
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.21 / $23.45 / $47.64
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.84 / $19.84 / $19.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $19.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $19.84