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Oklahoma rates for HCPCS J1205

Injection, chlorothiazide sodium, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.40 / $86.78 / $555.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.60 / $42.60 / $42.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.35 / $96.76 / $153.44
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 / $447.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.38 / $49.65 / $219.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.47 / $40.38 / $40.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $39.45