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Florida rates for HCPCS J1205

Injection Chlorothiazide Sodium Per 500 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.45 / $69.43 / $116.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $43.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.21 / $39.45 / $39.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $39.45
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.33 / $39.45 / $39.45
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $41.68 / $41.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $59.18
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $40.38