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New Hampshire rates for HCPCS J1205

Injection, chlorothiazide sodium, per 500 mg

Facilitymedian $74 · 10th–90th $58–$1260%10%20%10th90th$74Professionalmedian $58 · 10th–90th $47–$870%50%10th90th$58$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $64.57 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $61.66
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $97.72 / $173.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $57.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $93.33 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $46.77
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $81.28 / $89.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $57.54 / $72.44