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North Dakota 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 / $72.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $48.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.80 / $43.01 / $43.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.38 / $42.95 / $43.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.08 / $33.40 / $41.34
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.38 / $61.57 / $98.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.47 / $40.38 / $43.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.53 / $39.45 / $42.84