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Iowa rates for HCPCS J1205

Injection, chlorothiazide sodium, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.95 / $98.38 / $101.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $67.77 / $143.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.08 / $38.97 / $41.34
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.56 / $39.45 / $238.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.97 / $50.02 / $207.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.38 / $40.38 / $136.84
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.97 / $48.46 / $90.70
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.33 / $77.34 / $249.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $40.63
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.38 / $40.38 / $40.38
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.38 / $40.38 / $40.38