go back

Texas rates for HCPCS J1205

Injection, chlorothiazide sodium, per 500 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.84 / $96.65 / $279.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.84 / $65.42
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.38 / $388.02 / $822.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.94 / $82.94 / $82.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.21 / $39.45 / $39.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $39.45
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219.40 / $430.71 / $716.58
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.84 / $56.41 / $310.77
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.29 / $39.45 / $109.43
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.21 / $39.45 / $99.82
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.29 / $39.45 / $71.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $39.45 / $39.45
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.45 / $53.26 / $60.46