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Wyoming rates for HCPCS J1120

Injection, acetazolamide sodium, up to 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.23 / $17.23 / $17.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.23 / $17.23 / $19.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.49 / $47.64 / $47.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.72 / $18.72 / $18.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $28.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.84 / $19.84 / $19.84