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Ohio rates for HCPCS J1205

Injection, chlorothiazide sodium, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.45 / $85.61 / $125.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $40.63 / $112.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.18 / $92.31 / $256.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $74.95
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.45 / $39.45 / $67.06
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $53.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.21 / $37.21 / $39.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $131.57
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $136.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.60 / $47.09 / $57.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $51.36