go back

West Virginia rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.23 / $43.15 / $43.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.39 / $19.84 / $22.04
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.84 / $29.76 / $29.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.72 / $19.84 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $57.96
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $68.40 / $92.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $49.55