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Minnesota rates for HCPCS J1205

Injection, chlorothiazide sodium, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.45 / $39.45 / $80.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $143.55
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $73.26 / $121.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.29 / $40.38 / $121.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.23 / $129.47 / $157.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.40 / $42.01 / $47.70
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.90 / $118.16 / $148.29
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.08 / $33.08 / $44.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.06 / $40.38 / $157.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.38 / $40.38 / $73.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $73.14