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Acetazolamide Injection

Washington rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Rates data updated July 2026.

Facilitymedian $48 · 10th–90th $27$1740%10%20%10th90th$48Professionalmedian $27 · 10th–90th $25$630%50%10th90th$27$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
Setting
Facility
Modifier
Global
Typical Low
$26.92
Median
$48.98
Typical High
$173.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$26.92
Typical High
$77.62
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$24.55
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$24.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$47.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$30.20
Molina
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$75.86
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$19.95
Median
$21.88
Typical High
$38.90
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$39.81
Typical High
$39.81
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$18.62
Median
$25.70
Typical High
$25.70
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$24.55
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$24.55
United
Setting
Facility
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$60.26
United
Setting
Professional
Modifier
Global
Typical Low
$25.70
Median
$25.70
Typical High
$25.70
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$31.62