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Pennsylvania rates for HCPCS J1205

Injection, chlorothiazide sodium, per 500 mg

Facilitymedian $115 · 10th–90th $59–$1780%10%20%10th90th$115Professionalmedian $58 · 10th–90th $58–$1070%50%90th$58$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$58.88 / $114.82 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $151.36
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $63.10 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $165.96 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $46.77
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $46.77
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $81.28 / $81.28
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $70.79 / $154.88
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $63.10
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $40.74 / $45.71
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $40.74 / $46.77
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $107.15